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1:23

Ozempic is a drug

1:25

designed for diabetes, but which

1:27

has been found have game changing secondary

1:29

use. It has the power to

1:31

transform the lives people living

1:33

with complex obesity. But

1:36

access to it has been put at risk

1:38

by its association with celebrity weight

1:40

loss and its

1:41

popularity. Social media.

1:43

It's the talk of TikTok. I

1:46

just start dropping pound something. Right?

1:48

The topic Ozempic has over

1:50

three hundred million views It's

1:53

only available in Ireland on prescription

1:55

through GPs or medical consultants for

1:57

people with type two diabetes. And

2:00

in very limited circumstances for

2:02

those with obesity.

2:04

But some people, like the Linda, have

2:06

found another pathway to access seeing

2:08

the injectable drug. I went

2:11

on the internet online doctors.

2:13

I had a consultation and he

2:15

gave me prescription for Ozempic in

2:18

about three

2:19

minutes, but

2:21

it's not without side effects. Risks

2:23

and the potential for misuse. TikTok

2:26

and Instagram are

2:28

are shaping the narrative around

2:31

this. It's phenomenally negative

2:33

messaging. You know, we're making progress in our

2:36

understanding around the disease of obesity,

2:38

and it's still being given

2:41

taboloid treatment that

2:43

is unhelpful for its true

2:46

role. I'm Bernice Harrison. And

2:48

this is in the news from the Irish Times.

2:51

Today, what you really need

2:53

to know about Ozempic, the weight loss

2:55

drug that has taken the internet by storm.

3:01

Blinder, you've been sharing your weight

3:03

loss journey with the drug Ozempic

3:05

through your Instagram

3:06

page. Which is called Ozempic

3:09

insights. Can you tell me about

3:11

your relationship with food and

3:13

your feelings about your I'm

3:17

forty seven. I have been

3:19

dieting far over thirty years

3:21

now since I was about

3:23

fifteen. Dieting from

3:26

thirty years, no success. Dights

3:28

have worked, but ultimately failed

3:30

in the long run, be it

3:32

on sustainability or me not

3:34

being able to do it. Went to watchers,

3:37

went to slimming world, went

3:39

to all of the classes in the world,

3:42

The only one that ever really worked

3:44

for me in later life was Kisho. I

3:46

lost, like, five stone on that. But

3:48

again, in the end, that was unsustainable

3:51

long term. It's very strict.

3:54

Then I went and had an operation on my back

3:56

and gained the weight

3:58

back. And then I was on the Internet,

4:00

and I seen people speaking about Ozempic,

4:03

Saxenda, Wego v. All

4:05

of these injections that

4:08

help you to lose didn't have

4:10

a clue about them. So I just went and

4:12

found out what I could. So how did you

4:14

find out? went

4:16

to my doctor. First

4:19

of all, to ask about Weycovey,

4:21

And if he could prescribe it to me, and

4:23

he said, no. He doesn't

4:25

feel comfortable doing so due to the side

4:28

effects. It was side effects

4:30

with tumors in your thyroid and

4:32

things like that. But all of these side effects were

4:34

only found in rats. There's thousands

4:36

of people around the world on Wigolfi.

4:39

And live in a successful, you

4:41

know, weight loss life on Wriggolfi. And

4:44

had

4:44

you ever had a conversation with your doctor

4:46

about your before? Yeah.

4:48

I have. Yeah. And I was just

4:51

told to eat less and move more.

4:53

That's the story everybody's been told, but

4:55

obviously, it doesn't work, you know, for everybody.

4:58

Can we just explain little about

5:00

why your doctor might have been reluctant? Because

5:03

this is a prescription medication.

5:05

That was designed, created

5:09

for people who are

5:10

diabetic. Yes. Sachsenda

5:13

and Ozempic. Yeah.

5:17

So Saxenda is now, like, covered

5:19

and Ozempic is covered by of drug's

5:22

payment scheme in Ireland and the medical

5:24

card as well. Unfortunately, with

5:27

Ozempic, you have to be diabetic

5:30

to get it. Okay? And

5:32

with Saxenda, you have

5:34

to have a high risk of

5:36

cardiovascular disease, and

5:40

high cholesterol, and your

5:42

markers have to be of

5:44

a certain sentage. So there's a

5:47

tiny, tiny subgroup of people

5:49

that are only allowed to apply for

5:53

Saxenda. So

5:55

you'd no luck with your GP. So what did you do

5:57

then? I went on

5:59

the Internet and found out how

6:01

other people were getting there. Nope. There are people

6:04

that sell us from their home

6:06

and stuff, but I wouldn't be interested in

6:08

doing that. So I heard about

6:10

online doctors and I

6:13

just went on. I had a consultation. I

6:15

paid twenty four euros for the consultation. And

6:18

he gave me prescription for Ozempic

6:21

in about three minutes.

6:26

Now, we're always cautioned

6:29

to be very

6:31

sort of nervous about

6:35

such online,

6:38

you know, sourced medication.

6:41

How did you feel about

6:42

that? I mean, like, you're saying three minutes.

6:44

Now that doesn't that that doesn't make me

6:46

feel that that's a good thing. Yeah.

6:48

Because when I gosh, the prescription, I looked

6:51

at my thoughts, why was that so easy?

6:53

How could that possibly be that

6:55

easy? But then ten minutes

6:57

later, my mind, it was,

7:00

I don't care. I'm so

7:02

far down the line of My

7:04

mental health is suffering chronically

7:07

because of my weight. I would

7:09

have stuck something in my eye at that

7:11

point to to help me lose weightloss

7:14

how much weight at that point did you

7:16

feel

7:16

you had to lose? About six stone.

7:19

So how do you take it? Yes. It's

7:22

like an EpiPen. It comes in an EpiPen.

7:24

There you get four needles with it.

7:26

It's a month, a weekly injection.

7:29

You get four injections

7:31

out of the pen. You inject it into your

7:33

tummy or your thigh. And

7:35

then what happens then? Within

7:39

about two days,

7:41

I'd say maximum three days, my

7:44

appetite was suppressed like,

7:48

I can't even describe it

7:51

how low my appetite went because

7:53

I have spent the past thirty

7:56

years with a

7:59

huge, huge appetite that I've

8:01

never been able to do anything about. That

8:04

this was like freedom to me.

8:06

It was like the noise in my head

8:08

had stopped. It

8:11

was it was amazing amazing. And

8:14

to this

8:14

day, it's like six months later, it's

8:17

still the same. So

8:28

there's no such thing as a drug that with

8:30

outside effects. What are

8:32

the side effects that you're experiencing of

8:35

Ozempic?

8:36

So in the beginning, it would have been

8:39

gastric side effects. You

8:42

could have chronic diarrhea or constipation.

8:47

Tommy upsets most of the

8:49

time while you're getting used to it

8:51

and you're going up in your

8:54

milligrams. Bosch,

8:57

nothing now that you're just talking about first

8:59

or so, you know, maybe six weeks while

9:01

you're getting used to it. But on a day to day

9:03

basis, I don't notice any side effects in

9:06

my life now.

9:07

So how much does it cost? So you

9:10

said it's not on you can't get it

9:12

on the drugs

9:13

plan. How much does it cost? It costs.

9:15

Hundred and forty million euros a month.

9:18

And that's on the lower scale in Dublin.

9:21

They're they're charging, like,

9:23

maybe two hundred euros.

9:25

So you've spent three decades since

9:28

you're a teenager on a diet. On your

9:30

your diet, it's gone up, gone down. Presumably,

9:33

you know, every new diet that you try.

9:36

Every new thing you think this is it.

9:38

And maybe for couple of weeks, a couple

9:40

of months, you'd say, you know what? Weight Watches is

9:42

the thing. You know what? Slimming word is like, ketos,

9:45

all every new thing. Do you not

9:47

feel the zenamental of that about this?

9:50

Alone.

9:52

Why? It depends. You

9:54

know, like you were just mentioning all those other

9:56

things as well. A lot of a lot

9:58

of those things worked for a lot of people. You

10:01

know, Weightloss Watchers worked

10:03

for thousands of people, Soon World.

10:06

My best friend, Glass nine's donuts, and kept

10:08

it off. You know, that works for her,

10:11

but everyone is different and different things work

10:13

for different people. And unfortunately,

10:15

I was just really late in life finding what worked

10:17

for

10:18

me. And how do you feel about

10:21

the the statistics that would say that

10:23

that ninety five percent of people

10:25

who go on this who go on

10:28

Ozempic, they'll put

10:30

back on the within five years

10:32

once they stop taking

10:33

it. What do you think about? So

10:35

the question then is if I

10:37

had if had diabetes?

10:42

I would be on that drug for the rest of my life,

10:44

wouldn't I? So

10:46

Yeah. Why why am I not going to stay on this

10:48

drug? It will eventually

10:51

come onto the medical card for

10:53

people and onto the drug's payments scene.

10:55

Eventually, it will. Hopefully.

10:58

But I suppose, though, it's a new drug,

11:00

we don't know the side effects of us for -- It's

11:02

ridiculous. Yeah. -- you know. So

11:04

does that concern you? No.

11:08

Well, if if I put it if I put it

11:10

like this, in

11:12

six months, I have gone from

11:15

constantly thinking about

11:17

food, constantly feeling horrible

11:20

about the food I put in my mouth at

11:22

every single mirror. Beating

11:24

myself up first feeling guilty,

11:28

feeling less than because of the food I put

11:30

in my mouth and constantly putting

11:32

smile on my face like I'm okay

11:34

with this. No one's okay with this.

11:36

People say they are, but they're not.

11:39

And constantly having to cover

11:41

up physically and emotionally for

11:44

fears the roles on my Tommy would show

11:46

and the cracks on my face would show.

11:49

This constant cover up of a whole of

11:52

decades. And I've gone from

11:54

that to this. I

11:56

don't care. I

11:58

don't care, you know, in twenty

12:01

years' time if they say, oh, probably shouldn't have taken

12:03

that. It's fine. It's fine. I'm I'm

12:05

taking the chance and I want him to do that.

12:11

Coming up, will Ozempic and

12:14

drugs like it get the go ahead for

12:16

weight loss treatment in Ireland. I

12:18

talked to professor Donald O'Shea, clinical

12:20

lead on obesity with the HSE to

12:22

find out.

12:37

I'm here with professor Donald O'Shea, the clinical

12:40

lead on obesity with HSC. So

12:43

if I first heard of Ozempic, you would

12:45

have heard of long time before me, and

12:47

I only heard of it last year because it

12:50

was reported that Kim Kardashian had used

12:52

it to get into Bartleman Rose's famous speed

12:54

address at the Met Gala in New York. And

12:57

we were told then it was a drug developed for

12:59

diabetes and that

13:01

was then discovered because instant

13:04

weight loss. And it's now

13:06

sort of I suppose being presented in kind of a

13:08

Hollywood way as a miracle

13:10

job. I I mean, is it how do

13:12

you view it? It's a very

13:14

effective treatment for diabetes. When

13:17

I moved to London in nineteen ninety

13:19

two, the units I joined was working on

13:22

it as a developmental treatment

13:25

for diabetes because

13:27

of its effect on insulin release

13:30

and also some described

13:32

effects on satiety and

13:34

making a feel full earlier. And

13:37

we've been using about the diabetes area

13:40

for the last maybe thirteen

13:43

years. And it, you know,

13:45

is it clear that in a certain percentage

13:47

of individuals who started, there

13:50

is an exquisite response in terms

13:52

of weight and

13:55

you need higher doses than

13:57

for diabetes to achieve

13:59

the optimal weight loss but

14:02

the, you know, last week, the economists

14:05

the the front page, the economist was

14:07

ease, inject, repeat.

14:09

Like, what do you think of that? Because that sounds

14:11

so extreme to me. It's

14:14

phenomenally negative messaging.

14:16

You know, we're making progress in our understanding

14:19

around the disease of obesity. We're

14:21

making progress on how to treat it. And

14:23

it's still being given tabloid

14:27

treatment celebrity endorsement

14:30

that is unhelpful for its true

14:33

role because obesity is a

14:35

chronic disease. And like

14:37

other chronic diseases, the treatment

14:40

is not a course of Ozempic

14:43

or a course of cholesterol medication. It

14:45

is life long

14:48

treatment in association with

14:50

change to your lifestyle

14:52

around optimizing your nutrition optimizing

14:55

your physical activity levels. So

14:57

to give it that kind of miracle job,

15:00

Elon Musk endorsement is

15:04

incredibly negative for people living with

15:06

obesity. It also

15:08

drives the agenda that those

15:10

who have can afford us

15:13

and will get access to us and

15:15

access and keeping up

15:17

with the demand within

15:19

the setting of the disease of

15:22

diabetes, within the setting of the disease

15:24

of obesity is a massive challenge.

15:26

And if it gets hijacked, into

15:29

aesthetic clinics. It's

15:31

just a massive setback

15:33

for the management

15:36

of obesity. As a serious

15:38

medical condition.

15:44

Now, you know, we we talk jokingly all the

15:46

time of us, you know, doctor or Google. Now it seems

15:48

to me that when you're talking about weight

15:50

loss, and obesity and what

15:52

people do to lose Instagram

15:55

and TikTok is is where a lot of people

15:57

are getting a lot of information. And

16:00

there's very active Instagram accounts,

16:02

particularly, people who are charting their

16:04

journey on Ozempic.

16:06

Today, I'm gonna be giving you an Ozempic

16:08

update. The top ten

16:11

things I wish I knew when I was starting Ozempic,

16:14

and I hope this answers a lot of questions.

16:16

Today, we're gonna jump

16:18

on the scales, give you away. I know it's been

16:20

off for a while. We talked to one of those

16:22

women, Belinda, and She

16:25

has been on Ozempic for the last

16:28

six months. She's lost nineteen

16:30

kilo, roughly three stone. She

16:32

says she's got another two stone to

16:34

go. And she she

16:36

describes it very powerfully. She describes it as

16:38

quieting the noise inside her

16:40

head. Unless I remind

16:43

myself to eat, I won't think

16:45

about it. Then

16:47

that's the biggest thing

16:50

because previous to this,

16:52

when I tell you every minute of my

16:54

day, was constantly

16:57

filled with parts of food. To

16:59

go from

17:00

DASH, to having to remind myself

17:02

to eat, it's

17:04

huge. Does

17:07

that sort of, in a sense, make sense to

17:09

you in terms of brain response to

17:12

a drug like this?

17:14

That the impact of Ozempic

17:17

and those who respond to as well,

17:20

the descriptions are fascinating

17:23

to listen to because it's

17:25

GLP Ozempic is a hormone.

17:27

you know, people know about gyro

17:30

hormone. And if you're missing that and you start

17:32

on us, you feel immediately better.

17:35

Steroids are hormone. And if you're

17:37

missing steroids, you're very seriously

17:39

ill. And when you start, you're better

17:42

immediately, there is

17:44

certainly a group of people

17:46

who when they start Ozempic, it

17:49

appears as as if they have been missing

17:51

GLP and you are giving them back

17:53

something that their body didn't

17:56

have, and they will describe a very immediate

17:59

response around calmness,

18:02

well being and

18:04

an an ability to, if

18:06

you like, deal with cravings that

18:09

they just never had before

18:11

they started, but that's probably

18:13

ten percent of people who started or

18:16

or less. The majority of people who

18:18

started and benefit benefit

18:20

over time in combination with

18:23

changes to their lives and lifestyle, and,

18:25

you know, it's it's a small

18:27

number that are exquisite responders.

18:30

TikTok and

18:32

Instagram are shaping the

18:34

narrative around this way

18:37

beyond anything that the medical journey

18:39

or the scientific community

18:42

who are involved with it are able

18:44

to influence and it's not

18:46

taking on if you like,

18:49

a narrows of the people in the

18:51

weak management field want us to

18:53

to take on at all.

18:56

Now, could we ask her about how

18:58

she accessed it? And I

19:00

imagine her experience is very, very

19:02

common for a lot of Irish people.

19:05

She went to an online doctor, an online doctor

19:08

in another country, and she

19:10

was prescribed as in three minutes. What

19:12

do you make of that sort of pathway

19:15

to a drug like this? Well,

19:18

it's an appropriate pathway. Can

19:21

understand somebody's frustration

19:25

at our own system, not allowing

19:27

access to a medication that

19:30

they want. And within

19:32

the HSE obesity

19:35

program that I'm kind of clinical lead

19:38

for at the moment. We are

19:40

trying to get access for

19:43

patients to the

19:45

GLP-one treatment. Saxenda

19:49

is the once daily equivalent of

19:51

Ozempic, which is a once weekly injection.

19:54

The once weekly injection isn't

19:56

yet licensed for weightloss,

19:59

and that will happen next year. But

20:01

there are people who are

20:03

carrying a few extra pounds don't

20:05

have diabetes, don't have insulin resistance,

20:08

don't have sleep apnea, you

20:10

know, they don't need a treatment

20:13

from a medical point of view for

20:15

their ways. It's not causing medical

20:18

problems. For somebody

20:20

like Belinda who's six stone

20:23

overways, and, you know, maybe in their

20:25

late thirties, forties, or fifties, When

20:27

they go to their GP, what the GP should

20:29

be doing is a risk assessment of,

20:32

is is that way he's actually causing a

20:35

health problem that will benefit

20:38

from treatment with,

20:40

say, one of the GOP treatments, and

20:43

At that degree of overweight, you would

20:45

expect there would be health problems

20:48

associated. And

20:50

in time, when the

20:52

treatment becomes more widely available,

20:54

you would expect that the indications

20:57

for starting treatment to

20:59

prevent those complications developing

21:02

and would be comattained. At the

21:04

moment, the supply is

21:06

so laminate. That it's really

21:08

important to target the treatment

21:12

to those who will benefit the most.

21:15

But that situation will

21:17

change because the history of drugs that

21:19

are licensed to treat, say, high cholesterol,

21:22

they all started with a very high cholesterol, and

21:24

then the trial showed benefits and

21:26

then the level as which you started, the

21:28

cholesterol treatment came down. So I have no

21:30

doubt the indications over time will widen

21:33

And in the meantime, there will be frustrations

21:35

for people like Belinda.

21:40

That's what we're hoping for, aren't we? You

21:42

know what I mean? To be able to go into your doctors and

21:44

to be able to say that, look, I've been obese

21:46

for three decades. I, on

21:48

my own, have tried everything in this

21:51

world. Somebody helped me

21:53

and nobody helped me. So

21:55

I had to go and do it on my own. And

21:58

there are thousands of women in Ireland

22:00

doing it on their own and not knowing

22:02

exactly what we should know about it

22:05

because we're having to do it on our own.

22:08

So while you I suppose while you're

22:10

working away, you know, in a very official

22:13

way to to create pathways for

22:16

for people to access this drug to

22:18

the HSC and so on. There's

22:20

gonna be a huge number of

22:22

people who are accessing it privately. And

22:24

it costs about, you know, we we

22:26

hear figures of one thousand

22:28

five hundred, two thousand a year for

22:30

it. So that's going to

22:32

create sort of quite a division, isn't it?

22:34

Oh, and that's a huge concern

22:37

that I have. Obesity

22:39

is a condition that already has a massive

22:41

socioeconomic association.

22:44

So the last well off parts of

22:46

our society are affected

22:49

way more disproportionately with severe

22:52

and complex obesity. And

22:55

they are the individuals who will not

22:57

be able to afford this

22:59

treatment and those who have

23:02

a lesser degree of obesity but

23:04

are better off because they're able

23:06

to pay for

23:06

us, we'll we'll be able to get us. As

23:09

a solution to obesity?

23:13

Like, is it just putting,

23:14

you know, a sticking glass rather problem? That's the

23:16

sort of the the idea of a job like this.

23:19

No. I think any treatment or

23:22

any condition that has been poorly understood

23:25

and obesity you know,

23:27

is the last remaining kind of acceptable

23:32

stigmatized condition. So

23:34

it's no longer acceptable to

23:37

stigmatize people over health conditions

23:39

with with the exception of obesity. They

23:41

feel judged. But as we get to understand

23:44

obesity, better. It

23:47

means will treat us.

23:49

With any other condition of when we've treated

23:51

us, we've begun to

23:54

energize prevention even

23:56

more. But it's only when you start

23:59

treating a condition that prevention

24:02

pieces get really mobilized aggressively.

24:05

And that's what needs to happen because

24:08

treatment of this disease is going

24:10

to break the

24:12

budget of the health service. So

24:16

redouble our efforts to

24:19

get our children's

24:22

eating patterns and approaches to food

24:24

preparation and physical activity up

24:27

to something approaching a decent

24:29

level.

24:31

The old guard of weight loss is getting

24:33

on board with the latest weight loss sensation.

24:36

WW International formerly known

24:38

as Watchers announced it is buying

24:40

the company's sequenced for one hundred

24:42

million dollars. I

24:44

thought it was interesting this week. I don't know did you see

24:46

it that watchers in America has

24:48

bought sequenced. It's a company

24:51

that for a ninety nine dollars a month subscription.

24:54

It helps connect customers to

24:56

doctors who can prescribe GLP-one

25:00

drugs, sort of way go via Ozempic

25:02

in America. And, you know,

25:04

we think of Weight Watchers as sort of either

25:06

mere be the inventor of the calorie canteen

25:08

load plans and and all that. I know

25:10

they have transitioned over the the years to

25:12

more sophisticated versions, but actually It's

25:15

their mother the Watchers model. I

25:17

was pretty much a calorie count move

25:19

more model. So

25:22

they bought sequins. And

25:24

the shares in Watchers international

25:27

surge by twenty percent as

25:29

soon as that was noticed. So it's as if

25:32

the markets and it's as if the popularization

25:34

of these drugs has

25:37

really taken hold. You know, it does

25:39

sort of suggest a trivialization in

25:42

sense that it's it's sort of nearly outside the

25:44

mainstream medical that

25:46

if you can get in America, you can get

25:48

ozempic on group on. So

25:51

it has to be very worrying for people

25:53

like you trying to

25:55

get a quite quite a different message across.

25:58

I think it's worrying where

26:01

for people who are living with severe and

26:03

complex obesity, becoming

26:06

a stock market agenda

26:09

item. It's worrying

26:11

for people involved in

26:13

the weight management area like myself, you

26:16

know, that's another

26:18

really negative step in trying to

26:20

deal with obesity and

26:22

the way we have dealt Historically as

26:25

a profession with other medical

26:27

conditions, which is you improve your understanding,

26:30

that that informs treatment, active

26:32

treatment, drives the need

26:35

for prevention. And you

26:38

have that cycle, if you like, of

26:40

prevention and treatment of a chronic disease

26:42

running in parallel help. But here,

26:45

you know, that that's economists

26:47

headline, ease and inject, to repeat.

26:50

You know, my heart sunk to my

26:52

boots when I read it because I said, if, you know, that's

26:55

a reason to do reputable magazine and

26:57

that's the best it can do with

27:00

a chronic disease that

27:02

is currently driving

27:05

two hundred and twenty other chronic

27:07

diseases, like type two diabetes,

27:10

like sleep apnea, like cancer, like Dementia

27:12

that are crippling our health service and

27:16

their

27:17

headline is ease inject

27:19

repeat.

27:22

Thanks very much, Donald. Thank you very

27:24

much.

27:28

That's it for today. Thanks again

27:30

to my guests, Belinda and Dr. Donald

27:32

O'Shea. For more Irish Times journalism,

27:35

subscribe at irishtimes dot com

27:37

forward slash subscribe. This

27:40

episode was produced by Suzanne Brennan and

27:42

Decathlon Conlon. In the news, we'll

27:44

be back on Wednesday.

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