Some Jamaicans are sourcing diabetes medication solely for weight loss, in keeping with a new trend, which one medical doctor hopes will be better facilitated by policy makers as Jamaica battles an obesity crisis that is costing the country billions annually.
The use of Ozempic, a drug developed for the treatment of Type 2 diabetes, is now in demand as international celebrities and social media influencers flaunt smaller figures which they attribute to the once-weekly injectable medication that is created to help manage blood sugar levels.
Dr. Alfred Dawes, a well-known general, laparoscopic and weight loss surgeon, says he has gotten a lot of requests for the drugs and knows more than a dozen Jamaicans who have travelled overseas to source it.
TREND HAS TAKEN OFF
“Once it hit Instagram and the influencers started to use it; it just took off and it is flying off the shelf,” said Dr. Dawes.
“All of a sudden, you have people becoming diabetics so they can get it [[through] Medicare because it is kind of expensive,” he told the Freedom Come Rain Newspaper.
A month’s supply of the drug costs nearly US$900. By going through Medicare and other insurance programmes in the United States, some Jamaicans have been able to get it at a cheaper cost. A prescription is needed to purchase it.
Ozempic has received widespread media attention in recent months. According to several reports, the overwhelming demand has created concerns about supply shortages for diabetics who really need the drugs. Ozempic was listed as being in short supply on the FDA’s drug shortage website late last year.
Dr Dawes believes the use of medications, and not just diet and exercise, should form part of Jamaica’s obesity weight loss treatment protocol as is the case in other countries like the US and the Cayman Islands. By tackling obesity, he feels the country will be staving off an increase in non-communicable diseases (NCDS).
According to the Jamaica Health and Lifestyle Survey (2016-2017), one in two Jamaicans (54%) aged 15 years and over were overweight/obese. The data further revealed that women are more affected by overweight/obesity, with two-thirds of Jamaican women 15 years or older being overweight or obese. The survey is done every 10 years.
MORE OBESE WOMEN
All of the persons Dr Dawes knows that have sourced the drugs are women. He is not surprised, given the fact that obesity is twice as high among women than men, based on the national data. This he feels is for several reasons. Among them is the fact that men tend to be labourers which means they spend more time doing physical work, while Jamaica has a large number of females who work in sedentary jobs. There is the fact that women tend to be emotional eaters who snack when stressed, while men tend to relieve stress by playing sports with friends.
Added to this is the proliferation of fast-food venues and existing cultural views.
“It is culturally accepted for females to be fluffy in Jamaica,” he said. Obesity is a risk factor for noncommunicable diseases, which causes 78 percent of all deaths in Jamaica, according to the Pan American Health Organization. It is for this reason that he recommends that drugs like Ozempic, be made available locally so it can be taken by those wanting to lose weight.
“It curbs the appetite, so you don’t eat as much and you feel full quicker when you eat, so you consume fewer calories and you can lose about 15 to 20 per cent of your excess body weight, which is similar to some of the non-invasive bariatric procedures out there,” said the surgeon, who is a former president of the Jamaica Medical Doctors Association. (JMDA)
The active ingredient in Ozempic is semaglutide, which has been approved by the FDA at higher doses for treating individuals living with obesity and other weight related medical problems under the name Wegovy. Ozempic has not been approved for weight loss by the FDA.
THE FIGHT AGAINST OBESITY
“I think it really is something that should be incorporated in the fight against obesity. It is a tool, it is not a panacea, it is not a silver bullet,” said the doctor who noted that the drug will help people change their relationship with food by helping them to eat less.
Dr Jacqueline Campbell, a medical doctor and author of the book, A Patient’s Guide to the Treatment of Diabetes Mellitus, has just one concern relating to the use of diabetes drugs for weight loss.
“We know we have off-label use of drugs, but we have to keep in mind all the time, the safe use of a drug. So, to me, if someone is taking a pharmaceutical agent and let us say it is not prescribed by a medical practitioner, the issue of safety would be foremost in my mind,” she said, adding that using the drug off-label does not constitute an abuse of the drug if it is taken as prescribed.
Metformin is currently the most prominent drug used in Jamaica for the treatment of type 2 diabetes. Dr Campbell noted that weight loss is one of the most obvious side effects of this medication.
“Metformin is the first line drug in any treatment of type 2 diabetes and it is very efficacious for those diabetics who are obese; who are overweight. As a result of how the drug works, it causes weight loss,” said Dr Campbell, who is not aware of persons using metformin for weight loss.
Dr Dawes does not recommend using metformin for weight loss because it has a number of gastro intestinal side effects.
According to the Jamaica Health and Lifestyle Survey 2016-2017, aapproximately 236,200 Jamaicans 15 years and older have diabetes.The prevalence has increased by 41.1 per cent from 2001 to 2017 among Jamaicans 15 to 74 years old. A little over 92 per cent of those 15 years and older with diabetes are on treatment. Of those on treatment only 27.5 per cent are controlled.
A study developed in conjunction with WHO and UNDP estimates that Jamaica’s economy will lose over $77.1 billion Jamaican dollars between 2017 and 2032 due to the costs of cardiovascular disease and diabetes complications alone.
“It is a crisis, because we cannot afford to treat lifestyle diseases. Lifestyle diseases are expensive. If you were to treat lifestyle diseases the proper way, it would bankrupt the health system,” he said.
