Brownstein: Scientist will give the skinny on Ozempic during symposium at McGill

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Dr. Patricia Brubaker has spent decades researching and speaking on studies relating to the development of the intestinal hormone glucagon-like peptide-1 (GLP-1) for the treatment of patients with Type 2 diabetes and obesity.

But Brubaker, a professor emerita in the departments of physiology and medicine at the University of Toronto, acknowledges while such GLP-1 studies may not resonate much with laypeople, as soon as she attaches the word “Ozempic” to the discussion, ears perk up.

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“In the early days, conferences about GLP-1 may have drawn crowds of about 37 people,” Brubaker quips in a phone interview. “At a conference I attended a few years ago, when the Ozempic craze was starting, it was held in a room holding over 1,000 people. There were also two overflow rooms and people were getting into shoving matches just to get into the overflow rooms.”

Hopefully, there won’t be any jostling, but it’s doubtless Brubaker will draw a receptive and curious crowd at McGill University’s Leacock Building on Monday night when she delivers her speech The Basic Science Underlying the Beneficial Actions of Ozempic. Her talk encompasses the aforementioned research — with a snappier title.

Brubaker is one of the two keynote speakers at this year’s Trottier Public Science Symposium, appropriately titled Baffled! Scrutinizing Trendy Science. The other speaker, Harvard medical school professor and internist Dr. Pieter Cohen, will be discoursing on “Dietary supplements: Are they what they appear to be?”

Admission is free, but those wishing to attend must register for the event through the McGill Office for Science and Society.

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Suffice to say that Ozempic — actually semaglutide, Ozempic’s active ingredient — has become the med-du-decade on this continent, probably more for its role in weight loss than in treating Type 2 diabetes, its apparent intention when brought to market. When Oprah Winfrey and her fellow celebs jump on board, it’s no surprise that the floodgates have burst wide open.

Oprah spoke openly about her weight issues and backed Ozempic, as well as meds like Wegovy, Zepbound and Mounjaro, in last March’s TV special Shame, Blame and the Weight Loss Revolution. It has become a massive business bonanza for their makers, with sales estimated to soon topple the US$100-billion mark.

While these medications have become like a panacea for those seeking quick body transformations, their use has also led to an array of questions, some rather troubling. There are the side-effects — both negative and positive. There is the high-cost issue — clearly meant for the well-heeled. There is the demand-overwhelming-supply matter, with diabetics caught in the crunch and resulting in many buying bogus and dangerous meds instead.

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Those attending the symposium can expect that Brubaker will give them the skinny on the subject.

“This has been just an amazing scientific ride, a true bench-to-bedside discovery that has happened in a really incredible short period of time,” Brubaker says.

“It’s not unprecedented, but the initial discovery of GLP-1 — the fact that it stimulated insulin secretion — really happened in 1987. (Canadian endocrinologist) Daniel Drucker is credited with being one of the discoverers and in his initial paper, he said that it all merited future investigation. That was really the kick-off to this incredible story.”

By 2005, the American Food and Drug Administration (FDA) had approved the first long-acting equivalent of GLP-1 for treatment of Type 2 diabetes. Then came discoveries like the molecule in venomous Gila monster lizards that acts like GLP-1 with a longer half-life.

“It then became quickly apparent that people with Type 2 diabetes are often overweight or obese, and that not only was their glucose being improved, they were also losing weight,” notes Brubaker, who received her BSc and PhD degrees at McGill.

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By 2017, the Danish multinational pharmaceutical manufacturer Novo Nordisc had developed a compound now known as Ozempic. A huge advance for Type 2 diabetics, it required a weekly injection.

“Even in the first clinical trial of Ozempic for people with diabetes, it was very effective at lowering blood-sugar levels and very effective at body-weight loss.

“But we have to remember that while Ozempic works well, we’ve been using these molecules for treating Type 2 diabetes for decades. But we haven’t been using them for body-weight loss specifically until fairly recently. … That’s when Hollywood took over and it became a craze, creating all sorts of problems, like shortages for people with diabetes not being able to get it.”

Brubaker points out that in most medical quarters, obesity is viewed as a disease that should be treated. But this has led to problems.

“The reality is not everyone can lose weight on their own. So demand for Ozempic and the others has just overwhelmed availability,” says Brubaker, a Type 1 diabetic for whom these meds aren’t an antidote. “I’ve read that one in eight Americans have actually taken the drugs.

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“Novo is now building factories in multiple locations, trying to catch up with Ozempic supply. I feel it’s a great drug and it’s doing good things for the heart. It also helps protect the kidneys and vascular system and a lot of these long-acting molecules can help the brain. But it does have some serious caveats with consequences about taking a very high dose of something that has normal physiological effects. And we don’t know, 20 years from now after clinical studies, what we will be saying about these medications then.”

She counsels the drugs be taken at a lower dose to start, under a physician’s supervision, to avoid side-effects of nausea and vomiting sometimes leading to hospital visits. On average, people on these meds can lose between 15 and 20 per cent of their body weight.

“’Faux-zempic’ is a completely different story. Some people are desperate for these drugs, but the cost and lack of availability sends them online to buy something that might be non-pharmaceutical-grade or contaminated with bacteria and that could cause all sorts of horrible complications. Some may contain insulin, which could result in severe hyperglycemia.

“But there’s a lot going on out there, like TikTok stuff about ‘oatzempic.’ Eat oatmeal and lose weight? If eating oatmeal would cause everyone to lose weight, we wouldn’t have a problem. Sadly, people are jumping on the bandwagon trying to take advantage of so many desperate people.

“It’s quite scary out there at present. But the good news is other companies are now making similar compounds and in the next few years, we’re probably going to see a lot more choice. And hopefully, then prices will come down.”

AT A GLANCE

Dr. Patricia Brubaker and Dr. Pieter Cohen are the speakers at this year’s Trottier Public Science Symposium, Monday at 7 p.m. at McGill University’s Leacock Building, Room 132. Admission is free, but people must register via the link at mcgill.ca/oss. More information: [email protected].

[email protected]

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