Blood sugar lowering injections have become a "magic drug for weight loss"? Doctors: Private use of drugs is risky

In order to seek treatment options, Ms. Wu went to the Endocrinology Department of the First Affiliated Hospital of Sun Yat-sen University in February this year. According to the doctor, she first learned about the drug "Semaglutide". "Semaglutide is useful for people like us who have difficulty losing weight due to insulin resistance. But the doctor also made it clear that the hospital cannot prescribe this type of drug to non-diabetic patients at present, because the supply is relatively tight and the management is more stringent. Currently, the hospital only prescribes for patients diagnosed with diabetes."

Source: China Workers Network

Semaglutide injection

Finally, Ms. Wu bought semaglutide through an online platform and started using it on her own. "This hypoglycemic injection is injected into the stomach just like insulin, and only one injection is given a week. The dosage is gradually increased. In the first two weeks, you will experience diarrhea and vomiting. After that, the effect of suppressing appetite will decrease, and the dosage will be increased. Now I am in the sixth week, but I feel that the effect of the drug has decreased." Ms. Wu said that in the past month and a half, through the injection of semaglutide and exercise, she has lost 20 kilograms.

In fact, there are many people like Ms. Wu who need to lose weight. When searching for terms such as "semaglutide" and "weight loss injection" on social platforms, the reporter found that some people regard the drug as a "miracle drug", while some "experienced people" remind everyone to use it with caution.

So, does this blood sugar-lowering injection really have a weight-loss effect? ​​The reporter learned that semaglutide was originally a drug used to treat adult patients with type 2 diabetes. As early as December 2017, semaglutide was approved by the FDA for the control of blood sugar in adult patients with type 2 diabetes; in January 2020, the FDA again approved semaglutide for use in adult patients with type 2 diabetes with cardiovascular disease to reduce the risk of related diseases; in April 2021, semaglutide was approved in mainland China, and its indications are the same as the above two indications that were first approved in the U.S. market, and it was able to enter medical insurance. In June 2021, the drug was approved for long-term weight management in the United States, and clinical research results showed that obese patients who continued to receive the drug were able to achieve an average weight loss of 17%-18% after 68 weeks. However, at present, the drug has not yet been approved for weight loss indications in China.

Experts remind you to lose weight wisely

Purchasing and using medicines privately may be risky

Combining clinical experience, Professor Wei Guohong from the Department of Endocrinology of the First Affiliated Hospital of Sun Yat-sen University told reporters that the main mechanism by which semaglutide can achieve blood sugar lowering and weight loss is that it can activate the GLP-1 (glucagon-like peptide-1) receptor, promote insulin secretion in a glucose concentration-dependent manner, inhibit glucagon secretion, delay gastric emptying and increase satiety, and suppress appetite by inhibiting the action of the hypothalamic feeding center, thereby achieving the effect of lowering blood sugar and reducing weight.

The weight loss effect of semaglutide attracted many people, and the drug soon became in short supply. Ms. Wang, a citizen, encountered a shortage of the drug when she went to a hospital for treatment for obesity last year. "The drug was not available on the same day. After several days, the diabetes care system notified me that the drug was available. I then made an appointment for a regular outpatient clinic that day and got the drug."

Wei Guohong told reporters: "When semaglutide was first launched in China two years ago, the public had high expectations for its weight loss effect. Our hospital did encounter many patients who came to see the doctor for weight loss needs, and the drug was even out of stock at one point, so diabetic patients could not use the drug normally. Later, we made adjustments to strictly control the indications and only prescribe the drug to diabetic patients, but even so, the drug is still in short supply on the market. Our hospital has currently adjusted the authority to prescribe semaglutide to only endocrinologists, and the pharmacy only distributes semaglutide to patients diagnosed with type 2 diabetes, ensuring that the drug is never out of stock again."

Since non-diabetic patients cannot get prescriptions through regular hospital offline channels, some people started looking for ways to buy medicine. Ms. Pan first learned about semaglutide from the media. Since the hospital in her city did not have regulations for prescribing medicine for obese patients, Ms. Pan asked a friend with diabetes to prescribe the medicine in a hospital and then resell it to her for injection. Within two months, Ms. Pan, who weighed 120 pounds, lost 6 pounds. More drug buyers choose to turn their attention to online Internet hospitals, pharmacies, or even obtain the drug through medical beauty institutions or overseas purchasing agents.

The reporter searched online and found that there are multiple platforms selling semaglutide, including the price of 1.5ml/tube (0.25mg, 0.5mg dosage), with the price ranging from 578 to 650 yuan, and the price of 3ml/tube (all 1.34mg/ml), ranging from 1,000 to 1,200 yuan. This price is higher than that of Zhongshan First Hospital, and the drug can only be reimbursed if it meets the medical insurance reimbursement conditions.

The purchase volume of this drug on the online platform is also extremely astonishing. Some purchase pages have more than 5,000 user reviews, and some even have more than 20,000 reviews. The reporter operated on the grounds that he needed to buy semaglutide, and found that he only needed to go through an online consultation at an Internet hospital and then check the "diabetes" option, and he did not need to provide relevant prescription proof to buy it online. Ms. Wu told the reporter that when she bought semaglutide online a month ago, there was an "obesity" option. "Now, perhaps because of drug management reasons, there is no obesity option."

From the perspective of a clinician, Wei Guohong advises that the public should not regard semaglutide as a "magic drug for weight loss." "There are many causes of obesity. From a professional perspective, it is recommended to rule out secondary obesity first, and then undergo regular lifestyle interventions. If the weight loss effect is not obvious, then use the drug under the guidance of a doctor. And healthy lifestyle interventions must be carried out throughout the entire process of weight loss and subsequent management, otherwise the effect will be greatly reduced, and the disease will rebound after stopping the drug. For people who are not obese, if they only pursue the so-called 'thin is beautiful', they should not buy and use this drug privately."

"Although current clinical studies have shown that semaglutide has good safety, it does not mean that it has no side effects." Wei Guohong added that the use of semaglutide often causes side effects on the gastrointestinal tract, such as abdominal distension, abdominal pain, constipation and even vomiting; in addition, animal experiments have found that GLP-1 agonists including semaglutide have the effect of stimulating thyroid C cell proliferation, so the drug is contraindicated in patients with a history or family history of medullary thyroid cancer and multiple endocrine neoplasia syndrome type 2. "In addition, after long-term use of this drug, the appetite suppression and weight loss effects will gradually decrease; after stopping the drug, if you do not pay attention to diet and exercise, weight rebound will also exist, so it is recommended that you be cautious when buying drugs privately." Wei Guohong said.

Obesity problem cannot be ignored

"Weight loss injections" cannot cure the root cause

According to the reporter, in addition to semaglutide, the GLP-1 receptor agonists currently approved in China include a total of 7 products from companies such as Eli Lilly, AstraZeneca, Hausen Pharmaceuticals, and Renhui Biopharma, and all of them have certain weight loss effects.

The popularity of these "slimming injections" and "slimming pills" reveals the current "body anxiety" of the public, and also indirectly reflects that the problem of obesity cannot be ignored. "Especially according to epidemiological studies, the obesity prevalence in our country is over 20%, which is a large base." Wei Guohong said. According to a report from the Chinese Nutrition Society, overweight and obesity will increase the risk of coronary heart disease, type 2 diabetes, female breast cancer and other diseases. "For these patients, the most important thing is to intervene in a healthy lifestyle, and to achieve a gradual weight loss by developing good living habits and healthy exercise."

In the past 10 years, Ms. Wang has spent a lot of time and money on weight loss. "Now, semaglutide is a more expensive weight loss attempt." Ms. Wang told reporters that she has spent more than 4,000 yuan on the drug in the past six months.

Ms. Wang believes that relying solely on the drug is not a long-term solution. Different individuals react differently to the drug: some people say it took them one and a half months to lose 20 pounds, but it took Ms. Wang seven months. "Because I really don't have time to exercise, I lose weight slowly." At her highest, Ms. Wang's weight once reached 160 pounds, which made her, who was less than 40 years old, face problems such as lumbar disc herniation, fatty liver, and three highs. "In the middle, I only insisted on playing badminton and controlling my diet for a year and a half and lost 15 pounds, but I didn't stick to it later, and coupled with overeating, my weight rebounded again."

After nearly 10 years of fighting obesity, Ms. Wang finally understood the simple truth: "There is no such thing as a 'magic drug for weight loss'. If you want to be healthy, you still have to control your diet and move your legs."