Women taking the anti-diabetes medication Ozempic might have an extra reason to pat their tummies. Not only does the injectable drug lead to weight loss, a finding that has sparked frenzied off-label demand worldwide, but in recent months it has also been linked to a surprise baby boom.
Now scientists are trying to unpick the mechanism behind the “Ozempic babies” phenomenon, which has been reported by users of similar medications, too. This matters: the drugs were never tested for use by women who were pregnant or trying to conceive, and animal studies on Ozempic’s key ingredient, semaglutide, suggest an association with birth defects.
Today, the number of people taking weight-loss medications makes this an urgent health issue. While they are prescribed for diabetes, obesity and weight-related health complications, they also appear to improve heart and kidney health. That has led to calls for more widespread prescribing, for drugmakers to slash prices and for insurers to pick up the tab. But it feels presumptuous to regard the medications as indispensable when their long-term impact, such as on the health of babies born to users, remains unknown.
Ozempic belongs to a class of injectable drugs known as glucagon-like peptide-1 receptor agonists (GLP-1 agonists). These were originally developed to treat diabetes: they slow down processes in the stomach, which helps to control blood glucose levels and insulin production. But its active ingredient, semaglutide, also suppresses appetite and causes weight loss. That has whipped up off-label demand beyond diabetes and spawned similar drugs targeting obesity. There are other injectables approved for diabetes and weight management: Ozempic and Wegovy contain semaglutide; Mounjaro and Zepbound contain tirzepatide.
This year, some female users, mostly of Ozempic, began sharing tales of unexpected pregnancies, with the hashtag #OzempicBabies trending on social media. Some had previously struggled to conceive; others were on contraception at the time (as the prescribing guidelines all clearly advise). While there no firm figures on how many people are affected, Novo Nordisk, the manufacturer of Ozempic and Wegovy, has opened a pregnancy registry to follow up babies in their first year of life. A spokesperson for Eli Lilly, which makes Mounjaro and Zepbound, said the company had not studied the effect of tirzepatide on fertility and said it should not be used by pregnant women or those hoping to conceive. And a spokesperson from Novo Nordisk stressed that semaglutide should not be used during pregnancy and that the company did not condone, suggest or encourage any use outside of approved indications.
Most researchers believe that the baby boom is simply down to weight loss boosting fertility. Diabetes and obesity are known to disrupt the menstrual cycle and ovulation; both diseases lower female fertility and raise the risk of miscarriage and other complications. They also hammer male fertility by compromising sperm quality.
But Charlotte Moffett, a pharmacology researcher at Ulster University, thinks there might be more to it, because the same receptors targeted by the weight loss drugs are found in the reproductive system. “These GLP-1 receptors . . . are in the pituitary gland and the hypothalamus,” she told me. “We see them on the ovaries, on the testes and all along the endometrial lining.” That means they could be involved in hormone production, ovulation and implantation, as well as in male fertility. Her hunch is that gut hormones play a role in fertility, which could one day lead to treatments for infertility. But not yet. While small observational studies suggest that babies born to women using weight-loss drugs seemed healthy, Moffett said, there was far too little safety data for comfort.
Where does that leave us? Weight loss medications are increasingly seen as wonder drugs, able to cut obesity, diabetes and more besides. This immediately benefits individuals, employers, healthcare providers and society — a good thing. But the long-term effects, including on a developing foetus, are unquantified. More targeted studies must be a priority, and clearer risk warnings are needed.
That is especially urgent as so many young women trawl social media platforms for health information and to access online pharmacies. Weight-loss drugs might now be viewed as fixes for two deeply felt aspects of female identity: body image and motherhood. For those desperate for a child, the hashtag #OzempicBabies will not be a red light but a call to action.
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Fonte: Financial Times