If you’ve turned on any form of news broadcast over the past six to twelve months, you probably would have heard the name Ozempic, or Semaglutide, being thrown around. It has been reported widely across the media as a miracle for those seeking to lose weight.
But what exactly is it? How does it work? And should athletes be allowed to use it to shed a few extra kilos?
WHAT IS OZEMPIC/SEMAGLUTIDE?
Ozempic, which goes by the drug name Semaglutide, is a glucagon like peptide-1 (GLP-1) receptor agonist. It is available in a once weekly injection, which is the Ozempic name people are familiar with . Semaglutide is also available as an oral tablet, taken once a day under the brand name Rybelsus.
Semaglutide, in both oral and injectable forms, has been approved by the Therapeutic Goods Administration (TGA) for use in the treatment of type-2 diabetes. It works by increasing insulin production, which helps to keep blood sugar levels in diabetics under control.
OZEMPIC/SEMAGLUTIDE FOR WEIGHT LOSS
As already stated, Ozempic, or Semaglutide, has received a rather lot of attention as a weight loss drug. It can help with weight loss by both reducing appetite, as well as delaying gastric empying, which can make you feel full for longer.
Despite its popularity and promotion, Semaglutide has not actually been approved for use as a weight loss treatment. It is only indicated for the treatment of type-2 diabetes. The supply of Semaglutide for weight loss is known as “off label” prescribing.
Due to a world wide shortage, the TGA has actually advised doctors not to prescribe Semaglutide for weight loss. Diabetics are struggling to access the drug due to the large number of people seeking it for weight loss. Many pharmacies are also refusing to supply it unless a patient has a prescription specifically for the treatment of diabetes.
OTHER TYPES OF GLP-1 MEDICATIONS
There are a number of other drugs within the same class as Semaglutide. One such drug, Liraglutide (Saxenda), has actually been approved for weight loss; and it has been available for many years. However, this drug has not been overly popular, with cost restrictions being one of the reasons.
Newer drugs within this class, such as Mounjaro (Tirzepatide), have also only been approved for type 2 diabetes treatment. However, they are already being widely prescribed and used for weight loss benefits.
The maker of Ozempic, a drug company known as Novo-Nordisk, have also developed a form of Semalgutide known as Wegovy. They are seeking to have this approved as a treatment for weight loss; but at the moment, it is not available in Australia.
SHOULD THESE DRUGS BE BANNED IN SPORT?
For many sports, weight plays an important role. Lower body weight, as well as lower body fat content, can improve the performance of athetes in most sports.
Higher body fat can have a negative impact on range of motion, endurance and balance; whereas lower body fat levels can improve agility and speed. Athletes competing in sports with weight classes can definitely benefit from shedding excess kilograms, in order to be classified in a lower weight category. In addition, there are also many sports which are particularly sensitive to overall body weight. Put simply, some sports benefit from athletes being lighter.
With this in mind, some athletes may be looking at additional measures to eliminate unwanted kilograms, or to keep their body weight at a minimum. Banned drugs such as Clenbutrol have been abused in the past; and substances such as Semaglutide, or indeed some of the other molecules in this class of drug, are susceptible to abuse.
WHAT IS THE CURRENT STATUS?
Currently, none of the GLP-1 drugs are on the WADA banned list. Most interestingly, Liraglutide (Saxenda), which has been available as a weight loss drug for many years now, is currently classed as a “not prohibited” substance.
As of 2024, WADA will place Semaglutide (Ozempic) on the monitored substances list. This means that they will be closely looking at any potential use/abuse of this drug by athletes. But with the potential for other molecules within this class of drug to be used by athetes for weight loss, does WADA need to put a blanket rule in place for all these substances?
WHAT NOW?
At this point in time, these types of drugs, particularly Semaglutide, are not banned substances. However, the research is clear that these medications can be used to achieve weight loss. The research also indicates that the resultant weight loss can lead to improved body mass composition; reducing body fat above lean muscle, which can improve sporting performance.
As these types of drugs continue to be used and are promoted for weight loss, there is a chance they will gradually creep into the sporting world. WADA have obviously noticed this. They will surely be keeping a close eye on the potential abuse of not only Semaglutide, but also any existing and new molecules which may appear in this class of drug.
……and for anybody out there wanting to improve their performance by losing a bit of excess weight, this is not the way. Please speak to your coach, your dietician, your doctor, or your pharmacist. There are much healthier ways to keep you weight in check as an athlete.
The Sports Pharmacist 