Revealed: How did prescription blood sugar-lowering drugs become a “weight loss magic tool” available to everyone?

"Do you have 'slimming injections' for sale here?"

"'Weight loss injection'? Are you talking about semaglutide? We're out of stock. Please join a group first. I'll notify you when it's in stock..."

"I can buy it once it's in stock, right? I don't need to go to the hospital to get a prescription, right?"

“No, we can prescribe it here. It would be even better if you have an electronic prescription from an online (medical e-commerce platform)…”

Prescription hypoglycemic drugs have been turned into "weight loss injections" and are being sold out in many places

The above scene is a conversation between Li Xu (pseudonym) and a staff member at a physical pharmacy in Beijing. It was this conversation that lifted the veil on the illegal and abused "weight loss injections" that are popular all over the Internet and the market chaos that is rampant.

Initially, Li Xu started to pay attention to "weight loss injections" when he was browsing Xiaohongshu. After seeing various bloggers posting about how they easily lost dozens of pounds after using "weight loss injections", he, who believes that "thinness can hide a hundred uglinesses", could not help but develop a strong curiosity about this magical "weight loss injection".

Introduction and sharing of various videos on short video platforms

Searching for the keyword "weight loss injection" on major platforms often yields three results: the informal term for Chinese medicine acupuncture weight loss treatment, weight loss injections of botulinum toxin or lipolysis injections that fall under the category of medical beauty, and the so-called "weight loss injection" that has been popular on the Internet in the past two years - a new type of prescription drug called glucagon-like peptide-1 receptor agonist for the treatment of diabetes. Currently, the prescription drugs of this type approved in China mainly include polyethylene glycol loxenatide, semaglutide, liraglutide, exenatide, dulaglutide, etc. These injections, in addition to lowering blood sugar and blood lipids, can also inhibit gastric emptying to keep the recipient feeling full for a long time, thereby suppressing appetite, reducing food intake, and having a direct weight loss effect.

Various recommendations and discussions about semaglutide on the Xiaohongshu platform

In other words, using this "weight loss injection" does not mean that the drug has some magical effect of weight loss, but it allows you to achieve the weight loss effect of "I am losing weight due to hunger" with the psychological feeling of "I am not hungry"!

Of course, in this era where personal feelings and experiences are generally valued, the personal perceptions of actively resisting hunger and passively not being hungry are completely different. This is probably the main reason why this type of product is so popular.

After searching on major platforms, Li Xu found that among the above-mentioned glucagon-like peptide-1 receptor agonist injections, the most popular one is Novo Nordisk's semaglutide injection (Novotec). The drug was approved by the National Medical Products Administration (NMPA) in April 2021 for the treatment of type 2 diabetes (T2DM) in adults and to reduce the risk of adverse cardiovascular events in patients with T2DM and cardiovascular disease, and was included in the medical insurance catalogue at the end of 2021.

This drug is a long-acting drug that only needs to be injected once a week. Patients can use it at home, which is convenient and fast.

In addition to the convenience of usage, the current promotion of this drug in the domestic market has also, to some extent, fueled off-label and off-prescription use.

As early as June 4, 2021, Novo Nordisk China's official website announced that the US FDA approved Wegovy (semaglutide 2.4 mg subcutaneous injection once a week) for chronic weight management, suitable for obese (BMI ≥ 30kg/㎡) or overweight (BMI ≥ 27kg/㎡) adults with at least one weight-related comorbidity.

Since then, news such as "The U.S. Food and Drug Administration (FDA) has approved the use of semaglutide as a weight-loss drug, and semaglutide has also been applied for weight-loss indications in China and has entered the clinical trial stage..." began to flood various media, self-media and traffic platforms.

Online e-commerce prices and store promotions

In this context, the sales of semaglutide are extremely hot. When searching, Li Xu found that the price of the 1.5ml specification of the drug on the online shopping platform is between 650-860 yuan, while the price of the 3ml specification is between 1280-1430 yuan. According to people familiar with the matter, the price fluctuation is mainly related to the drug demand in the area where the drug sales agency is located.

In other words, this blood sugar-lowering prescription drug may have been sold out in some areas under the name of "weight loss injections"!

Li Xu searched major drug sales e-commerce platforms, online second-hand trading platforms, short video platforms, and went to hospitals to register for prescriptions and physical pharmacies to inquire. He found that on well-known pharmaceutical e-commerce platforms in the industry, the platform will directly issue electronic prescriptions and sell drugs after a simple communication between online doctors and buyers. There are no obvious obstacles in the whole process. In the two physical pharmacies that Li Xu randomly entered in Beijing, semaglutide was out of stock. One of the pharmacies asked Li Xu to join the store's WeChat group and said that he could come to the store to buy it directly after the goods arrived, and he did not need to go to the hospital to get a prescription in advance. Although the other pharmacy was relatively cautious, it still revealed that it could sell drugs after registering identity information.

In the medical e-commerce business, merchants clearly stated that they can prescribe on behalf of others.

It can be seen from this that although it costs more money, it is still easy and convenient to buy semaglutide, provided that it is in stock.

During this process, no one cares whether the buyer is using the drug to control blood sugar or lose weight, and no one tells them whether they meet the applicable criteria for the drug, whether there are any safety risks in using the drug, what are the instructions for using the drug, and what to do if adverse reactions occur.

Semaglutide is not absolutely safe, and it is not suitable for everyone!

As mentioned above, the drug has strict applicable standards in my country. Even though Novo Nordisk China claims that it has applied for semaglutide in China and entered the final stage of clinical trials for weight loss indications, the results of the China Drug Evaluation Center's implied approval query on the drug's clinical trials also clearly pointed out that the intended approved population for semaglutide should also be obese patients with an initial body mass index (BMI) ≥ 28 kg/㎡; or overweight patients between 24 kg/㎡ and 28 kg/㎡ with at least one weight-related comorbidity. As for slightly obese or even normal-weight people, the benefits and risks of using semaglutide are still unknown.

In other words, even if domestic regulatory authorities approve the use of semaglutide as a weight-loss drug in the future, it will not be available to everyone.

This is the case even in the United States, where the drug has been approved for weight loss indications. Wang Shaocheng, deputy chief physician of the Department of Endocrinology at Tsinghua Chang Gung Hospital affiliated to Tsinghua University, pointed out in an interview with Beijing Daily on August 24, 2022 that for semaglutide, the U.S. Food and Drug Administration (FDA) has strictly restricted its indications for weight loss: it is suitable for patients with a body mass index (BMI) ≥ 30kg/㎡ in the adult population; overweight adults (BMI ≥ 27kg/㎡) with at least one weight-related disease (such as hypertension, type 2 diabetes, high cholesterol).

Therefore, Wang Shaocheng suggested that doctors should not blindly use semaglutide to help patients lose weight in clinical practice, especially the following groups should use this type of drug with caution: patients with hypoglycemia, those with a history of pancreatitis, those with renal insufficiency, patients with medullary thyroid carcinoma or multiple endocrine tumors, pregnant and lactating women, and patients with diabetic retinopathy.

In addition, patients who are severely allergic to semaglutide or excipients (sodium hydrogen phosphate dihydrate, propylene glycol, phenol, hydrochloric acid, sodium hydroxide) should stop using the drug immediately and seek medical attention if they suspect a severe allergic reaction. Patients who are taking oral medications at the same time should also be aware that semaglutide can slow gastric emptying, which may cause the body to absorb oral medications more slowly.

It can be seen from this that semaglutide is definitely not the kind of "magic weapon" for weight loss that is "safe, has no side effects, and is suitable for anyone" as claimed by various short videos, notes and self-media authors.

Related search terms stated by semaglutide users

After all, semaglutide is a medicine! According to public information, common adverse reactions of semaglutide are gastrointestinal reactions, including satiety, anorexia, nausea, vomiting, diarrhea, constipation, etc., and Feng Wenhuan, chief physician of the Department of Endocrinology at Nanjing Drum Tower Hospital, also said in an interview with the Yangtze Evening News in June 2022 that patients using semaglutide are at risk of gallstones. With the popularity of the drug, there are more and more statements describing the consequences of using semaglutide on major traffic platforms and search platforms.

Faced with these facts and the ancestral motto that “all medicines are poisonous to some extent”, how could these bloggers, UP hosts, and answerers easily violate it?

A grain of sand in the industry chaos is a mountain on one's head

In fact, compared with the exaggerated dissemination of various "sales promotion parties" and the lax supervision of the platforms they belong to, the impact of the off-label use and illegal sale of semaglutide, a prescription glucose-lowering drug, as a "weight loss injection" in the market is even worse and more shocking.

At a time when medical technology is not yet developed, human declaration science is far from being fully explored, and the causes and treatments of many diseases are still in a state of fog, both traditional Chinese medicine and modern Western medicine are still in the stage of treating many diseases according to the individual and the disease. Many prescription drugs must be used in specific scenarios and course management. The attending physician must randomly adjust according to the patient's course of disease and individual conditions in order to achieve the relatively best efficacy and avoid risks as much as possible. This is far from being controlled by the patient himself or even non-professionals. Therefore, strict control of prescription drugs and even the entire pharmaceutical industry environment is necessary, and it is also the protection of the state and relevant regulatory authorities for the citizens.

However, the phenomenon of over-indication sales and abuse of semaglutide, which is regarded as a "weight loss injection", shows that there are still many chaos in the sale and use of prescription drugs in my country's pharmaceutical market, and these chaos may eventually lead to tragedies for patients. A grain of sand in the industry may be far more than a mountain when it falls on the heads of individuals and even families...

References:

[1] Popular Science on Weight Loss Injections

https://lemon.baidu.com/ala/articles?q=%E5%87%8F%E8%82%A5%E9%92%88&from=5716

[2] National Medical Products Administration, “Announcement of Information on Drug Approval Documents to be Collected on April 29, 2021”

https://www.nmpa.gov.cn/zwfw/sdxx/sdxxyp/yppjfb/20210429162506168.html

[3] Center for Drug Evaluation, National Drug Administration

https://www.cde.org.cn/main/xxgk/listpage/4b5255eb0a84820cef4ca3e8b6bbe20c

[4] Beijing Daily: Can the “magic slimming injection” really give you a sexy body? Is it really free of safety risks?

https://www.takefoto.cn/news/2022/08/24/10138543.shtml

[5] "Yangtze Evening News" Lose 10 pounds in two weeks! Is the popular "weight loss injection" reliable? Professional doctors: It is actually a type of hypoglycemic drug that has the effect of reducing weight

https://baijiahao.baidu.com/s?id=1735880713648800387&wfr=spider&for=pc

Note: This article is an original article from NetEase (Yanjianweishi) and may not be reproduced without permission.