Revolutionary new class of weight loss drugs offers hope and frustration

The new class of weight loss drugs is changing the way Americans and their doctors treat obesity.

The diabetes drug Ozempic and its sister Wegovy — specifically marketed for treating obesity — use semaglutide, which targets a particular gut hormone.

"The medication works by making you feel fuller helping you to regulate your weight." said Dr. Amanda Velazquez, director of obesity medicine at Cedars Sinai Center for Weight Management and Metabolic Health.

For many patients, talk of the new drugs sounded too good to be true.

"Initially I was like everyone else: Another magic pill that they’re trying to sell us because that’s what a lot of it has been up until now," said social media influencer Kiki Monique. The true crime podcaster was struggling to see results from diet and exercise and began to consider Wegovy.

They’re changing your biology. If you take the medicine away, your body reverts back to what it was doing.

Dr. Amanda Velazquez, Cedars-Sinai Center for Weight Management and Metabolic Health

"Even when you’re doing those right things, sometimes stress, lifestyle, your body just shuts down." said Kiki Monique. "Even if you are eating right, and you’re working out, you still can’t lose weight, and you’re just like, 'What am I doing wrong?'"

"I think because of societal norms, we still think of it as a lack of willpower, you just need a metabolism boost," said Dr. Velazquez. "But that’s not how they work. They’re changing your biology. If you take the medicine away, your body reverts back to what it was doing."

Velazquez said semaglutide and tirzepatide are part of a new class of medications that mark a turning point in treating obesity and chronic diseases associated with it.

But insurance isn’t always on board. Kiki Monique was first denied coverage.

"I think insurance is so used to certain disease being lifelong, and they’re like, 'OK, yes, we can prescribe this, but no, this is too new. We don’t know about this.'"

Paying for Wegovy out of pocket was something NBC4 assignment editor Jamie Bankson considered.

"Can I afford to do this myself if I wanted to pay for it? I was seriously thinking about it," Bankson said. But she decided that at a thousand dollars a month, "that’s just too much."

She said she’s struggled with her weight for decades.

"Even In the last five years, I’ve lost 100 pounds and picked a lot of it back up."

She hikes regularly, counts calories and attends WeightWatchers. But the scale’s not budging, and her blood pressure is too high. She finally decided to talk to her doctor about the medication, got approved by insurance, then tried to fill the prescription.

"Basically, the pharmacy almost laughed at me. They’re like, 'It’s backlogged. We haven’t had it since summer,' and this was back in December." said Bankson. "I did the round robin of pharmacies in San Francisco, Los Angeles and Las Vegas because I have family in all those locations."

But Bankson said she heard the same thing from the drugs stores.

"Backlog, backlog backlog." 

Novo Nordisk, the maker of Wegovy, announced at the beginning of the year it was doubling production for the lower starting doses but said "overall demand will continue to exceed supply which means that some patients may still have difficulty filling Wegovy prescriptions."

"Basically, the pharmacy almost laughed at me. They’re like, 'It’s backlogged. We haven’t had it since summer,' and this was back in December.

Jamie Bankson, weight loss patient and NBC4 employee

And that has led to some weight loss patients getting their doctors to prescribe Ozempic to them, off label, disrupting the supply for diabetics. Others have turned to potentially dangerous alternatives.

"I hear about patients buying it on Facebook," said Dr. Marilyn Tan, chief of Stanford's Endocrine Clinic. "Patients end up sometimes buying various medications online. And then also I've heard about patients going to, for example, Mexico and buying it at the airport in Cabo San Lucas."

Tan also warns of med spas and pharmacies that promise a compounded version of Ozempic or Wegovy.

Novo Nordisk says it “does not directly or indirectly provide or sell bulk semaglutide to compounding pharmacies.”

The I-Team found med spas advertising “cycles” of compounded semaglutide for a month or three month. But the drugs are supposed to be a lifetime commitment, coupled with diet, exercise and lifestyle changes.

Kiki Monique eventually filled her prescription for Wegovy, chronicling her journey on Instagram where she’s stood up to some criticism.

"I think that people think fat people should be indefinitely punished forever. And it’s very odd. I feel like it’s one of the lingering forms of discrimination that’s still allowed. And I just want to fight and break that stigma."

Kiki Monique did not experience any of the common side effects of nausea, vomiting or diarrhea. She's partnered with WeightWatchers new diet drug program for ongoing support. She said she’s no longer pre-diabetic, and her blood pressure is now normal. She also said she feels healthier, and the food noise that used to monopolize her thoughts is gone. 

Kiki Monique has lost 65 pounds, but for patients like Jamie Bankson, it's a waiting game with no end in sight.

"I think the biggest thing people need to know is there is this fantastic drug that’s out there that is helping a lot of people, but it it’s just not accessible."

Dr. Velazquez said she works with her patients on a plan B, C and D because there’s no telling when supply chain issues could interrupt prescriptions or insurance could change.

But considering only 2% of people who qualify for the medications are currently taking them, she said the demand will only grow. 

Dr. Velazquez and Dr. Tan both received modest payments from Novo Nordisk as consultants beginning in 2022.