Author: Liang Xiang Editor: Gong Zheng
On June 25, semaglutide injection (trade name: Novo, Wegovy) for weight loss indications was approved for marketing in China. In the past few years, semaglutide has been passed on by word of mouth among people who are losing weight with its legend of "losing 10 pounds a month", as well as its relatively safe and easy-to-obtain characteristics.
Today, on average, 1 in 3 people on the mainland is overweight and 1 in 6 is obese. Projections show that the global adult population with obesity will double from 810 million in 2020 to 1.53 billion in 2035. The official approval of semaglutide has opened up a new solution to the global public health problem of obesity. However, under the discipline of social aesthetics, some young people who are not obese have also begun to abuse the so-called miracle drug, and even turn a deaf ear to the side effects of the drug.
"Miracle medicine for weight loss", after losing 10 pounds a month and installing needles, Miss Wang from Wuhan was a little stunned for a while.
It's the summer of 2022, and Miss Wang, who is 1.6 meters tall and weighs 128 pounds, is determined to lose weight. Exercise and fitness, fasting, liposuction surgery and other means have created challenges to the perseverance, desire, time and even wallet of dieters. Mountains that are difficult to lose weight are stacked like fat.
At this time, Miss Wang heard about a "miracle drug" - semaglutide. It doesn't matter if the name is hard to remember, the important thing is that it is said to "lose 10 pounds a month, the price is not expensive, the side effects are not large, and there are many places where you can get it." ”
"A lot of places" in the mouth of friends refers to gray channels. In regular hospitals, semaglutide is only approved for blood sugar control in adult patients with type 2 diabetes, and weight loss is an additional feature that cannot be easily obtained.
Through a friend of a medical representative, Miss Wang finally saw the rumored "miracle drug" at the manufacturer: a small tube similar to a ballpoint pen, 1.5ml of liquid contains about 2mg of semaglutide, 500 yuan a piece. Semaglutide is inactivated by heat, and the temperature must be controlled from 2 °C to minus 8 °C, and it can only be transported in the cold chain. Due to the special channel, after handing over the money and delivering the goods with the other, the semaglutide that Miss Wang got was hidden in an ice pack and dripping with water in the hot summer sun.
Miss Wang's heart was racing and she quickly took a taxi home, "It feels like I'm involved in a smuggling business like an organ transplant." ”
I don't have a doctor's advice, so I can only read the instructions by myself. Ms. Wang turned the syringe to reach the recommended amount of 0.25mg for the first injection, but after aiming the needle at about 3 cm of her belly button, Ms. Wang hesitated for a few minutes.
When I close my eyes, I feel almost no pain. It seems that the body has not changed much.
It was only after dinner that Miss Wang realized that she had no appetite at all—the injection of medicine had worked.
As a GLP-1 receptor agonist, semaglutide mimics the GLP-1 hormone released in the gastrointestinal tract after eating, which not only lowers blood sugar, but also gives people a long-term feeling of fullness for a few days. The temptation of food, which was originally difficult to resist with will, was easily dismantled.
A month later, Miss Wang, who was on a drug diet, lost seven or eight pounds. After tasting the sweetness, Miss Wang made another move and shared three injections. In just two months, his weight dropped from 128 pounds to 104 pounds. It seems that the rumors in the rivers and lakes are true, and the use of semaglutide is indeed 10 pounds per month on average.
With the cooperation of fasting, running for 1 hour a day and losing 10 pounds also have to run for 3 months; If you really choose liposuction, the cost is 1~30,000 yuan according to different parts; The choice of semaglutide, one injection per week is painless, and the cost performance is leading in all aspects.
Even if you can't find the manufacturer directly like Miss Wang, you can easily buy it by clicking on the e-commerce platform on your mobile phone. The price of the same 1.5ml semaglutide injection ranges from 600~900 yuan.
The trend of Miss Wang helping her girlfriend buy medicine to lose weight has long been irrelevant to gender, and more and more men are also flocking to semaglutide.
Cheng Yue and Fleck from Beijing, one is a host and the other is a graphic model, for professional reasons and personal needs, they also joined the army of semaglutide in the summer of 2022. "If you don't cut it down, you won't get a job."
With the help of friends with diabetes or e-commerce platforms, Cheng Yue and Fleck both got the miracle drug for weight loss in their own way, and they both successfully lost more than ten pounds in a month.
30 years old, 1.72 meters tall, 138 pounds in weight, Xiao Zhuang, in order to achieve the goal of weighing 120 pounds, also got the so-called "weight loss miracle drug" from drug dealers in 2022, "Losing weight is completely for stinky beauty." ”
After spraying, a whole wheat loaf in the morning will keep you feeling full until the afternoon. Eat some salad at noon and some boiled vegetables in the evening, and Xiao Zhuang's body has no hunger reaction.
"According to the most scientific, nutritious, and most weight-losing way to eat, if you eat less oil, less salt, and less sugar, you can't resist it for a few days. I would be very hungry, very hungry at tea time, especially at night when I went to bed. But with this medicine, I was able to stick with it easily. ”
Two months later, Xiao Zhuang overfulfilled the task, and his weight was as low as 114 pounds - a full 24 pounds.
Xiao Zhuang began to recommend semaglutide to the people around him, even his 57-year-old mother, who also recommended it to his close neighbors.
When asked how he dared to give his mother a prescription drug that he had obtained privately, Xiaozhuang replied: "So many diabetic patients older than my mother have been using it for a long time, and there will be no problem with the safety of this drug." I believe in the weight loss effect of this drug. ”
Rebound, young people tied up with diet pills
There's no denying that humans are getting fatter.
According to the World Obesity Report 2024, the number of adults affected by overweight/obesity will increase from 2.2 billion in 2020 to 3.3 billion in 2035, and the global share will rise from 42% to 54%. It is unimaginable that in the future, half of the people walking on the street will be plagued by obesity.
In addition to bloated appearance, obesity is exacerbated by cancers (tumors), coronary heart disease, stroke, diabetes, and other diseases that can lead to death. High blood pressure, hyperlipidemia, metabolism-related fatty liver disease, atherosclerosis, gallbladder disease, etc. can also come to the door due to obesity.
Data source: World Obesity AllianceWhen overweight and obesity are increasingly becoming a public health problem that needs to be solved urgently around the world, the popularity of semaglutide has more significance. In Nature's 2023 Top 10 People of the Year, Moisov was named for identifying glucagon-like peptide-1 (GLP-1). Her research and development laid the core foundation for the birth of semaglutide.
In October 2022, Tesla CEO Elon Musk posted on social platforms that he had lost 18 pounds a month by relying on regular fasting and Wegovy.
Wegovy, trade name Novo, is a semaglutide injection developed by the Denmark pharmaceutical company Novo Nordisk. The opinion leader's speech caused Novo Ying's global sales to skyrocket, and at the same time, it also led to the global shortage of Novo Tey, a sibling product whose main active ingredient is semaglutide.
Novotech is mainly used for the treatment of type 2 diabetes, and it is also the main product traded privately in China. The crazy rush of a large number of people who lose weight once made it difficult for diabetics who really needed this drug to be treated.
Although the ingredients are similar, there is still a strict difference between Novo Ying for weight loss for injection and Novo Tec for hypoglycemic injection from a pharmacological point of view. It is worth noting that semaglutide injection currently approved for weight loss in China is Novo Ying, not Novotech.
Even if it is approved by Novoying, there are two groups of people who are pharmacologically applicable:
- Obese people with a BMI of > 30.
- 27≤ people with a BMI of ≤30 but one or more overweight-related comorbidities, such as hypertension, hyperlipidemia, obstructive sleep apnea, and cardiovascular disease.
注：BMI=体重（kg）÷身高（m）2
BMI is not applicable to exercisers and pregnant women with high muscle mass
Only those who are medically obese can get a prescription from the hospital. Young people who are thin and beautiful are still entrenched in the gray field and secretly buy medicines. As for whether it is Novo Ying or Novo Tai that they buy, it may not matter to them.
FigAfter Fleck's unapproved Novo Dangdang weight reached her target weight, Ms. Wang from Wuhan stopped taking three pills. The appetite returned, and at the same time the weight returned.
Four months later, after Miss Wang, who lost weight to 104 pounds because of semaglutide, her weight rebounded to 130 pounds - two pounds heavier than before the medication.
Miss Wang felt anxious and once again asked the manufacturer to buy semaglutide. In order to lose weight more efficiently, Ms. Wang decided to increase the dosage from 0.25mg to 0.5mg.
This time, the stomach ache of the drill heart arrived. At night, Miss Wang was so painful that she couldn't sleep, so she could only take painkillers. The pain lasted for three days, but the feeling of fullness lasted for a week. "That's the price of beauty."
With just one injection, Sister Xiao Wang was visibly emaciated, and she couldn't tell if it was because of the effect of the medicine or because of her illness. For the second injection, Miss Wang gritted her teeth and chose a dose of 0.5mg. This time, she was so painful that she almost fainted and was taken to the hospital.
In the face of the doctor's inquiry, Miss Wang did not tell the truth anyway. Eventually, the condition was diagnosed as "stomach cramps". The doctor tactfully reminded not to use some unofficial items for personal use.
Weight regain is a problem that is common to almost all people who use semaglutide. The hormonal effects of drugs once controlled a person's mouth, but it never really changed the diet and rest of dieters.
Xiao Zhuang, who claims to be a heavy user of semaglutide, has been repeatedly injected with the drug for two years because of weight regain. July 2022, January 2023, April 2023...... When the weight regains due to the discontinuation of the drug, Xiao Zhuang will take the medicine again.
In May this year, Xiaozhuang was diagnosed with a thyroid nodule during a physical examination. Although the nodule is small and benign, after self-examination, Xiaozhuang judged that this may be a side effect caused by semaglutide. Because it was mentioned in the instructions, semaglutide has the possibility of inducing thyroid tumors, but the probability is rare.
"It's just a benign nodule, it doesn't matter. Everything has a price, and compared to liposuction and vomiting, what is this worth? ”
Medication side effects, and pathological aesthetics
What are the side effects of semaglutide?
It is a medicine that is three parts poisonous, and as a medicine, side effects are the inevitable shadow under the light of healing. Wen Xuan, a doctoral student from Dongzhimen Hospital of Beijing University of Chinese Medicine, who studies diabetes, introduced the possible harm caused by semaglutide in an interview:
- Gastrointestinal adverse effects. More than 40% of people experience nausea after using it, and nearly a quarter of people may experience problems such as diarrhea, constipation, stomach pain, bloating, vomiting, etc.
- Undernutrition. Dieting leads to insufficient nutrient intake, which may cause hair loss, low bone mass, anemia, etc. Some women may also experience menstrual irregularities.
- Si Mei face. Loss of skin muscle and loss of facial fat lead to facial depression and accelerate facial aging.
- Impotence. According to a study published in the International Journal of Impotence Research, non-diabetic men who use Novo are more likely to develop erectile dysfunction (ED).
- Blindness (rare). Semaglutide may increase the risk of non-arteritic anterior ischemic optic neuropathy (NAION). This rare disease usually affects people over the age of 50 and there is currently no specific treatment.
- Carcinogenesis (rare). Semaglutide is contraindicated in patients with medullary thyroid cancer and also has the risk of inducing pancreatic cancer.
- Psychological problems. Physical discomfort may also lead to depression, anxiety, bipolar disorder, etc.
While it may seem scary to list the side effects alone, in most cases, the drug is safe to use wisely. Even if it is a common cold medicine, the side effects on the label are also shocking.
It is important that drugs are used under the guidance of a doctor, rather than blindly putting one's health at risk for efficacy.
A professional and regular doctor will judge whether the patient meets the criteria for medication through a series of examinations, inform the corresponding adverse reactions, and at the same time contact the patient, respond quickly in case of abnormal situations, and inform how to make emergency treatment more safely.
Patients who buy drugs privately are obviously missing out on this important support.
Miss Wang complained to her best friend
Xiaohongshu blogger "ZHU Zhu" is a nutritionist who is passionate about fitness and is also a medical doctor candidate. He believes that in the context of drug approval, it is not a professional topic to discuss "whether to recommend semaglutide".
"The experts at the FDA are definitely more authoritative than we are. Since they recognize the approval, as doctors, as long as the patient does meet the criteria, we will definitely prescribe the medication. It's not a matter of personal recommendation, it's a matter of safety and process.
But from my personal point of view, if a friend who simply wants to lose weight asks me about this medicine, I will ask him, what do you think is beauty? Can you accept the price of taking shortcuts? ”
In the view of "ZHU Zhu", aesthetic pathology is a stubborn disease that cannot be overcome by any medicine. The problem of obesity in the medical sense needs to be solved, and the problem of obesity under the social concept needs to be more vigilant - the concept of pursuing white and thin, A4 waist, butterfly shoulders, and waist is full of hand, which is not essentially different from the three-inch golden lotus of the past.
Nowadays, there are more and more people abusing semaglutide. From January to November 2023, the United States Poison Center reported nearly 3,000 cases involving semaglutide overuse. There are said to be extreme users, who were injected 10 times the standard dose. It is conceivable that he lost not only weight, but also Yangshou.
But medical technology itself is innocent. On January 26 this year, semaglutide oral tablets were approved for marketing by the State Drug Administration, and the main target is still for the treatment of type 2 diabetes. Eliminating the need for injections and making it easier to use will be a boon for diabetics.
With the patent for semaglutide set to expire in 2026, at least ten Chinese generics are already in the clinical stage. It is foreseeable that the price war triggered by the acceleration of Chinese pharmaceutical manufacturers to seize the market will further reduce the price of semaglutide and benefit more patients who meet the drug standards.
On July 19, the indication of "long-term weight management" for tirpatide injection was also approved by the National Medical Products Administration. Together with semaglutide, it is known as the "double giant of weight loss injections", and it gathers in China to leverage the 10 billion market together.
At the same time, we must also be vigilant that when the threshold of drugs is low enough to be readily available, can an ordinary person successfully escape the prison of aesthetic concepts and accept his less perfect self. Or, using health as a bargaining chip, a desperate bet on that dangerous beauty.
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