Illustration by Jaimee Haddad.
Illustrations by Jaimee Haddad
BEIRUT — It’s all over social media, and its name itself has become a buzzword. It’s Ozempic, and it is seemingly everywhere in Lebanon.
Ozempic — a diabetes drug now also used for weight loss — is transforming the landscape of medical interventions for obesity, reshaping the perspectives and discourse on weight management and promising many Lebanese to leapfrog from obese to “skinny.”
Here, join the journey of Sarah* who tried the medication for weight loss.
‘I didn't really have time to think’
Sarah, 31, lives in Lebanon and works as a freelance photographer and editor.
She says she’s struggled with weight for essentially her entire life.
She had gained 35 kg after returning to Lebanon from France, where she lived for 13 years. “I was over 100 kilos,” Sarah says.
“I was dangerously overweight,” Sarah recalls, adding that it drove her to run many medical tests to see if the weight gain was related to a medical condition. “You know, you're also kind of in denial.”
Illustration by Jaimee Haddad.
But, all tests came back “very good.”
One day, a friend recommended an eating disorder specialist. That was in 2020.
“I liked her approach at the beginning because she was trying to understand my eating patterns,” Sarah says. The approach of the specialist, whom Sarah says also has a PhD in cognitive neuroscience, was non-restrictive (meaning she was allowed to eat everything in moderation), which was right up Sarah's alley.
“But every time I visited her, the scale showed that I gained weight.”
“[The therapist] was supposed to understand why every time I leave her clinic, the only thing I'm thinking of is eating a croissant,” Sarah says.
Soon, Sarah started feeling that the therapist did not help her specifically tackle her eating disorder.
“I felt like she wasn't really trying to help me, but was rather trying to get results off of me, so she could share the ‘before and after’ picture and prove her approach works,” Sarah says.
During one of the visits to the therapist's clinic, Sarah again showed weight gain.
In response, her therapist prescribed medication, allegedly instructing Sarah: “Go buy this now and come back, I'll show you how to use it. It's urgent; you won't be able to live without it,” before shutting the door.
Illustration by Jaimee Haddad.
Feeling alarmed, pressured and rushed, Sarah purchased the medicine at a nearby pharmacy. “I didn't really have time to think,” she said.
The therapist also made it sound like “this medication is my only solution.”
Curious, Sarah asks the pharmacist: “What is this for?”
“It's a type two diabetes medication,” the pharmacist answered.
Why all the chatter?
Ozempic is a once-in-a-week injectable, which was approved by the US Food and Drug Administration (FDA) in 2017 for type two diabetes.
In 2019, it first reached the market in Lebanon.
Ozempic and similar drugs gained recent social media attention for their unintended positive side effect of weight loss, alongside their primary function as anti-diabetic medications.
Illustration by Jaimee Haddad.
Ozempic ads frequently pop up on Sarah's social media feed until this day.
“I'm not looking for those ads, but they keep coming up,” she says.
“Social media influencers rely on people’s emotions and needs. In this case, quick weight loss. And this is why, in a nutshell, Ozempic has become famous or rather infamous on social media,” Nakhleh says.
Nakhleh is a content creator on Instagram. His page is dedicated to debunking misinformation in the health and fitness industry.
“People hear about this magical pill or drug that makes them lose weight, so they hop on the hype train, without understanding the drug’s background, why it is used, for whom, whether it works or not, and most importantly, whether they are medically eligible to use this drug or not.”
That allure is powerful: According to a 2016 study published in the World Journal of Cardiovascular Diseases, 23 percent of the Lebanese population would opt for medication for weight loss.
‘An amazing promise’
At the pharmacy, as Sarah heard the word “diabetes,” horrified, she thought, “I was never tested for diabetes. Wow! So why is she giving me this?”
Sarah said each round of two Ozempic pen injections (each of which lasted around two weeks) cost her LL500,000, equivalent to around $185 at the lira-US dollar rate in 2020. On top of that, Sarah was paying the therapist $100 per session.
Illustration by Jaimee Haddad.
Sarah says she blindly trusted the therapist because she had a PhD. She was also persuaded by the therapist’s “skinny” physique, hoping she could achieve a similar body shape.
After showing Sarah how to inject herself with the Ozempic shot, which she promised would help her control her appetite, the therapist told her, “You are going to lose weight very quickly; in six months… you are a supermodel.”
Sarah was sold. “What an amazing promise to receive — in just six months I will have that body by just injecting this shot in my stomach.”
The therapist also told her that Ozempic would help her tackle her “insulin resistance,” a condition where body cells don't respond effectively to insulin, a hormone that helps regulate blood sugar levels.
The condition is a precursor to type 2 diabetes. Sarah said the therapist never ran any lab tests to confirm she suffered from insulin resistance.
Asked whether Ozempic is approved for weight loss, Nakhleh — who is also a former fellow of immunology and microbiology at Johns Hopkins University — said, “The short answer is no.”
“Ozempic is not approved for weight loss. It should only be used by people with type two diabetes. Most scientific studies to date suggest that Ozempic does aid in weight loss — but not necessarily in the long term,” Nakhleh explained.
‘It hurt all the time’
“You feel so happy at the beginning because you're losing weight quickly,” Sarah says. “You're like, yes, it's working.”
But, it didn't take long until Sarah started feeling “weak and nauseous all the time.”
One evening, Sarah went out with friends, feeling “amazing because of my new slimming body.”
She was at a friend's house and they were having food, before she “threw up everything,” prompting her to go back home.
“I felt weird. It hurt all the time,” she adds.
“I felt dizzy every time I took it. I would stick myself then directly go lay down on the couch and put my legs up,” she says.
Asked whether Ozempic is safe for weight loss, Nakhleh says, “You will never find a drug with zero side effects, no matter how small. Some of the recorded side effects of using Ozempic are gastrointestinal issues, such as diarrhea, vomiting, constipation and abdominal cramps.”
“On top of being fat, you now have bruises on your stomach from sticking yourself with a needle over and over,” Sarah says.
Sarah says she was not able to do much more than attend to her part-time job in photography while on Ozempic.
Besides being nauseous, “I was afraid to eat,” she says. “Because every time you're going to put something in your mouth, you are worried about how your body is going to react to it.”
“Every time I got closer to the fridge,” where Sarah stored the shots, “I felt like there was something wrong, like my body was rejecting it… like my body was telling me ‘please, don't do this to yourself. Don't do this to me, we don't need this.’”
When she ate, Sarah opted for “healthy food” options, “because now that you're paying a lot of money for [the medication], you are naturally going to be more careful of what you are eating.”
Sarah was losing weight, but she never knew whether what she was losing was fat, muscle or water weight, because the therapist did not have a body composition machine.
Over a month after being on Ozempic, Sarah decided to visit her family in France. On her travel checklist was “passports, IDs: FR LB, permis de conduire [French for driving license], zaatar, summac and Ozempic.”
Once in France, she visited her family doctor, who, upon learning about the injections, reacted strongly, Sarah says.
“You're going to immediately stop this medication!” Sarah said the doctor ordered her.
And so, after being on it for six weeks and losing around 10 kilos, Sarah quit Ozempic.
She never checked in with the therapist again.
Is relying on medication for weight loss actually sustainable?
Dietician Moujaes says that losing weight on Ozempic has a big success rate, but “weaning off of it” and keeping the weight off does not.
“I honestly have not seen a good case [of sustainable weight loss] after weaning off [Ozempic],” she adds.
“Because most of the time, the problem is in the mindset about weight loss,” dietician Stephanie Baddour explains. The only way that would help those people not regain the weight is “changing their habits and their lifestyle, even while taking Ozempic.”
“If people look for quick shortcuts without changing anything, more likely than not, they will be back to square one,” according to Nakhleh. “Any weight loss approach — be it via drugs or something else — is doomed to fail without emphasizing better lifestyle changes such as better eating habits, better relationship with food and introducing physical activity,” he adds.
Illustration by Jaimee Haddad.
Nakhleh cites a 2022 study, in which participants in the US, Japan, Canada, Germany and the UK who took Ozempic for 68 weeks experienced an average weight loss of 17.3 percent, equating to approximately 21 kg for someone weighing 120 kg. These individuals did not suffer from diabetes but had a BMI of over 30.
However, those participants regained approximately two-thirds of their initial weight loss one year following the withdrawal of Ozempic.
Nakhleh pressed that such solutions for weight loss must be prescribed for a very specific subpopulation of people, mainly those who are “extremely obese and/or people with cardiometabolic conditions. It shouldn’t be used for people who want to shave off one or two kilos off of their weight.”
He also highlighted that “only medical doctors or physicians are allowed to prescribe and recommend Ozempic. Exercise coaches, physiotherapists, or any other specialty personnel should not be allowed to prescribe Ozempic.
‘Easier said than done’
“The best way for weight loss, and specifically fat loss, should be a good, balanced diet with a slight caloric deficit coupled with resistance training [weight training] to ensure the maintenance or increase in muscle mass and strict fat loss,” Nakhleh says.
“Even though this answer is the right answer from the scientific standpoint, we cannot forget that this is easier said than done,” he adds. “The goal is to educate people steadily about the importance of changing habits.”
And despite everything Sarah knows about Ozempic today, she still “feel[s] kind of jealous, when I see a girl promoting it on Instagram — I keep thinking they're gonna lose weight faster… they're going to look good for summer…. that I'm not going to lose weight as quickly as they will.”
Despite the fact that she seeks to lose 10 more kilos, Sarah today is more comfortable with the way she looks and is more knowledgeable about exercise and nutrition.
She says she now focuses on goals beyond just shedding a couple of kilos.
She exercises so that, in the long run, she wouldn’t “feel like I’m dying when I go up the stairs, to be able to drag my suitcase…”
“I started playing tennis again. I love tennis,” she says. “I stopped seeing exercise as a punishment and more of a way of life.”
* Name has been changed at the request of the interviewee, to maintain their privacy
