In October, Elon Musk gained attention on Twitter not for a hot take, but for his fitness.

A fan asked: what did he do to get fit?

Musk said fast and also Wegovy, the FDA approved the chronic obesity drug in 2021. It was the first newly approved obesity drug in seven years.

Now, some are rushing to a new generation of injectable drugs to treat obesity or lose excess pounds. On TikTok, hashtags of prescription drug names have gone viral. #Wegovy has 148 million views, #Ozempic 386 million views and #Mounjaro 267 million views.

“Mounjaro is the new drug we’re all excited about that just came out last month, FDA approved for diabetes only at this time, but already in off-label use for obesity. I’m a Board Certified Family Physician in obesity and I already use it for both of those reasons as well,” said Jennah, a doctor also known on TikTok as @weightdoc.

Alissa Dee lost 32 pounds; user Karolina Ochoaa lost 80 lbs.

Online hype has skyrocketed demand. Wegovy and Ozempic are rare, according to the Food and Drug Administration. It also raises new questions about how to treat obese patients.

For more than a century, doctors have tried to create pills to treat what the Centers for Disease Control and Prevention considers a chronic disease.

The first pills, introduced in 1892 and 1932, claimed to boost metabolism, increase body heat production and burn fat.

But patients who got the drug from pharmacies suffered thyroid, eye and nerve damage.

In the 1990s, drugs like “fen-phen” suppressed appetite by decreasing the amount of serotonin in the brain. But the FDA recalled the drug in 1997 after patients suffered side effects, including heart and lung problems.

Today’s weight-loss drugs are inspired by the science of diabetes treatments. It has been proven for years that these have fewer and less serious side effects.

For example, the obesity drug Wegovy and the type 2 diabetes drug Ozempic share the same active ingredient called Semaglutide. It mimics a hormone the body naturally makes to regulate blood sugar.

It also impacts how the brain judges how hungry and full we feel. In the studies of Mounjaro, which uses a similar active ingredient. Animals given the drug seemed less hungry, so they ate less and used less energy, so their metabolism reduced the desire for food.

In its approval, the FDA said many participants in clinical trials of the diabetes drug were obese and had lost an average of 15 to 23 pounds.

The fat-fighting potential of Wegovy became evident in 2022 in a study published in the New England Journal of Medicine.

Of the more than 2,500 patients with high body mass index, those taking the drug lost up to 20% of their body weight, according to drugmaker Eli Lilly. Those who took a placebo lost 3%.

In November, social media posts celebrating Ozempic as a weight-loss drug spiked demand for the drug.

This put it out of reach for some patients who urgently needed it.

“Due to the unfortunate TikTok trend, we are running out of Ozempic for diabetics. For diabetics, it’s a life-saving drug, for heart attacks and strokes,” Dr. Frank Chae, who works at Sky Ridge Medical Center.

Today, Ozempic’s drugmaker Novo Nordisk says it has ramped up production to meet demand. And the FDA is now considering approving the use of Mounjaro, known as Tirzepatide, for obesity.

These new drugs can have side effects, although they are considered less serious than those of older obesity drugs. For Mounjaro: “The side effects most frequently reported by patients were nausea, diarrhea and decreased appetite”.

In its approval of Mounjaro, the FDA noted that the diabetes drug caused certain thyroid tumors in rats. And it was unknown whether it could cause such tumors in humans.

Demand for the drugs can only increase as the FDA recently approved Wegovy for use in children 12 years of age or older.

But the cost of the drugs, often over $1,000 a month, is more than many patients can afford. Many health insurance plans do not cover drugs.

Doctors say someone should take the meds and keep a healthy diet and exercise, especially when it comes to wanting a leaner body.

Here’s how the Mayo Clinic puts it: “Weight loss drugs aren’t an easy answer to weight loss. But they can help you make the lifestyle changes you need to lose weight and improve your health. “

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