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First came the weight loss. Then came the drama around Ozempic.

Ever since Hollywood and TikTok discovered Ozempic is a miracle weight loss treatment, things have gotten intense

Ozempic started life as a drug to treat Type 2 diabetes.greg klee/globe staff illustration/julien - stock.adobe.com

Ozempic drama — who would have expected it? And yet the situation is getting intense.

What started simply enough as a prescription treatment for Type 2 diabetes was (of course) secretly repurposed as an off-label weight loss trick by Hollywood’s beautiful people. It hit TikTok, filtered down to the masses, and has now become so inescapable — and divisive — it could run as Trump’s VP.

Never mind that you have to inject the drug weekly and if you go off it the weight comes back. Or that serious side effects can include gallbladder disease and an increased risk of thyroid cancer. And that it can make you feel so lousy people are turning to Facebook support groups. Or that a lot of the interest is being driven by people who want it for cosmetic, not health reasons.

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As Billy Crystal said on “Saturday Night Live,” “It is better to look good than to feel good.”

The drug’s reach goes from the Oscar stage — where host Jimmy Kimmel gazed at the glamorous crowd and said, “When I look around this room, I can’t help but wonder ‘Is Ozempic right for me?’”— to East Boston, where Crystal Curry, an RN-BSN (Bachelor of Science in Nursing) and TikToker, gives discount shots of a generic with the same active ingredient at her Coconut Aesthetics medspa.

“This doesn’t just have to be for rich white folks,” she told the Globe. “I’ve had a person who’s literally a dishwasher come to me.”

Controversy is flaring as a growing number of people slim way down using Ozempic, or two other new prescription drugs, Mounjaro, which is also for Type 2 diabetes, and Wegovy, a prescription medication for adults with obesity or who are overweight and have weight-related medical problems.

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The anti-diabetic medication Ozempic made by Danish pharmaceutical company Novo Nordisk.JOEL SAGET/AFP via Getty Images

In certain circles, the Ozempic look — newly skinny body, suddenly hollow cheeks — has become so distinct that a fancy Manhattan dermatologist coined a term: “Ozempic face.”

Some doctors are blasting telehealth companies for making prescriptions easy to get, in some cases, reportedly without so much as even a phone call with a provider.

Other doctors don’t like that the medications are being prescribed as a quick fix, instead of as part of a more comprehensive plan that includes changes in diet and exercise along with the drug.

Anger with influencers who pretend their enviable physiques are the result of hard work, not a subcutaneous injection, is also rife.

Basically everyone is disgusted with people who hogged so much Ozempic — which can cost $1,200 or more per month if you have to pay out-of-pocket — that diabetics have been left scrambling.

This renewed focus on skinny-at-all-costs is frustrating people who have worked to encourage the acceptance of all body types, and it’s triggering body image issues for people who have a history of eating disorders, said Boston psychologist Elaine Espada.

Some of her clients have stopped listening to radio shows or podcasts that discuss the drugs and have muted the words “Ozempic,” “Wegovy,” and “Mounjaro” in their social media feeds, she said.

“They feel like it’s adding fuel to the fire.”

Weight Watchers — which rebranded itself as WW in 2018 to shift the focus from “weight” to “wellness” — has been under fire since early March, when it announced it was acquiring a digital health company that offers telehealth prescriptions for the appetite-suppressing drugs.

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“As we all know, that ‘pivot’ was a damn lie,” @freeblackgirl tweeted upon the news.

The drugs are being called “game changers” in the fight against obesity. The long-term story has yet to be written, and many people will recall, for example, that fen-phen, the 1990′s miracle weight loss drugs, were eventually taken off the market after evidence linked them to potentially serious heart valve problems.

But what’s clear right now is that taking one of the current miracle drugs is not without stress. The challenges are pouring out on Facebook and Reddit self-help groups.

“Hey guys,” one person wrote on Facebook. “I need some advice on how to manage symptoms- specifically sulphur burps and diarrhea. Does it go away or should I expect this every week?”

On Reddit, a user feared the drug was triggering an eating disorder. “Yesterday I ate under 800 cals (not on purpose, just wasn’t hungry) and today I weighed myself and saw my progress and I felt so good and like I wanted to eat very little again…”

If you have diabetes, the drugs can be covered by insurance, but those who just have obesity often have to pay out of pocket, either for one of the brand name products or a generic from a compounding pharmacy, said Katherine Gergen Barnett, a family medicine physician at Boston Medical Center.

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“This is especially true for people on MassHealth or Medicaid,” she said, “further perpetuating the disparities in the treatment of obesity in traditionally marginalized communities.”

A nurse from Weymouth, who asked for anonymity to protect her privacy, found herself in a perfectly 2023 quandary.

She was having trouble losing about 30 pounds and asked her nurse practitioner for some “magic.” Ozempic might be right for you, she was told, but it would only be covered if she’s pre-diabetic.

“I don’t want to be pre-diabetic,” the nurse told the Globe, but, she confessed, she also thought it might not be “so bad.”

Meanwhile, some people are being shamed for taking the drug — while others are being shamed for not taking it, said BMC’s Gergen Barnett, who is also a clinical associate professor at Boston University Chobanian & Avedisian School of Medicine.

“It’s seen as a moral failing if there are these solutions ― weight loss surgery and now an increasing number of medications — and you aren’t pursuing them,” she said.

“But there are many people who are in the overweight category who are healthy, and living beautiful, full lives,” she said. “We are so quick to create a one-size fits all solution without recognizing that there are gray areas.”


Beth Teitell can be reached at beth.teitell@globe.com. Follow her @bethteitell.