Is Ozempic the 'biggest thing since penicillin'? Physicians weigh in

Is Ozempic “the biggest thing since penicillin,” as described on TikTok by Dr. Jonathan Kaplan?^[]

Ozempic and other GLP-1 receptor agonists (GLP-1RAs) have gained much attention in recent years as effective treatments for type 2 diabetes and obesity. More recently, patient reports about their unexpected side effects have dominated the news cycle.

Their ability to curb addictive habits (from gambling to binge drinking), potentially slow cognitive decline, and reduce the risk of many chronic diseases (to name just a few) has many HCPs feeling positive about their long-term impacts on global health.

@realdrbae GLP-1’s: The biggest thing since penicillin! #greenscreen ♬ original sound - Jonathan Kaplan

Changing the landscape

Srividya Kidambi, MD, a board-certified endocrinologist with Froedtert Health & the Medical College of Wisconsin network, describes herself as an “early adopter” of GLP-1RAs in treating obesity in addition to type 2 diabetes. Among the success stories she has seen with her patients, she says that she is particularly pleased when she is able to take patients off of insulin treatment thanks to these medications, thereby easing patients’ burden.

But what about other potential applications and benefits of these medications? Supriya Rao, MD, is a board-certified gastroenterologist working in private practice in the Boston area. She is also board-certified in obesity and lifestyle medicine. Dr. Rao describes how GLP-1RAs can go beyond suppressing appetites, explaining that they can “turn off what people describe as ‘food chatter’ in their brain.”

Similarly, Dr. Kidambi emphasizes additional benefits of GLP-1RA treatment and subsequent weight loss, including more successful bariatric surgeries with better recoveries. She also notes that the brain’s reward system for food could be similar to that for alcohol and other addictive substances, so there is hope for GLP-1RA treatment to have benefits for substance use disorders as well.

In addition, she notes the difference these drugs have made in treating patients with chronic kidney disease in whom other treatments would not be indicated. “One of the remarkable things, for which I am incredibly grateful, is that we can use these drugs in patients with chronic kidney disease,” she says. 

Countering misconceptions and stigma

According to Dr. Rao, misconceptions around GLP-1RAs do exist. Some people “think it’s the easy way out,” she explains. “There is no easy way with weight loss,” she adds.

Dr. Rao says that a patient’s seeking help is a huge first step, which she finds admirable. She recognizes the stigma and shame experienced by many obese patients. “Society still has a bias against patients with excess weight.” This is all the more reason, she says, to work with a healthcare provider “who can help empower you to be the best version of yourself, and [help] get you to a healthy weight, so you avoid chronic medical issues as you get older.”

Barriers to access

Alongside the positive attention Ozempic and other GLP-1RAs are receiving, both Drs. Kidambi and Rao acknowledge hurdles in access, notably with insurance coverage. Dr. Kidambi, however, states that she sees insurance coverage and drug availability as “temporary hurdles."

"I think that hopefully in 10 years we won’t be talking about the cost. The future is bright, and different formulations may not be as difficult to manufacture,” Dr. Kidambi continues.

Looking ahead

Dr. Kidambi says that she has hopes for future drug developments to prevent the onset of diseases such as obesity. Right now, she says, “We’re looking to treat obesity, or diabetes—we’re not in the prevention realm yet. But what would happen if someone were prevented from ever reaching a BMI of 30? It’s incredible to have hope for the possibility of prevention.”

“I think it’s really easy to lose weight on them,” Dr. Rao says, “but it’s harder to maintain weight loss. Having a comprehensive lifestyle medicine program is really important.” She emphasizes the importance of working with a nutritionist and focusing on diet, activity, and exercise. Additionally, Dr. Rao recommends strength training, maintaining adequate sleep, and managing stress to maintain weight loss alongside GLP-1RA treatment. “This combination is what makes someone successful with weight loss and maintenance,” she says.