Thinking Critically About Drug-Induced Weight Loss

Wegovy and Ozempic are trade names of an injectable drug that is reported to help people lose weight. Should we believe what we’re hearing about them?

By Dave Hendry, Co-Founder, eSavvyHealth

Regular injections of drugs that reportedly can help people lose weight have suddenly become a quite popular topic in the news. Coincidentally, not long ago we published an Insight on the subject of critical thinking. This seems like a good opportunity to apply some of those techniques of critical thinking to the news we are seeing.  

Here’s the first critical thinking question that we recommended: 

Question #1: Are the sources of information reliable—do they have expertise in the subject they are providing information about?

  1. Are they experienced in this field?
  2. Are they recognized experts?
  3. Do they have any sort of financial interest in making me believe what they’re saying?
  4. Do those who endorse this author or support their work have any sort of financial interest in making me believe what they’re saying?
  5. Have I read other articles by this author that have proven to be true?

Two of the types of sources of information that I’ve seen quoted in recent articles are celebrities and a technology industry leader (not biotechnology). None of those people have (or claim to have) any expertise in the fields of nutrition, health, or biochemistry. Even if one just considered these statements to be their reports as “test subjects,” their lifestyles are extremely dissimilar to that of 98% of the American population (and a higher percentage of the world population), so their experience is not generalizable. Conclusion: Their thoughts on this matter, while possibly well-intended, should be ignored. 

Another source of information is the FDA, an organization which presumably does have considerable expertise in this field. The FDA has approved these drugs based on study results presented to them by the companies who were applying for that approval, and those researchers can also be presumed to be experts. That takes care of Question 1 parts (a) and (b). But then we come to part (c), and discover that these injections cost on the order of $1,000 a month. The pharmaceutical companies who submitted applications for those drugs stand to make billions of dollars every year based on that approval. On the face of it, the companies’ reports are therefore highly suspect, and consequently the FDA approval that is based on them is, unfortunately, not reliable.  

That doesn’t mean no information can be gathered from the reported study results. It’s safe to assume that the drugs did not have better outcomes than these reports indicated. We can infer, then, that unfavorable information reported about these drugs is probably reliable. Along that line, two facts emerged, though it required a little digging to turn them up: 1) People who quit taking the drugs were likely to regain much of the weight they had lost, and 2) The drugs have many side effects, and in fact carry what’s called a “black box warning,” which is “the highest safety-related warning that medications can have assigned by the Food and Drug Administration…intended to bring the consumer’s attention to the major risks of the drug.”1

Let’s also consider critical thinking question #3: 

3) Does this seem true or false to me based on other things that I know to be true or false? 

In view of the fact that we’re talking about injections that at least some people are likely to have to continue to take to maintain the drug-induced weight loss2, we might reasonably expect that such drugs would have been tested for 5 to 10 years on subjects. But that didn’t happen—the trials conducted by the drug developers lasted just 16 months. So we have to ask ourselves: Does it make sense that a 16-month trial would reveal health risks that might result from years of monthly injections? 

My own conclusion: There’s no reason to believe that these drugs do not pose significant health risks.

Which is not to say that no one should ever take them. The obesity often associated with diabetes presents its own serious health risks. Someone with reason to be concerned about those risks might well decide they outweigh the unknown risks of these drugs. Thinking critically doesn’t necessarily make it easy to make that decision, but it can help to ensure that the decision is based on reliable information—or at least not based on unreliable information. 

References:

  1. Black Box Warning
  2. Bodyweight rebounds after semaglutide withdrawal

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