Ozempic might be 'ubiquitous,' but it's not for everyone, says diabetes researcher

If you've never heard of Ozempic, you likely will. 

From ads on television to transit vehicles in Toronto — even behind home plate at the Rogers Centre —the drug is being pushed by an aggressive advertising campaign by manufacturer Novo Nordisk. 

It's also making headlines — for shortages and crackdowns on its use, including an American who was stripped of his Canadian medical licence after he was tied to some 11,000 prescriptions for the drug south of the border.

So what is Ozempic?

In 2018, Health Canada approved the drug to treat adults with Type 2 diabetes. 

By law in Canada, ads can't say much more than "ask your doctor," so we asked one.

How diabetes drugs differ

Dr. Stewart Harris is the medical director of the Primary Care Diabetes Support Program at St. Joseph's Healthcare in London, Ont., and the Diabetes Canada chair in diabetes management at the Schulich School of Medicine at Western University. 

"Ozempic is a very potent form of the natural occurring hormone," he said.  "It's exactly a replication, with some minor modifications, of a naturally occurring human hormone GLP-1 [or, glucagon-like peptide-1]." 

[Ozempic is] a very potent blood glucose or blood sugar lowering agent for people with diabetes.- Dr. Stewart Harris, medical director of the Primary Care Diabetes Support Program at St. Joseph's Healthcare in London, Ont.

Ozempic, like Rybelsus and Wegovy, has the same active ingredient. How they differ, Harris said, is that while Ozempic comes in an injectible pen, Rybelsus is in pill form. Wegovy is also taken through an injection pen, but while it's approved by Health Canada, it's not commercially available in this country. 

Known by the trade name "semaglutide," the medications help lower blood sugar by working the same way GLP-1 does, by promoting insulin production, slowing food from leaving the stomach and stimulating the part of the brain that promotes appetite reduction, Harris said.

"It's like a super dose of this hormone. It's a very potent blood glucose or blood sugar lowering agent for people with diabetes, and that's what Ozempic is prescribed, and designed, and been tested and evaluated for — as a diabetes drug.

"It is a fantastic drug to treat people with diabetes," he said. Not only does it lower blood sugar, he added, but in many cases, it gets people off insulin and the medicine has been tested to protect against future heart disease or stroke in people at risk, something he called a "win, win, win."

"Of course it's being used beyond that."

Health Canada says on its website there are reports in the news and social media that Ozempic is being used as well for weight loss, adding that's "not an approved indication."

The government also notes the decision to prescribe a drug for off-label use is part medical practice, which in Canada is regulated by provincial and territorial governments. "It involves the health-care professional diagnosing a patient's symptoms and deciding which treatment would be most appropriate for that patient."

André Gagnon, a spokesperson for Health Canada, said in an email to CBC News on Friday that anyone with concerns surrounding Ozempic's use is encouraged to contact their provincial Ministry of Health or the appropriate professional regulatory college.

Drug used 'appropriately and inappropriately'

Harris said because the drug has a weight-reducing side-effect, it's being used "appropriately and inappropriately" off label by people who don't have diabetes. 

"Ozempic on label is designed for people, is approved for people with Type 2 diabetes, and that's how it's supposed to be prescribed," he said. "But clinicians and lots of clinics are using it in people who don't have diabetes, often at a much lower dose." 

Dermacare, a skin care clinic in London, is one such example, prescribing the drug through a partnership with Reviv Toronto, a vitamin therapy and IV injection clinic. 

Despina Oosterhoff, who works at Dermacare, told CBC News on Wednesday the medication is but "one tool" for weight loss and "does need to be prescribed very responsibly."

She said the prescriptions are handled by Jovana Pecic, a registered nurse who works at Reviv Toronto. Pecic told CBC News she was unavailable for an interview. 

Harris said Ozempic is now being used "ubiquitously" to help people lose weight, fuelled by an ad campaign on a scale similar to Viagra and the stories of celebrities and Hollywood stars who have said they've lost weight thanks to using the drug. 

"They don't have diabetes, but they want to lose weight and so it's very popular in clinics everywhere for all purposes as a weight-reducing agent, and it works."

Anyone who takes it, takes it for life

Harris said anyone who takes Ozempic would need to be on it for life or risks gaining the weight back.

There are side-effects in some people, including diarrhea and gastrointestinal issues, but the data from testing and safety studies suggest almost no consequences for people with Type 2 diabetes over a five- to seven-year period. 

Health Canada also notes people who shouldn't be using Ozempic include anyone who's had medullary thyroid cancer or has a family history of it, are allergic to Ozempic or any of the product's ingredients, or is pregnant or breastfeeding.

Harris said that in his practice, the medication is a "game changer," reshaping lives with weight loss while protecting people from heart disease. 

"The media is really kind of spun this like pharma companies are making a lot of money and people using this drug when it's not prescribed properly, etcetera, and people are losing weight like it's a bad thing. But in my clinical experience, what I can tell you is that when people start to lose weight with this drug, it really kind of reinvigorates people's energy and enthusiasm.

"It gives people kind of a new lease on life, a new chance to try something that has failed over and over in their lifetime in trying to lose weight, which is a beneficial thing."