Lottie Moss and the hospitalization for anti-diabetic drug abuse, what it is and how it works

Born as antidiabetics, they are now also used to treat obesity. Often even inappropriately, when there is no need, such as model Lottie Moss, younger sister of the more famous Kate Moss, rushed to hospital after taking high doses of Ozempic* – the first of these drugs – which caused her to have convulsions, an epileptic seizure, and severe dehydration. But how do they work and what are the risks associated with taking the new weight-loss drugs?

Ozempic – we read on the website of the Mario Negri Irccs pharmacological research institute – is the commercial name of semaglutide developed by the Danish pharmaceutical company Novo Nordisk. For some time it has been in the spotlight on social media, and not only, as a ‘miracle’ medicine for losing extra pounds. It is not only sought by obese subjects, that is, people with a body mass index greater than 30 kg/m2, but also by many overweight people, disappointed by the unsatisfactory results obtained both from sports practices and from the most diverse diets.

The drug is part of the family of Glp-1 agonists, which mimic the action of a natural hormone, glucagon-like peptide-1, or Glp-1. These drugs were created with a specific use: the treatment of type 2 diabetes. Their mechanism of action – explain the experts at Mario Negri – involves an increase in the production of insulin, the hormone that lowers blood sugar levels. Furthermore, these drugs reduce the secretion of glucagon, the hormone that increases glycogenolysis, i.e. the release of carbohydrates that are stored in the liver. They thus allow blood sugar levels to be kept under control. By mimicking the behavior of the Glp-1 hormone, they also have the ability to slow down gastric emptying after food intake and reduce appetite by sending satiety signals to the brain. Hence the increasingly widespread use of them to lose weight.

When these effects were noted in clinical trials and in population use, some doctors began to prescribe Ozempic as an obesity remedy ‘off label’, that is, to treat health problems other than those for which the active substance was originally developed. For this reason, about three years ago Novo Nordisk applied for approval for a new drug called Wegovy, which is essentially Ozempic, but with a higher dosage and specifically designed as a remedy for obesity. It has been approved in the European Union since the beginning of 2022 and has won the ‘discovery of the year’ award.

These drugs have become extremely popular, but who can they be prescribed to? In Italy, semaglutide is reimbursed by the National Health System only for the treatment of adults with inadequately controlled type 2 diabetes mellitus, in addition to diet and exercise. The Italian Medicines Agency Aifa, taking on board the positive assessment of the European Medicines Agency, has also approved the drug for the treatment of obesity. In this case, however, Ozempic is paid for.

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