Some time ago, a girl knocked at the clinic of hypertensive pathologist Maria Poikilidou in Thessaloniki. “She asked me to prescribe her a medicine for obesity. She was young with a body mass index of 26, meaning she had five extra pounds and had no other health problems. I explained to her that she was not eligible for injections because she was not obese and that she could lose her desired weight relatively easily through diet and exercise. “I mean, what should I do, go get fat and come back?” he answered me.”

This is one of the many cases doctors and pharmacists have to report since the discovery of new drugs to regulate diabetes that have also been found to promote weight loss (Victoza, Trulicity, Ozempic, etc., with the active substances liraglutide , semaglutide and dulaglutide), began to spread and became widely known in Greece.

Although these drugs are a valuable tool in the hands of doctors to treat type 2 diabetes and obesity, today there is a great demand for people who want to lose a few pounds without the effort of diet and exercise.

It is no coincidence that injections have already disappeared from pharmacy counters on the eve of summer. “You’ll only find them if you’re a pharmacist’s cousin,” says the typical doctor in K.

It all started about a year ago at the Met Gala in New York, where Kim Kardashian appeared in the iconic dress of Marilyn Monroe. As she told reporters, she had to lose 8 kg in three weeks to fit into a tight dress, which provoked stormy rumors about how she managed to do it. The word “semaglutide” became popular on TikTok, although Kardashian never commented on it.

In October last year, Elon Musk, known for his bad eating habits, looked noticeably emaciated. When asked on Twitter about his secret, he replied: “Interval diet. And “Vegovi” (s.s. semaglutide for the treatment of obesity). Hollywood’s most… poorly kept secret revealed.

At the recent 95th Academy Awards, host Jimmy Kimmel trolled the audience: “Looking around this room, I can’t help but wonder if Ozempic is right for me).”

Today, the #ozempic hashtag alone has 737 million views on TikTok. Several thousand also correspond to the Greeks. This is not only from those who want to quickly get a “beach” body. He is also one of those who in recent years again fell in love with himself and his extra pounds. Almost overnight, years of progress in the body positivity movement towards body acceptance were lost.

But what are these medicines and, above all, are they really “miraculous”? As Efthymios Kapandais, a diabetes pathologist and president of the Hellenic Obesity Medical Association, explains to K, these are drugs designed to treat type 2 diabetes that mimic the action of incretins, the hormones our bodies produce when we eat, to produce insulin from the pancreas and lower blood glucose levels. At some point, they were found to reduce body weight, so they can also be used to treat obesity.

“These engineered peptides appear to act in the brain’s hypothalamus region, which is the center of appetite, while at the same time inducing greater satiety and slowing gastric emptying.” In other words, the patient feels “full” faster and longer. The first substance to receive European Medicines Agency approval was liraglutide called Victoza (1.8mg) for diabetes control, according to Mr Capandais. Shortly thereafter, Saxenda (3 mg) for weight control was released from the same company (Novo Nordisk) with the same active ingredient. While Victoza has also helped obese people lose some weight, a higher dose has been found to produce much better results. Both formulations are available in Greece. In fact, by a ministerial decision in January, Saxenda was added to the list of reimbursed drugs for obese people with a body mass index > 40, established cardiovascular disease or sleep apnea. However, at the moment it has not entered the system of electronic prescriptions.

Doctors “baptize” patients as diabetics to get a prescription for drugs, or they get them from a relative with diabetes.

A little later, semaglutide, a substance developed by Novo Nordisk as a long-acting alternative to liraglutide, was approved in Europe. The reason is the anti-diabetic drug Ozempic with a maximum dose of 1 mg and the obesity drug Vegovi (2.4 mg), which are injected once a week instead of liraglutide once a day. A clinical study published in the New England Journal of Medicine in 2021 found that semaglutide resulted in an average weight loss of 15% in a group of nearly 2,000 patients, and a third of the study group lost more than 20% of their weight (liraglutide). results in an average weight loss of 10%).

Since Wegovy is not yet available in our country and Saxenda is hard to come by, doctors are reportedly prescribing anti-diabetic drugs (Victoza and Ozempic) also for weight loss (doubling the dosage).

Patients are “baptized” diabetics without being, or diabetics are prescribed drugs so that obese relatives can take them. Of course, special preparations can also be bought without a prescription, paying 110 euros for a monthly treatment with Ozempic (Saxenda costs 240 euros). Prescription participation 10%. It is noted that the treatment takes months, so the total cost can be high. But not as much as in America, where a box of Ozempic costs over $1,000.

The above leads to the fact that diabetics are deprived of the drugs they need. An apothecary in central Athens, who wishes to remain anonymous (his data is in our possession), says the demand is huge. “People without much weight problems come and ask for Ozempic or Trulicity (an anti-diabetic drug with the active ingredient dulaglutide). Most often they come by prescription for diabetics. We can’t say anything since it was written by a doctor. Others ask for it privately, without a prescription. But somehow we don’t find medicines for people who really need them.” Everything is in short supply today. “I owe five Trulicities at 0.75mg and four at 1.5mg,” he says. “We have exhausted the mood for walking in a pandemic. People forgot to try. He wants a magic pill—or a magic injection, for that matter.

Demand in the region is also high. Ms. Dina Kefala, a pharmacist from Karditsa, tells K characteristically: “They desperately ask for them because they have a slight effect. There is a war going on with Ozempic and Saxenda over who gets the box. It is naturally in short supply. Ozempic they find a way to label him diabetes. The trend in society towards easy weight loss without changing habits is very strong.”

However, according to experts, drugs can actually help many people. 63% of Greeks over the age of 18 are overweight or obese. Obesity is not an aesthetic problem, it is a disease with serious health consequences. “I have morbidly obese patients who receive these injections and pay significant monthly fees,” says Ms. Poikilidou. “But if you think about the fact that they have been giving psychologists, nutritionists, drugs a balm for them all their lives in tears.”

When she finished her residency 10 years ago, there were no such drugs in the arsenal of doctors when it came to obesity. “We had Xenical, but it had terrible side effects and there was no long-term cure. Few people stop taking modern drugs because of side effects (the main ones are nausea, vomiting, diarrhea, constipation). They are usually mild and patients tolerate them with significant weight loss. In the hands of an experienced doctor, that is, with good nutrition, the drug works. Unfortunately, not everyone can afford it.”

This is certainly not a panacea. The medicine only works as long as you take it. “Obesity is a chronic relapsing disease,” continues Ms. Poikilidou. “Having stopped treatment, hunger will return. According to studies, if someone stops taking medication at 20 weeks, they will gain weight again by 48 weeks if they are not careful.” As Mr. Kapandais says, either someone will change their eating behavior, or they will … take drugs all their lives. “Obesity drugs are an adjunct to a balanced diet and activity.” It is noted that there is a percentage of patients in whom they have no effect. “If they don’t lose 5% of their weight in the first trimester, that means they should stop treatment,” says Ms Poikilidou.

And the quiver of doctors is constantly growing. Among others, Mysimba (naltrexone and bupropion), a pill that reduces cravings for treats, will soon be back on the market, as is Eli Lilly’s Mounjaro (tirzepatide), which has been found to result in a 22% weight loss, a weight loss percentage usually achieved. only with bariatric surgery. Given all these developments, experts believe that the number of bariatric surgeries will decrease in the future.

“It is estimated that the obesity drug market could reach $150 billion by 2031, moving closer to the current cancer drug market,” concludes Ms. Poikilidou.

$150 billion By 2031, it is estimated that the turnover of the obesity drug market could equal that of the current cancer drug market.