Weight Limit is a series that examines the rise of weight loss drugs like Wegovy and how they impact young people. This story explores how young people who take Ozempic for diabetes are impacted by shortages.
Diagnosed with Type 1 diabetes at the age of 8, Noelle has spent much of her life trying to get her insulin needs under control. When her doctor prescribed Ozempic, it felt like a breakthrough — but she was only on the medication for two months before she had trouble getting it. Noelle has been trying to fill her prescription for Ozempic since December. She’s tried three different pharmacies and even had her provider send a prescription for Wegovy — which has the same active ingredient as Ozempic but in different doses, and is meant exclusively for weight loss, not diabetes management.
For Noelle and other diabetic patients who are searching high and low for medication, the reason behind the shortage seems clear: in the past year, the popularity of a drug originally intended to treat diabetes has exploded in a weight-loss craze.
Ozempic was approved to treat Type 2 diabetes in 2017 (recent studies have suggested it may also help people with Type 1 diabetes, like Noelle). The drug was also found to result in weight loss, which led to the 2021 introduction of Wegovy — which has the same active ingredient as Ozempic but is meant specifically for weight management. Wegovy exploded in popularity and eventually went into shortage, leading to doctors prescribing Ozempic off-label for weight loss. Now, both drugs are in shortage. For people who use Ozempic to control diabetes — which is its intended purpose —that can mean trouble finding the drug they need to manage their disease.
“I haven’t been able to even get [this medication] because of the ‘hot craze’ that’s going on right now,” Noelle says. “I’m in a few Diabetics groups on Facebook and tons of people are having the same issue.”
Nancy Crimmins, MD, an endocrinologist in Cincinnati, says the shortage has made things difficult for providers as well. As a doctor who treats patients with diabetes, she has patients who are facing issues filling their prescriptions. “It’s been very difficult as a provider to make sure our patients are getting [the] drug and then are able to pick it up and continue it,” Dr. Crimmins says. If patients can’t get Ozempic, Dr. Crimmins may prescribe a different medication – but insurance companies may not cover it, forcing doctors’ offices to fight for prior authorizations and leaving the patient in an even longer limbo. Even if the drug is covered by insurance, it may be more expensive than the original one the patient was on, burdening them with the cost as well as the stress of having gaps in medication. “And while we’re trying to figure this out, the worst case scenario is they could be off the drug for a while,” she says. “Certainly, their diabetes control could worsen.”
When that scenario may be prompted in part by people who are seeking Ozempic for weight loss alone, it can be tough to stomach. “To have people using them for cosmetic reasons is really hard to see as a doctor,” Dr. Crimmins says.
Of course, many people taking Wegovy and Ozempic for weight loss do have a medical need, not just a cosmetic one. Sarina Dhaliwal, a 29-year-old pharmacist in Arizona, explains that semaglutide, the drug in Ozempic and Wegovy, can help treat patients with weight-related health issues, and those who are pre-diabetic. These patients would typically be prescribed Wegovy, but because of the shortage, providers may prescribe Ozempic in its place. And, taking these drugs for a cosmetic reason alone isn’t wrong or bad — there are many reasons that might be the right choice for someone. But, using Ozempic off-label in a way that has led to a shortage for people with diabetes has created an ethical question, Dhaliwal says.
“This is definitely a topic of conversation [with] like every other patient,” she says. If a patient has been on Ozempic for weight loss and hasn’t been able to fill their prescription, Dhaliwal says that presents the opportunity for pharmacists and health care professionals to inform the patient. “That’s a good talking point to educate them, [to say], ‘well, you don’t have a diabetes diagnosis and those patients need this drug.” Dhaliwal says education on lifestyle changes, including nutritional counseling and exercise interventions, can be helpful in moments like this as the shortage persists.
Noelle is frustrated by what she sees as a trend getting in the way of her successfully managing her disease, though she feels sympathy for people who are seeking out Ozempic for other purposes. “Do I believe people should be able to use the medication if it helps them? Yes, of course. But when it’s becoming an issue for people who the medication was first made for, then it’s a big issue,” she says, referencing people using Ozempic off-label. “It’s not trendy to need medication. And that’s exactly what it’s turning into, a trend.”
Read the rest of the series here:
Teens Are Taking Wegovy, and Experts Wonder What That Means for Mental Health
Ozempic Is Highlighting How We Link Our Worth to Our Body Size
Nearly 1 in 10 Teenagers Have Turned to Pills for Weight Loss, Research Shows
We Don't Always Know What's In Those Cheaper Ozempic "Dupes"
Diet Culture History: From Ancient Greece to Ozempic
