Doctor Q&A: Is Ozempic safe to take for weight loss? Dr Renée Hoenderkamp answers all your burning questions

I've tried everything but I cannot lose weight. Should I take Ozempic?

Firstly, can I say that I really do see and understand the frustration of people who want to lose weight and are really struggling. It is easy to see why the glitzy and dramatic claims of influencers and celebrities that Ozempic has turned them from an overweight person into a svelte and slim shadow of their previous self has appeal. But do the claims stand up to scrutiny?

Let's look first at what Ozempic is and does.

Ozempic is the brand name for semaglutide - a drug available only on prescription that helps people with diabetes control their blood sugar. It may also promote weight loss.

However - mainly fuelled by social media posts - there has been a recent surge in people without diabetes using Ozempic solely for weight loss causing a shortage affecting those who need the medication for diabetes.

Ozempic is not licensed in the UK for weight loss. However, Wegovycontains the same ingredient (semaglutide) and is licensed for weight loss.

Semaglutide works by lowering glucagon - a hormone that raises sugar levels and slowing the transit of through the gastric tract which keeps you feeling fuller for longer. As a result, it may promote weight loss.

However, like all medications, it has side effects and some of those are potentially lethal. And as with all side effects, it doesn’t matter how rare a side effect is if it affects you and there is no way of knowing if it will.

Most people using it will get gastrointestinal upset including diarrhoea, nausea, vomiting and constipation but these will for most subside.

The more serious potential side effects include:

• Pancreatitis (inflammation of the pancreas) It is important to note that there appears to be an increased risk of pancreatic cancer following pancreatitis. Pancreatic cancer is one of the deadliest cancers; only seven percent of patients live for five years.
• Vision changes
• Hypoglycaemia (low blood sugar)

Potentially life-threatening side effects include.

• Kidney problems
• Allergic reactions
• Gallbladder problems
• Thyroid tumours or cancer

It's important to remember all cancers are life-threatening unless treated successfully.

Let's now look at the actual success of data - not what the celebs are claiming. A once-weekly 2.4 milligram dose of semaglutide combined with lifestyle changes over 68 weeks led to:

• Five percent to 20 percent body weight loss
• Reduced waist circumference
• Improved blood sugar levels
• Improved blood pressure
• Improved cholesterol levels

And consider, when you stop using it, your appetite returns so does that mean lifelong use and a much higher risk of serious side effects? And the only people who can do that without any negative effects are the drug companies; they don’t want you to permanently lose weight, they want you as a customer for life.

So my answer to your question is NO. This is not the answer. The answer to effective and sustained weight loss is a lifestyle change. Think home-cooked and nutritionally-balanced food, smaller portions, no processed foods (which are the cause of much obesity) and exercise as the cherry on the cake.

Does cracking your knuckles cause arthritis? 

This could have been my shortest answer to a GB News question yet! The answer is no… but it is a myth that permeates strongly so let's unpick it.

People have been cracking knuckles and other joints forever, some never do it but those who do often report a satisfying feeling of release in the joint. And they are correct: the "pop" of a joint is caused by bubbles bursting in the synovial fluid which helps lubricate joints.

When you pull the bones apart the bubbles pop as the fingers are stretched by pulling or bending them backwards, creating negative pressure.

So you don’t need to worry about arthritis and can carry on happily cracking but chronic knuckle-cracking may lead to reduced grip strength. And there are reports of injuries suffered while people were trying to crack their knuckles. So perhaps its time to stop if you can!

How do I know my memory loss is a sign of ageing and not dementia? 

Bear with me… I can’t remember, it will come to me!

If the above is something you say often, it's most likely just a busy brain that is pretty full and wearing the effects of age. But it is an interesting question… how do you know? Well you will be pleased to hear that there are some simple standard tests to help you.

Whilst some memory loss is a normal part of aging, dementia is not. The worsening mental ability seen in dementia is much more serious. The time to think about a diagnosis of dementia is when your symptoms are significantly affecting daily life. So if you are having difficulties completing daily tasks about the house, at work, in the community you do need to see your doctor. If you go in to a room and forget why you went there or can’t recall a word or somebody’s name, that’s likely normal.

But can we be more scientific about it. Well there are definite areas of changing cognition which are not part of normal aging and can be seen in:

• Memory loss
• Confusion and needing help with daily tasks
• Problems with language and understanding
• Changes in behaviour

So in terms of examples of normal versus possibly dementia think about the following:

Memory/New information

Forgetting something you were told a while ago is likely normal but forgetting something you were told very recently is potentially not normal. And repeatedly asking about it is a concern, so asking ‘is the car locked?’ repeatedly might be a sign of concern.

Misplacing your keys or glasses from time to time is not concerning, but putting them in odd places repeatedly, like in the fridge, might be.

Planning/decision making

Making the occasional mistake when paying a bill is fine but being unable to cope with your finances, pay bills or plan is a worry.

Mood and behaviour

Occasionally feeling low or sad affects everyone but feeling constantly sad, anxious, frightened with a loss of concern may be a concern.

Orientation

Bring unable to place the day of the week or month occasionally and in the moment is likely normal ageing. Completely losing track of the time, day, date and season is not normal.

Language

Occasionally being unable to find the right word but it will come eventually happens to everyone but frequent difficulty in word finding and it never comes or finding yourself compensating with ‘that thing’ may be a concern.

Vision and perception

Any visual issue is not normal and should be investigated but may be normal eye aging and prescription changes or cataracts and these are not signs of dementia but being able to judge distances, perceive where a step is, mistake object shapes for other things may be.

So that’s a whistle stop tour of how you can differentiate between dementia and normal aging. For more detail, there is good information here.