What is Ozempic Face? Plus, GPL-1 Antagonists: Miracle or Menace?
The hidden tax of rapid weight loss. Plus, a hope for the end of Mounjaro shortages?
In this week’s issue, your Sage covers:
The NY Times Story about “Ozempic Face”
Eli Lilly expanding Mounjaro production capacity
The Long-term effects of Wegovy
And Morgan Stanley Projecting a $30 billion market opportunity
Have you Heard of Ozempic Face?
Today.com has a story citing Dr. Paul Jarrod Frank, a NY-based dermatologist who sees Ozempic face on a “daily basis” on patients.
“Ozempic face refers to the facial changes that patients who've lost a significant amount of weight sometimes experience: primarily a loss of facial fat that can leave the face sagging and looking older. It's especially common in middle-aged and older patients, Frank said.”
A patient quoted in the story described the effect as “gauntness”. But your results might differ:
…other factors can also contribute to Ozempic face… These include the natural aging process, genetics and being menopausal, as the lack of estrogen can contribute to wrinkles and sagging skin.
You're also more likely to see Ozempic face traits the more weight you lose.. Patients who take Ozempic to lose 15 to 20 pounds — and there are legitimate medical reasons for doing so, she stressed — won't see as many facial changes as those who lose 100 pounds, Salas-Whalen said.
The New York Times writes also covers the phenomenon this week in Those Weight Loss Drugs May Do a Number on Your Face.
Dr. Oren Tepper, a plastic surgeon in New York, said that it’s common for weight loss to deflate key areas of the face, leading to a more aged appearance. “When it comes to facial aging, fat is typically more friend than foe,” he said. “Weight loss may turn back your biological age, but it tends to turn your facial clock forward.”
…
I see it every day in my office,” said Dr. Frank, who said he coined the term “Ozempic face” to describe the condition. “A 50-year-old patient will come in, and suddenly, she’s super-skinny and needs filler, which she never needed before. I look at her and say, ‘How long have you been on Ozempic?’ And I’m right 100 percent of the time. It’s the drug of choice these days for the 1 percent’
With facial fillers costing $5000 - $10,000 and full facelifts upwards of $75,000, patients are facing an unexpected expense to “fix” this side effect.
The other piece that stood out in the article is the doctor citing her success with Mounjaro over the other semiglutide drugs on the market:
“Mounjaro is like the Apple 14 of these drugs,” said Dr. Salas-Whalen… it has the same ability to control blood sugar as Wegovy and Ozempic, but that in her practice, she had seen “almost double the weight loss and close to none of the side effects.”
This is the first time the Sage has heard a prescription being compared to a phone, though the price is about the same…. 🤷♂️
An End To Mounjaro Shortages?
Eli Lilly is opening up a $450m plant in North Carolina to manufacture Mounjaro, which has the common name tirzepatide. Right now Mounjaro is approved for diabetes, but Eli Lilly is predicting FDA approval for weight loss based on clinical trials that the Sage will cover in next week’s issue.
Goldman Sachs analyst Chris Shibutani, in a note on Monday, estimated the drug would generate sales $2.3 billion in 2023, fueled by rapid uptake, and $27 billion in peak sales in 2032.
An end to supply shortages is always good news. Back up the money truck LLY 0.00%↑ 💰🚚
Is Wegovy Safe for Long Term Usage?
Yahoo News questions the long-term safety of Wegovy, given the lack of long-term studies:
When patients ask McGowan whether it’s safe to take the drug for years, he tells them there are no long-term studies on Wegovy. But he notes that GLP-1 receptor agonists have been used for more than a decade to treat Type 2 diabetes, “so we do have a very reassuring track record in general with these medications.”
Dr. William Yancy, medical director of the Duke Lifestyle and Weight Management Center, in Durham, North Carolina, says that after reviewing the research, he is comfortable prescribing Wegovy knowing that a patient might have to take it for years or decades.
“With the information that we have available currently, yes. But that information is accumulating over time,” Yancy tells TODAY.com.
Another doctor interviewed for the story disagrees:
Dr. Robert Lustig, a neuroendocrinologist and professor emeritus of pediatrics at the University of California, San Francisco, says he has “major, major concerns” about people potentially taking Wegovy for years or for life, especially teenagers.
“The greater the time on it — teens will be on it longer because they’re teens — the greater the risk for pancreatitis,”
Bottom line, everybody should know the potential risks and side effects and weigh them carefully after discussing with their medical professional.
Miracle or Menace?
The Atlantic kicks things off for us this week with a story titled: The Weight-Loss-Drug Revolution Is a Miracle—And a Menace (Sage tip: paywall bypass here):
After a year, young patients on semaglutide said they lost nearly 35 pounds on average. Teens on the placebo actually gained weight (source: Nature).
Here was the breakthrough that Yanovski, the obesity-research community, and perhaps the entire world were looking for: the effects of bariatric surgery without the surgery….
Is the U.S. health-care system really ready to treat obesity like it’s any other disease? Obesity is not a failure of the will, Yanovski told me, again and again. “It is a complex chronic disease,” she said. “It affects almost every organ system. If you can successfully treat obesity instead of the individual conditions, it could have a positive impact on health.”
Morgan Stanley Projects Semaglutide Market at $30 Billion
A Morgan Stanley model projected that semaglutide and similar weight-loss drugs could be a $30 billion market by 2030! That’s 10% of all all US drug spending.
This Week’s Shape Shifting Success
From 207lb to 155lbs using Moujarno (2.5mg for 2 months then 5mg).
