Editor’s Note: This was recorded prior to Wegovy being approved for cardiovascular disease. View the story here.
This podcast episode explored the complex issue of celebrity influence on trends related to weight loss drugs and body image. Experts discussed how celebrities have long shaped aesthetic ideals in plastic surgery and beauty standards through their own appearance choices. More recently, social media posts from influencers promoting weight loss journeys using GLP-1 medications like Ozempic were analyzed. While this advocacy could boost awareness of obesity as a medical condition needing treatment options, it also risked promoting unsafe practices. Concerns were raised about potential restrictions to access for vulnerable patients who require these therapies. Overall, the episode provided insightful perspectives on both the positive and negative impacts of celebrity endorsement in health care. The role of pharmacists in properly educating patients emerged as important to ensure the safe, regulated use of emerging weight loss medications.
Timestamps
0:00:42 - Celebrity influence on aesthetics
0:03:18 - Social media trends and pediatrics
0:09:06 - Study on celebrity endorsements
0:11:49 - Response to Wegovy and social media
0:15:40 - Access issues and disparities
0:16:14 - Concerns about compounded drugs
0:20:02 - Supply chain issues and shortages
0:22:38 - Dangers of compounded semaglutide
0:27:59 - Celebrity influence and supply chain
0:31:20 - Oprah discusses medication responsibility
0:35:49 - Addressing obesity as a medical issue
0:40:41 - Celebrity power and techniques
0:42:30 - Pharmacist role in patient education
Experts Include:
Patricia Mars, MD, owner and medical director of Venus By Mars Cosmetic Surgery and La Paloma Surgery Center; Donna H. Ryan, MD, Professor Emerita at Pennington Biomedical Research Center; and Christina Madison, PharmD, FCCP, AAHIVP, the Public Health Pharmacist.
Key Takeaways
1. Celebrities have long shaped cultural ideals around aesthetics and beauty through their own appearance trends.
2. Social media promotion of weight loss journeys using GLP-1 drugs like Ozempic by influencers increased public interest, but also risked unsafe practices without medical oversight.
3. While celebrity disclosure of personal experiences can boost awareness of obesity as a medical condition, it's important for endorsements to encourage safe and supervised use of pharmaceutical therapies.
4. Compounded versions of medications like semaglutide lack proper quality control and approval, posing potential dangers.
5. Pharmacists play a key role in educating patients on appropriate and regulated use of emerging weight loss therapies.
References
- Han SH, Safeek R, Ockerman K, et al. Public Interest in the Off-Label Use of Glucagon-like Peptide 1 Agonists (Ozempic) for Cosmetic Weight Loss: A Google Trends Analysis. Aesthet Surg J. 2023;44(1):60-67. doi:10.1093/asj/sjad211
- Arillotta D, Floresta G, Guirguis A, et al. GLP-1 Receptor Agonists and Related Mental Health Issues; Insights from a Range of Social Media Platforms Using a Mixed-Methods Approach. Brain Sci. 2023;13(11):1503. Published 2023 Oct 24. doi:10.3390/brainsci13111503
- Quddos F, Hubshman Z, Tegge A, et al. Semaglutide and Tirzepatide reduce alcohol consumption in individuals with obesity. Sci Rep. 2023;13(1):20998. Published 2023 Nov 28. doi:10.1038/s41598-023-48267-2
Ashley Gallagher
Hello, I'm Ashley Gallagher from Pharmacy Times and you're listening to the Pharmacy Focus mini-series, Star Power: Celebrity Endorsements in Pharma, a 4-part series, including pharmaceuticals, vaccines, Ozempic, and public health. In this episode, we talked about aesthetic trends made popular by celebrities as well as the impact of celebrities on Ozempic for weight loss. The episode will also discuss other potential benefits for GLP-1 medications. Patricia Mars, owner and medical director of Venus by Mars, a cosmetic surgery center, started the conversation with a brief overview of aesthetic trends and the celebrity impact.
Patricia Mars
We know about celebrity influence all the way back in history. I would say once print started, magazine started, and television started, there came celebrity changes in the aesthetics. If you look back as far as let's say, we look to the 1920s and we look at flapper girls and the aesthetic, they're the thin brows, very thin, like everyone followed that same aesthetic and so whoever was rich and fluent during that time, affected everyone else, so everyone else followed that same kind of aesthetic. Then if you look into the 1950s, then the shape kind of changed, and everyone was a little bit curvier, kind of like Raquel Welch. So that aesthetic became popular during, I would say, the 50s. Then if you look at the 60s, it was someone like Twiggy, that very thin aesthetic. She was the model of the day and the look of the day, and so let's go now forward to the Kim Kardashian look. The aesthetic now is the [Brazilian butt lift], the large buttocks area, and the tiny waist and all of that aesthetics. I mean you see that all influenced in music and hip hop and just culture all over the United States, particularly down in Miami. Again, that's another celebrity influence and everyone follows.
I think it's really common. The other ones that have kind of been more recent, I would say kind of that sculpted cheek look. I don't know if you've seen that look at that buckle fat pad removal. Now we're looking at aesthetics that are influencing surgery and celebrities that are influencing trends in surgery. You can look at something like the kind of sculpted cheek lines in a Bella Hadid look where you're super sculpted in the cheek. I think like Chrissy Tegan is who had supposedly done that sculpted removal of the buckle fat pad. The other trend that happened maybe about 2 or 3 years ago, that again, aesthetic surgery was affected with the kind of fox eye where the eye was kind of really slanted up, I think it's just whatever is trendy with the celebrities, whether it's the aesthetic look of the body, the breast, the butt, the face, then it kind of just follows into the rest of the United States and into the world. So, yeah, it's been going on forever.
Ashley Gallagher
Likewise, Donna Ryan, professor at the Pennington Biomedical Research Center, added to the history and spoke on the effects of celebrity endorsements and social media trends. She also expanded on what this can mean for pediatric populations.
Donna Ryan
I think, to understand this, you have to understand that we all have certain celebrities that we admire and want to emulate. This has been around a long, long time, I think back to my childhood and the cereal boxes that have my heroes, my sports heroes on there. But certainly, it's pervaded television, print advertising for, really since those things existed, but the big change here that's going on is social media and the impact of these influencers, celebrities who just seem they're celebrated, mostly because of their ability to influence us. That's something that's new, and it's something that's very different. When you're around these young kids and observe their behaviors, you see how good they are with all the technology and their smartphones, and my grandchildren have to teach me about how to use the smartphone. They are great at it, and they are all on social media. They all want to fit in. Part of growing up is learning how to be part of a social group. They're very much influenced by what they see and what they hear on their social media platforms. What these influencers can do, if they're not ethically responsible, is they can really promote unsafe health practices, and it would be unsafe to take these medications if you don't meet the medical indications for them, and I think kids are also exposed to, they compare themselves with what they see on these social media platforms. It can create unrealistic expectations about what we ought to look like, what we ought to want to look like, and how we ought to want to behave.
I think it can promote this culture of comparison, comparing your body to someone else, comparing the celebrity to how she or he used to look. It can result in body shaming, and bullying, which is not a good idea. Over the weekend, I watched the documentary about Taylor Swift, and what was really good about that documentary is she seemed to have a very strong ethical responsibility to how she was being perceived by her fans. So as a celebrity, that ethical responsibility to your fans, I think, is something that we need to encourage and promote. She talked about how people would shame her on social media if she was caught in a pose where her stomach pooched out. She talked about how difficult it was to bear that and how it changed her behavior, and how she started adopting unhealthy eating practices, and she had to refrain from listening to that noise, from seeing that, because it's much healthier, as you grow up to get to have a little bit of extra energy storage when you're going to do your big concert, for example.
I think that is a very healthy sort of thing going on. There's been a lot of promotion of the body positivity movement, and we do need to be more accepting of variation in body size. Interestingly, some of the influencers who do have large body sizes, they really promote a healthy lifestyle, healthy eating, active living, being physically active. Some of these influencers were really offended when they were approached to promote these newer weight loss medications. I think what's going on there is industry, the pharmaceutical industry is not doing that. But where that's coming from is the off-label users like the medical spas that are using hopefully, the real thing off label, but they may be using some of this compounded stuff. Most of the body positivity movement influencers were offended, and rightly so that they would be asked to promote these weight loss drugs. I think that the whole area of weight management is, in a way, it's the victim of our culture, which has such an inordinate value on slimness. We need to get away from that; we need to be thinking about health. It's about how you feel, how you function, what your risk factors are, how healthy you are. That's what it's about. It's not really so much about how you look.
Ashley Gallagher
In a study published in Aesthetic Surgery Journal, Mars and colleagues found that celebrity endorsements have led to an increase in Google searches for Ozempic and other semaglutide products. Dr. Mars said,
Patricia Mars
I don't really think it was surprising because we saw so much information on Tik Tok and on Instagram. To me, this study was just confirming what we kind of already knew that there was this massive trend about people losing weight and what they looked like before and after Ozempic and everyone getting thin, and then all of these celebrities getting thin. I feel like it was kind of an expected result. It was nice to see on paper. It's nice to see that you research it, and you look for it, and you find that, indeed, the trend was huge. It just kind of confirmed what we already saw happening in front of our eyes that this is an incredible drug. I think it's an incredible drug; it's helping in so many other aspects besides control of diabetes and weight loss. It's a billion-dollar industry right now. I think it was kind of heading that direction. This research that was done just kind of confirmed what we already knew it was happening. I think the thing that I saw, the most identifiable name is Ozempic. Of course, Ozempic is the one that's used for control of diabetes, control of blood sugar, and the side effect of using that was found to be weight loss.
Ashley Gallagher
Dr. Ryan discussed the response for Wegovy, a GLP-1, indicated for medicated-assisted weight loss, as well as the impact of social media and why it is important to discuss the medical benefits for GLP-1 medications.
Donna Ryan
I think the big phenomenon that we all observe with these weight loss drugs was with the introduction of Wegovy. It was approved and put on the market in the summer of 2021, and immediately, it sold out. The company in no way anticipated the response to this medication. It's the first one that produces double digit weight loss on the average of about 15% to 17% of people who don't have diabetes, so robust weight loss. This is a prescription medicine. The thing that made it so popular, made it sell out, was not the doctors being detailed and understanding how this could help their patients’ health. It was the social media platforms where celebrities were posting their weight loss results with this. More often than not, those celebrities did not meet the criteria, the indication criteria, that are FDA provides for treatment with these drugs. They were using them strictly for cosmetic purposes. There was a year shortage before patients who really needed it could get it. What happened was people moved over instead of Wegovy, they took the same molecule, which was approved for diabetes, and that's Ozempic. They were taking Ozempic really off label, not just not for diabetes, but not really because you met the weight loss indications for Wegovy, the same molecule. It was, I think, that just shows the power of the influence of these of social media personnel.
It's kind of a double-edged sword, it's something that's very powerful. It can influence people, it can influence people for good, but it can also influence people for bad. When social media celebrities admit to taking these medications, they're not talking about the health benefits, and the health benefits are very powerful. These drugs can be life saving for people who need them. For people who have diabetes, they lower the hemoglobin A1C by 1 or 2 percentage points. Excellent. For people who have prior cardiovascular disease, it was just shown in the SELECT trial that semaglutide reduce the risk of stroke and heart attack by 20%. So very, very powerful health benefits. These drugs are also being shown to be potentially effective in preventing the need for dialysis and preventing kidney failure and having effects on atrial fibrillation. Wouldn't that be wonderful? There’s another study for Alzheimer disease and dementia, so lots of very, very interesting effects of these medications beyond weight loss. These are true medications that have powerful, wonderful health benefits. When our social media stars start promoting these just for cosmetic weight loss, wait a minute, these are real medications, and they have side effects. They have serious side effects, and you should not be taking them under certain conditions. It's a bit scary.
Ashley Gallagher
Semaglutide and tirzepatide has been studied for alcohol consumption as well as mental health disorders. According to a study published in Brain Sciences, after the initiation of GLP-1s, the weight loss was associated with changes in mood, anxiety, insomnia, and addictive behaviors. The changes were both positive and negative. Another study published in Scientific Reports provided real-world evidence that showed a reduction in alcohol consumption for those taking semaglutide or trizepitide. Dr. Mars agreed with Dr. Ryan saying,
Patricia Mars
They're doing all sorts of studies, and usually these studies have been well thought out. There have been several, of course, that have looked at more than just Wegovy and Ozempic. But have also looked at other of the GLP-1 medications. There's several of them that are injectable, just like Wegovy and Ozempic, and some of them are now even oral. A bunch of studies have now been done on almost, I'm not gonna say all of them, but many of the GLP -1 inhibitors, so they're a whole class of medications. Then they're made by different manufacturers, most of them are injectable, some of them are now oral. What's happening now in kind of the pharmaceutical industry is they're making ones that are maybe longer lasting, so that you don't have to inject every week. They're being manipulated in ways that they'll have less side effects, easier to take longer lasting, and maybe not injectable.
What they're studying now is that because there is this connection between the GLP-1, and not just the gut, but central nervous system, is that there's many other things that can be affected. What they're studying now is Alzheimer, Parkinson disease, drug addiction, bulimia, anorexia, gambling, any type of behavior that's obsessive compulsive, all of these kinds of behaviors, even gambling that are excessive, and guess what eating is one of those behaviors, that's excessive. All of these type of behaviors can be affected by a GLP-1s. In fact, I know some surgeons that are using a GLP-1 on patients that are on narcotics. They're on prescription narcotics in order to control their pain, and that's been controlled by a pain medicine. They're using these to get those patients off of their kind of methadone in order for them to have surgery. There's a lot of things that it's affecting. So that's why I think the good outweighs, kind of the risks of GLP-1s.
Even though you have to be on these long term, and maybe some people have to be on it permanently. Well, guess what we're on things permanently for our thyroid, we're on things permanently for diabetes, we're on things permanently for blood pressure control, look at all these things, and all these the research that they're doing in order in order to determine the benefits of GL-1s. So again, Alzheimer, Parkinson, I'm not sure about the central nervous system effect and why GLP-1 may improve these. I'm not sure about that connection. But the other ones that I mentioned, the behavioral issues, like gambling, bulimia and anorexia, drug addiction, smoking cessation, all of those things, I can see why they're be being affected by a GLP-1 because those are affected by the central nervous system, and there's an area of the brain that controls satiety, or, our desire to be fulfilled and have satisfaction, and that's what the GLP-1 is affecting. It goes to that center, and there are receptors where the GLP-1 sits and it says to the brain, ‘I feel good, I'm satisfied. I don't need to do this behavior,’ whatever it is.
Ashley Gallagher
Due to the public's interest in these drugs, there was a shortage of these medications. According to Dr. Christina Madison, the public health pharmacist, the companies producing these drugs did not anticipate the high demand.
Christina M. Madison
The first is that it does make me a little bit concerned, because we do see that this particular product, the manufacturer did not anticipate the demand. So they have had a really hard time keeping up with the amount of demand for the product, not necessarily for the weight loss aspect, but for people who actually need it for type 2 diabetes. These are people who have been maintained on this product that have had amazing results, we know there's heart benefit, on top of the actual loss of weight that people get, as well as glucose, glucose lowering and normalizing that they get from the GLP-1s. So that's my concern, is that the people who really do need this, and it's not for significant weight loss, it's really more for something that can be done with diet and exercise. On average, most patients lose anywhere from 30 to 40 pounds. If you're somebody who just wants to lose 15 pounds, and now you're taking it away from somebody who legitimately needs it, that's where my concern comes into play. Yes, they're not necessarily being paid to talk about Ozempic. But they are perpetuating that people who have money, right, because these products are expensive, are taking it away from somebody who really does need it or their health and wellness. I think that's where the concern comes in, and where we see an inequitable space, especially with access to historically marginalized communities, ethnic communities. That's where my concern is that this is really causing a divide between the haves and the have nots, and people who legitimately need it and can't get it. Then people who legitimately need it and then can't afford it are basically being side barred by people who can just say, “Oh, I'm going to just buy it and use it for myself,” because they have the means.
Ashley Gallagher
Dr. Ryan echoed agreement discussing compounded semaglutide products and why this could be problematic.
Donna Ryan
When legitimate sources for Wegovy and Ozempic dried up, well guess what? These compounding pharmacies stepped in to a vacuum and started importing non-[active pharmaceutical ingredients] semaglutide, trizepitide, even drugs that are not approved yet, retatrutide, that these compounding pharmacies are promoting the use of these drugs. This is not API, they're not in a formulation that has been studied and proven safe for humans, and some of them don't even have the drug in it. I don't know what they're doing. In most cases, these products are coming from China, they do not have the quality control on them. They have not been shown to be safe in humans. So when your plastic surgeon says, “oh, these drugs are available,” yeah, if you Google these drugs, you're the first thing you're going to find is these compounding pharmacies promoting these drugs. These are not the real drugs, the real drugs that are approved by the FDA and an API formulation, and were very, very difficult to get beginning in the summer of 2021, and really all through until the end of 2023 that it became easier. Look, these are peptides. It is difficult to make a peptide.
Novo Nordisk who had the first drug out in the field, semaglutide, which is marketed as Ozempic for diabetes, and it's marketed as Wegovy for weight management. They produced all of their product in Denmark, in 1 factory in Denmark. They have since begun construction on the second factory in Denmark, a third factory in France, but to produce these products these peptides are not simple. After the product is produced, it's shipped over here in barrels in dried form and then is formulated into the pens that are dispensed. Eli Lilly with trizepitide has done a bit better in meeting the demand. They actually went out and contracted with factories that had been making COVID vaccines, if you can make a protein for a vaccine, you can make a protein like trizepitide or semaglutide. So they've had less problems with drug availability, but there are still to this day problems getting some doses of Wegovy.
I think there’s nothing wrong with improving the way you look, I don't want to disparage cosmetic procedures or cosmetic treatments; they make us feel better, they make us feel better about ourselves, there's nothing wrong with that. But the treatment has to be balanced against the risk, the benefit has to be balanced against the risk. So when your benefit is strictly cosmetic, you have to have a very, very safe product, right? If your benefit is improving diabetes, or chronic disease, or obesity associated with sleep apnea, with diabetes with dysglycemia, with all the complications, if that is your risk, if your benefit is against that you can accept more risk. Pharmacists know this; they understand that risk-benefit equation. I don't think that our social media influencers who are not health care professionals, I don't think they understand that risk-benefit equation. Look, the GLP-1 receptor agonist, as a class are associated, fortunately, rarely, but with acute pancreatitis, that's a serious disease. They're also associated with it, we don't give them in in people who have a history or family history, imaginary thyroid cancer or a multiple endocrine neoplasia type 2, because in rodents, they produce those thyroid cancers. We haven't shown this in humans, but we're surely not going to test it out in people who've already gotten thyroid cancer or who are who are at high risk for it. So it's contraindicated there. These medications are wonderful, they are, I truly believe this is the most significant discovery in my lifetime. The ability to reverse the health consequences of obesity, severe obesity, but we need to be careful about this treasure that we've uncovered, and not use it foolishly.
Ashley Gallagher
However, Dr. Mars added that she believes celebrity endorsements did not affect the supply chain. She added that she believes it's the fault of the manufacturers.
Patricia Mars
I think in in a couple of ways. Number one, we know the flow of drugs is through the pharmaceuticals that make them. If their supplies are running a little low, like they did during the pandemic, maybe there would be a negative influence if you know, celebrities are saying run, go get your Ozempic or you Wegovy. Then, everyone's using up those supplies, but I really feel like that supply chain negativity and problem really is on the fault of that, is really on the manufacturers and the makers of the drug. I can't actually believe that the masses would be able to buy up all of those prescription drugs to the point where it would be lacking for a diabetic who's using it.
So why does that really happen? You really need to follow the money. And if there's all of this news and all of this information about Ozempic and Wegovy, those manufacturers are going to make more money, regardless of whether it's prescription oriented or whether people are getting pharmaceutical products that aren't made by the original manufacturer. So yes, there can be negative impact but I'm also wondering, if it's also a way for those manufacturers to get their drugs more noticed by the masses. I'm not sure it's that all that negative impact that people are saying, “oh, these celebrities are all getting thin and now the people that actually need it don't have it.: No, I just can't believe that supply chain is due to all of these masses of people taking over the prescriptions that's really just not possible. What they are now using are the ones that are not from the original prescription, you're using ones that are pharmaceutical grade that are being manufactured by pharmacies, and not by the actual, like NovoDisk, who is the one that manufactures Wegoby and Ozempic. So that's my thought about that. Yes, there can be some negative connotations from the overuse, I think it's really the overuse and for celebrities getting too thin and not looking very healthy. I think that's the negative connotation. I don't think the negative connotation is that people won't have access. But that's kind of been what the press has been about people who are celebrities who have been sothoughtught to be on Ozempic, and they're like, “oh, no, I would never use that. That's for the diabetics, and I wouldn't want to take it away from them.” That supply chain is not due to overuse from regular people that don't have a prescription for Ozempic and Wegovy. That's my thought on this.
Ashley Gallagher
Oprah Winfrey is a good example of a celebrity who took a GLP-1 medication and discussed her issues with weight loss, Dr. Mars said that responsibility is key when taking these medications.
Patricia Mars
I think you know, of course, if you have a celebrity that admits to taking it like Oprah Winfrey has admitted to taking it. She's freely admitted it. If you have, I think, someone with that scope of power, and a large following. I do think that there could be benefits from them saying, “hey, everything should be done in a way that is safe because there are risks with these medications. It's not risk free.” As we know, there's several risk factors that need to be looked at and several issues that can happen while you're taking it. So you need to be well informed and having a celebrity say “hey, you need to be followed by a physician or let your physician know” or make sure whoever's providing you with this medication is following your labs or has asked the appropriate questions because I use Ozempic in my practice, and we use it under the name of semaglutide. But I follow my patients carefully. We do we have a history and physical that we do. We do use screening tests to make sure that they don't have a history of neoplasia, particularly in the thyroid, and then I do a slew of tests in order to see where they're at right now, making sure their pancreas, their kidney, and their liver are in good health before I put patients on it. So you want someone doing that. Your patients can go to med spas right now and pick up the the pharmaceutical grade compounded version without any examination, without any questions without, knowing anything about their family history, or their health or what their laboratory evaluations are with respect to their kidney function, and their liver function, their pancreatic function, which can be affected by these medications by GLP-1. So yes, I do think it would be awesome if there were celebrities saying “hey, this is a great medication, but you really do need to be it needs to be done under the proper supervision.” I think that would be very beneficial, and would there be even a greater response with more people interest probably, if it would be possible for there to be even more interest, I mean, this is a multibillion dollar industry now, just where we're at right now, without you know, all of these future GLP-1s that are kind of in in the making with various drug manufacturers, so I think they're kind of here to stay.
I think the reason why so many people are seeking them and getting them not from the manufacturer because they're it's super expensive. You know, Mounjaro is even more expensive than Wegovy and I think Wegovy is more expensive than Ozempic, which doesn't quite make sense but out of pocket to get a prescription from your physician for the actual real prescription product is super expensive. I feel like that's why all these people are on the pharmaceutical grade product that's being manufactured by compounding pharmacies. It's just that it's so expensive, and people don't have the out-of-pocket expense to pay for the actual prescription. So, if you had a celebrity talking about all of the positive things from this medication, and getting the proper follow up, even if it's in in the face of not actually getting it from the original prescription from the manufacturer, then I think it would be beneficial. And yeah, I do think it would explode the industry even more, if that's possible.
Ashley Gallagher
Dr. Madison added that awareness about obesity and medicated assisted weight loss is okay. And it does help with health. She said that viewing these drugs as vanity products is a huge issue that needs to be addressed.
Christina M. Madison
First and foremost, I think there's a lot of fat shaming. There's a lot of fat shaming out there, there's a lot of this misperception that people who are overweight are choosing to be overweight, and that they are overeating, that they have poor diets, that they don't exercise, which is not always the case, and that oftentimes, it's genetic. That it's because they lack access to healthy food options, because they live in an area that has food apartheid. I tend to not use the term food desert, because the term desert to me makes it sound like it's natural, it is unnatural that we do not have areas of this country in the United States that people have had the ability to get fresh fruits and vegetables. I really do think that it is food apartheid. So, when we think about ways that we can help people, and how we can show them ways that you can have healthy choices that you can maintain a healthy weight. If you need medication assistance, it's okay. Part of this is the acceptance of being able to use a medication in order to lose weight. I think that's the upside of this is that now we're seeing more acceptance of people using medications to lose weight, talking about the overall long-term health benefits of maintaining healthy weight. My only concern is that we see insurance companies looking at this as a vanity product, and not a long term chronic medical condition, which is what obesity and being overweight is. I think that awareness is the key. Right? And so, wherever we get that awareness, I may an eternal optimist. So yes, there may be a few downsides. But I think we are starting the conversation, and the important part is that we're having the discussion about obesity, and people being overweight, as a chronic medical condition. That is different than the conversation that we had when you were saying the sort of the weight loss craze in the 80s, when we were seeing like phentermine and like epinephrine and all these things being used, which was terrible for heart health, which is very different than the GLP1s. And I think, the awareness and having the conversation and having the dialogue, especially when we're seeing celebrities talk about it, because it's like, oh, they're just like us, they have problems with their weight, too, and it does humanize it, and it does make it seem like it is more relatable than just only being for the elite or someone with a private chef and a personal trainer. Even those people need help, too.
I think that's part of the upside of seeing these people openly talk about the fact that they are using assistance for weight loss. I know that Oprah came out and said she's not quite at her goal weight, and she did say that she did use the GLP-1 to help her. But she was really honest. And she's like, I have a personal chef. I have a personal trainer and I just couldn't lose the weight and she was like; “this is the only thing that's really helped me to be able to get and to be able to maintain a healthy weight without making me starve myself to death.” And so, I think that's important. It's important for that dialogue and for that conversation to be out in the public, because now, there are people that are probably like if I hadn't heard it from her. I didn't even think that this could be something that could be accessible to me or that she's talking about it publicly. So maybe I should start talking with my health care professional to see if this is something that would be right for me and for my personal health care needs.
Ashley Gallagher
Dr. Ryan offered agreement saying that celebrities have a lot of power when promoting these medications and other weight loss techniques.
Donna Ryan
I recently saw something about Rosie O'Donnell, who does have diabetes and is taking these. Another example is Oprah. Yes, Oprah is taking them, and she met the indications and good for her, so I think that celebrities have so much power that we have to find a way to use them appropriately. A good example of how celebrities can help people is Dan Marino. He was a spokesperson for Nutrisystem; he got a lot of men taking Nutrisystem, which is a pretty healthy approach to losing weight through changing your diet. Other celebrities have endorsed Weight Watchers, they've endorsed Jenny Craig, these are all evidence-based approaches to losing weight safely and effectively. I think we could do the same thing with these medications. I don't see pharma embracing this, however. I know first of all, there's already a lot of interest in this. And I think the 2 companies that have drugs in the marketplace, Eli Lilly and Novo Nordisk, I don't see them embracing celebrity endorsements for this. This use, I think, their intention is more to make certain that their drugs are used appropriately and safely. They don't need the celebrity endorsement. Patients who have complications of their obesity are seeking help, and that's a good thing.
Ashley Gallagher
In conclusion, Dr. Ryan added that pharmacists have a unique role in helping to educate patients on weight loss and medicated-assisted weight loss.
Donna Ryan
I think our pharmacists are really dedicated professionals, and they've got a good head on their shoulder about nonsense. They understand the power of these medications and they want them to be used appropriately, they have as part of their mission, patient education. They want to make sure patients are using the drugs appropriately, the right patient is getting the drug, they want to make sure the patient is using the drugs safely. They don't want to see any mix ups there. I think that the pharmacists are not so much around the hype of these medications because they have a difficult time getting the drugs in stock. They can sell as much of it as they've got. What they really want to see is a safe use of these drugs appropriately because they do have such power to help people and I think that's what pharmacists are interested in. They want to see the regulatory compliance. I think to understand these medications, you need to understand that they've been a long time coming. They are truly based on our understanding of the biology, of food intake, regulation, and the metabolism of nutrients. Understanding that is really led us to target the GLP-1 receptor. When we eat, food enters the small intestine GLP-1, a hormone is released along with a whole symphony of other hormones. These hormones go through our bodies and go to our brains and tell the brain that food is on the way you can start feeling full. That feeling of fullness comes from the brain, not the stomach. They also affect and influencing the pancreas. They make the pancreas secrete insulin, if the blood sugar is high enough, they have other effects throughout the body that are positive and so exploiting that understanding has led us to identify these drugs.
These are not just appetite suppressant. These medications are powerful drugs that have pleiotropic effects, many, many of them very positive. We have the opportunity to change the way we're managing our chronic diseases, diabetes, hypertension, cardiovascular diseases, sleep apnea. These conditions are filling our offices, and we have the ability to change that disease paradigm. We can modify those diseases with these drugs. This is not about fitting into Marilyn Monroe's dress. It's upsetting to me to see all of this emphasis on cosmetic benefit when we have, on our hands here, something that can really transform how we manage the chronic diseases. And that's our public health challenge.
Ashley Gallagher
I hope you enjoyed this episode of the Pharmacy Times Pharmacy Focus miniseries Star Power: Celebrity Endorsements in Pharma. Tune in next week as we discuss celebrity endorsements and public health. You can listen to episodes 1 and 2 wherever you get your podcasts now. Thank you for listening!
