Weight-loss drug or symptom reliever? The downside of Ozempic

A small injection a week, dozens of kilos off, a lower risk of cardiovascular disease. Medicines like Ozempic, Wegovy, and Mounjaro are hailed as the breakthrough against diabetes and obesity. Celebrities—especially from America—swear by them and share spectacular before-and-after photos online.

Yet, criticism is growing. Behind the image of a medical breakthrough lies a series of ethical, medical, and societal concerns.

Metro previously reported on a poll by Ipsos I&O. It showed that many Dutch people want "weight-control medications" like Ozempic and Wegovy to be covered by basic health insurance.

The active ingredient, semaglutide, affects the hunger center in the brain. You feel full faster, eat less, and lose weight. In studies, participants lost an average of 15 to 20 percent of their body weight. In addition, the risk of cardiovascular disease, such as heart attack or stroke, decreased by 20 percent.

Although these results are very relevant and impressive, there is a dark side that is becoming increasingly visible.

Many users report mild symptoms such as nausea, diarrhea, and constipation. But there are also more serious side effects: severe abdominal pain, gallstones, fatigue, depression, hair loss, and in rare cases, even gastroparesis. There are reports of people having their gallbladders removed after prolonged use.

And then there's the Ozempic face: sagging facial skin after rapid weight loss, which suddenly makes users look older. For some, this is a major psychological blow.

If you stop taking the injection, the weight usually returns. This makes users dependent on an expensive medication for a long time. "You have to keep taking it to maintain the effect," says internist Edo Aarts. So it's not a cure, but rather symptom management.

For some, this feels like a pharmaceutical pitfall; it starts as a quick fix but ends up being a lifelong investment.

Treatment with Mounjaro quickly costs €410 per month – and in the Netherlands, it is only reimbursed for people with type 2 diabetes. Wegovy, specifically developed for obesity, is not (yet) included in the basic health insurance package because its long-term health effects are unclear. Nevertheless, the number of people paying for semaglutide medication out of pocket increased from 2,000 to 109,000 in one year. Those with the money and the assertiveness can often obtain a prescription. But for people on lower incomes – often those who would benefit most – this "miracle cure" remains out of reach.

Pharmacist Marloes Dankers calls it “a worrying widening of the health gap.”

Some experts warn that semaglutide also exposes a broader cultural reflex: the desire to solve complex health problems with a single injection. "Obesity is more than just overeating," says Jaap Seidell, professor emeritus of nutrition. "It's closely linked to stress, sleep, poverty, genetics, and the lack of healthy living conditions."

However, the social debate is in danger of narrowing down to whether or not to take a jab.

The cabinet is still awaiting advice from the Dutch Healthcare Institute regarding possible reimbursement for Wegovy and Mounjaro. The question is not only whether they work, but also at what cost—both financially and socially.

Because when millions of people soon need an injection to feel healthy, we must dare to ask: which problems are we solving – and which are we creating?

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