The Rise of Slimming Down: Medical officials expect weight-loss drugs’ popularity will keep growing

The landscape for weight management has been expanding in recent months as the surging popularity of drugs like Ozempic, Wegovy and Zepbound is a frequent topic for local medical professionals and their patients. 

Originally approved in 2017 by the U.S. Food and Drug Administration as a treatment for Type 2 diabetes, Ozempic’s side effects include weight loss. That’s led people to seek the drug  as a weight-loss solution. The common generic name for Ozempic, along with Wegovy, is semaglutide, while Zepbound, which received FDA approval in late 2023, is the brand name for tirzepatide. This class of drugs, called GLP-1 agonists, work by regulating the body’s hormones, decreasing appetite and slowing down the emptying of the stomach so that people feel less hungry. 

“They’re just very effective and they don’t have a whole lot of side effects,” said Dr. Eric Gifford, owner of Evolution Health & Wellness Center LLC, a Springfield weight loss management clinic opened in 2022. “I compare it similar to Viagra. Viagra was brought about as a blood pressure medication that happened to resolve erectile dysfunction and became a wildly popular drug. It’s very similar to this. They started out as diabetes, but then they realized, hey, we’ve got something here with weight loss.”

According to the Pew Research Center, 71% of semaglutide revenues in 2023 came from the United States. Novo Nordisk, the Danish company that produces Ozempic, Wegovy and Rybelsus, another diabetes medication, had combined sales last year of $21.1 billion. The combined total was nearly 90% higher than 2022. 

Gifford said new patients seeking weight-loss medications are an everyday occurrence at Evolution. While he primarily works at his other venture, 417 Sports Medicine & Orthopedics – both of which are in the Medical Mile Plaza on South National Avenue – Gifford aids patients with weight management every week. 

“I’ll have five or six new patients every Wednesday that we’re starting on a diet plan,” he said, noting his clinic provides semaglutide and tirzepatide. “It’s $400 a month for semaglutide, $500 for tirzepatide, and that includes all your counseling.”

Gifford said costs can range $1,000-$1,500 per month for the name brand medication, which is not commonly covered by insurance. 

“That’s why a lot of people look for alternatives such as us, where you get basically the compounded medication, which is the same formulation, almost, but obviously at a fraction of the cost,” he said. 

No miracle solution
Still, Gifford said these medications aren’t intended as a miracle solution to weight loss. Exercise and a proper diet are key contributors to maximize weight management, medical officials say. 

“If you don’t change a single thing in your life, you’ll probably have success, but you’ll have so much more success if you really stick with a meal plan and you get that accountability and that coaching,” he said, in response to those who want to simply take the drugs without altering their diet and engaging in exercise.

Dr. Rani Nair, an endocrinologist with Mercy Springfield Communities, agreed: “They probably are looking for a shortcut, but it doesn’t work that way.”

Nair said the drugs’ most common side effects are nausea, vomiting, abdominal pain, diarrhea and constipation. She added the medication is not for patients who have medullary thyroid cancer and multiple endocrine neoplasia.

A 2023 study published in the Journal of the American Medical Association suggests people taking injected medications such as Wegovy and Ozempic may be at higher risk for serious digestive problems such as stomach paralysis, pancreatitis and bowel obstructions, compared with those taking other types of weight-loss medications.

The popularity of the weight-loss drugs is increasing amid a rising obesity rate in the U.S. According to the Centers for Disease Control and Prevention’s 2022 Behavioral Risk Factor Surveillance Survey, 22 states have an adult obesity prevalence at or above 35%, compared with 19 states in 2021. Missouri’s adult obesity prevalence was 36.7%. A decade ago, no state had an adult obesity prevalence at or above 35%, according to the study. 

 Moving fast
At Grove Pharmacy, semaglutide is available via injectables and sublingual drops, while tirzepatide is also offered as an injectable. All options are very popular, said pharmacist Shade Piper, who is director of the pharmacy’s compounding lab. 

“It’s definitely our fastest moving product right now. We’re seeing probably more need than what even the doctors can keep up with,” he said. “We have a lot of patients come in and they’re trying to get the weight loss medication and they don’t even have a doctor that they’re seeing currently.”

In July, the pharmacy sold 95 sublingual drops, which start at $110, and 120 injections of semaglutide, which start at $165. Tirzepatide injections start at $295 and 65 of those were sold, Piper said. 

“The drops have been trending down as the shots are trending up,” he said, noting June sales were 110 drops, 70 injectables for semaglutide and 30 tirzepatide injections. 

While keeping the name brand products in stock was difficult for a few months, Piper said supply has improved as the drugs were placed earlier this year on an FDA shortlist.

“That’s meaning compounding pharmacies can make them to try to keep up with the demand for the drug,” he said. “It’s not as hard to get your hands on it anymore, but you’ve got to be willing to dispense the generic version instead of a brand that comes in the pens.”

Nair said insurance typically covers the drugs if there is a medical necessity, such as poorly controlled diabetes, or for some patients who have a body mass index of 30 or higher, which puts them in the obesity category. 

“There is no magic number, but oftentimes if their BMI is more than 35, I would say 60% of them get coverage for Wegovy,” she said. 

Officials say the ongoing demand for weight-loss medications means the marketplace will assuredly become more crowded as more drug companies look to increase options for consumers.  

“I guarantee there’s going to be others coming after these,” Gifford said. 

Additionally, Teva Pharmaceuticals in July announced the launch of a generic form of Victoza, also known as liraglutide, and similar to drugs such as Ozempic and Wegovy. It’s the first generic GLP-1 drug in the U.S., but Nair said she expects more similar generic options to soon come to market. 

“I cannot even imagine the demand because it gets more affordable,” she said. “And everybody’s going to be after this.”