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CNN Special Reports
"CNN's Dr. Sanjay Gupta Reports: Is Ozempic Right For You?" Aired 10-11p ET
Aired November 23, 2024 - 22:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
[22:00:24]
(BEGIN VIDEOTAPE)
JIM ACOSTA, CNN HOST: It's an industry that's slimming waistlines and creating huge profits. New drugs used to treat diabetes and obesity.
OPRAH WINFREY, AMERICAN TV PRODUCER: There's Mounjaro. There's Wegovy. There's Ozempic.
WHOOPI GOLDBERG, AMERICAN ACTOR AND COMEDIAN: Mounjaro. That's what I use.
GUPTA (voice-over): A weight loss revolution.
UNIDENTIFIED FEMALE: To lose 40, 60 pounds. Your body feels better.
GUPTA (voice-over): Fueled and popularized by high profile personalities.
UNIDENTIFIED FEMALE: You've been working on your health.
UNIDENTIFIED MALE: Know that's Ozempic.
UNIDENTIFIED FEMALE: I'm down 50 pounds.
GUPTA (voice-over): Social media influencers.
UNIDENTIFIED FEMALE: I am 55.2 freaking pound staff.
GUPTA (voice-over): All boasting remarkable results. Even calling these drugs a miracle.
UNIDENTIFIED FEMALE: Thank you Jesus for these injections.
GUPTA (voice-over): A brand new class of medications that are fundamentally changing the way we think about weight and how to lose it. Even changing the way we look at our own bodies and food itself.
UNIDENTIFIED MALE: There has never been a more exciting time to work within the field of obesity.
UNIDENTIFIED MALE: Essentially the more we make, the more gets used.
GUPTA (voice-over): But are these blockbuster therapeutics the future or another fad?
UNIDENTIFIED FEMALE: I looked at all the side effects. That's a no.
GUPTA: You thought not for me.
UNIDENTIFIED FEMALE: Not at all.
GUPTA (voice-over): Are they safe or dangerous?
GUPTA: This is a full warehouse of problem drugs.
UNIDENTIFIED MALE: It's more than full, Sanjay.
GUPTA (voice-over): Should you take it or leave it?
GUPTA: Do you have any concerns about this medication? I mean you're only 15.
GUPTA (voice-over): We weigh in with this year-long global investigation. Is Ozempic right for you?
GUPTA: Welcome to Denmark. This is Copenhagen. Quiet canals, picturesque buildings, pretty laid back lifestyle. It's also a culinary capital. So many talented chefs and acclaimed restaurants call this place home. Which may leave you wondering why did we decide to start our story here?
Well, that's because Copenhagen is also home to one of the scientists who helped identify a key ingredient that is now revolutionizing the entire weight loss industry.
So do you still get excited coming into the lab?
DR. JENS JUUL HOLST, SCIENTIST: I really do.
GUPTA (voice-over): Meet Dr. Jens Juul Holst. He's a scientist, professor and --
GUPTA: Am I interviewing a future Nobel prize winner?
HOLST: That is not to be to decide. If it were to you to decide, please go on, do something about it.
GUPTA: How big a deal is his work in all of this?
DR. GILES YEO, CAMBRIDGE GENETICIST PROFESSOR: I think it is a huge deal.
GUPTA (voice-over): Dr. Giles Yeo is one of the world's leading experts on obesity.
YEO: There has never been a more exciting time to work within the field of obesity because of the tools that are now available to at least begin to tackle the problem.
GUPTA (voice-over): In the 1970s and early 80s, Jens and a small group of researchers around the world stumbled upon a hormone called glucagon-like peptide?
HOLST: Yes, yes, yes.
GUPTA (voice-over): It's now widely known as GLP-1. At that time, though, they were actually looking for a solution to a totally different problem. It had nothing to do with obesity or diabetes.
HOLST: We were really busy with the treating of the bleeding ulcers.
GUPTA (voice-over): Bleeding ulcers? That's right. The original thought was that GLP-1 might protect the lining of the stomach and prevent the acid buildup that causes those ulcers. It was painstaking research. I mean, nowadays drug companies can quickly synthesize these hormones or they can rapidly ferment them in bulk like yogurt.
But back then, however, none of that technology existed, so Jens had to harvest these hormones directly from nature.
HOLST: That's a little bit like the needle in the haystack.
GUPTA: When you're trying to isolate these hormones. First you do it in pigs.
HOLST: They took these 10,000 of intestines from pigs.
GUPTA: 10,000 pigs.
HOLST: And ended up with 10 milligrams of substance, which was the pure peptide hormone.
GUPTA (voice-over): It was a lot of work for a very small amount. And after all that, they didn't even work. The hormones did not help treat the ulcers.
[22:05:03]
But in 1986, scientists did notice something else. It was something unexpected. The hormones Jens helped discover seemed to be increasing insulin production and also decreasing another hormone, glucagon. Collectively, they could help lower your blood sugar, obviously critically important for those with diabetes, a disease that by then was already on the rise, affecting more than 100 million people around the world. So Jens knew this could be big.
YEO: He's a gruff Rottweiler. Don't let him know I said that.
GUPTA: Well, it is on tape.
YEO: Oh, yeah, OK.
GUPTA (voice-over): So the very persistent professor connected with researchers at a local pharmaceutical company. They had heard about his work. That company is now known as Novo Nordisk.
HOLST: They were curious about what we were doing. They didn't believe it. GUPTA: Was their reluctance initially.
HOLST: Yes, yes, yes, yes. The old chemists, they said, why on earth should we bother with these stupid peptides? But they couldn't know that they were so good at that time.
GUPTA (voice-over): To better understand how that hormone was modified to make one of the most popular prescription drugs in the world, we traveled half an hour outside of Copenhagen to Novo Nordisk headquarters.
Right away, we noticed something quite striking. The massive building itself is shaped like an insulin molecule. It reflects the fact that treating diabetes has been that company's primary mission.
For nearly 100 years, Novo Nordisk had most of their revenue come from insulin. So the question was --
GUPTA: Was there a reluctance to do something that would take away from the insulin business?
KARIN CONDE-KNAPE, SENIOR VP OF GLOBAL DRUG DISCOVERY, NOVO NORDISK: Yes, at the very beginning, there was a lot of debate as to why we needed to do something more than insulin.
GUPTA (voice-over): Karin Conde-Knape is senior VP of Global Drug discovery at Novo Nordisk.
CONDE-KNAPE: But luckily for us, we have some very stubborn scientists that really kept saying, you know, we can apply the same learnings that we have done in modulating the insulin molecule to another molecule. And in this particular case, GLP-1 was chosen.
UNIDENTIFIE MALE: So welcome to our peptide lab.
GUPTA: All right, this is it.
UNIDENTIFIED MALE: This is it.
GUPTA: So the magic happens.
UNIDENTIFIED MALE: It is.
GUPTA (voice-over): This is one of the labs where scientists now synthesize those GLP-1 molecules. There's no more pigs like in Jens' lab, just a lot of high tech lab equipment.
GUPTA: How hard is it to make this medicine?
UNIDENTIFIED MALE: Oh, wow, that's a difficult question, Sanjay. It's hard to manufacture it at a large scale, I would say.
GUPTA (voice-over): In fact, it took them decades. Their first GLP-1 like drug for diabetes, a daily injection called Victoza wasn't approved until 2010.
GUPTA: So what is the best part of living in Copenhagen?
LINE SOERUP, OZEMPIC USER: The ambience.
GUPTA (voice-over): Line Soerup was one of the first people in the world to use this medication.
SOERUP: I tried what was called sort of the little sister of Ozempic called Victoza.
GUPTA (voice-over): For her, it. It didn't work. Her blood sugars did not budge. Line did not respond at all to that first generation daily injection. But everything changed seven years later.
UNDIENTIFIED MALE: Oh.
UNDIENTIFIED FEMALE: Oh.
GUPTA (voice-over): Novo Nordisk's second generation GLP-1 like medication. A weekly injection called Ozempic, something almost everyone has now heard of. But at the time it was just a dream, a prayer.
GUPTA: What was your first thought? Pray that it works.
SOERUP: Yes.
GUPTA (voice-over): At first those prayers went unanswered and the side effects were horrible.
SOERUP: The first time I tried Ozempic, I got really sick. It was like being seasick. I was actually panicking a little bit because I knew what once you injected yourself, it would be in your body for a whole week.
GUPTA: That sounds miserable.
SOERUP: So I had to stop very quickly. And then I tried again and the side effects were worse. But then I had another break. And then I tried again. And then. oh, finally it worked for me.
GUPTA (voice-over): For the first time in her life, Line's diabetes stabilized. Her blood sugar normalized.
SOERUP: I was very relieved. Oh, finally this miracle medicine is working on me.
GUPTA (voice-over): And something else amazing happened. She lost weight. A lot of weight. 70 pounds in total.
She called Ozempic the world's easiest diet.
SOERUP: It's easier than all the other failed diets I've been on. It's a good drug to start a journey.
[22:10:10] GUPTA (voice-over): A good drug that helps diabetics pretty clearly. But what about all that weight loss? Was that some sort of fluke or could it help the obese as well, who were not diabetic? Several pharmaceutical companies around the world got busy trying to answer that question.
DR. DAN SKOVRONSKY, CHIEF SCIENTIFIC OFFICER. ELI LILLY: We started working on this. It was for type-2 diabetes. And then what we started to learn is that these medicines could have a very dramatic decrease in body weight.
GUPTA (voice-over): Dr. Dan Skavronsky is the Chief Scientific Officer at Eli Lilly. Now, during those early days, he, like so many others, was skeptical that a diabetes drug could be used to treat obesity.
SKOVRONSKY: These molecules are injectable drugs and at the time it was thought that most patients wouldn't want to undergo injections for treatment of disease. Everyone who knew anything about the pharmaceutical business said, don't work on obesity drugs.
HOLST: To create the market for obesity drugs. I wouldn't have advised them to do it. Thank you very much.
GUPTA (voice-over): But for the man who helped start it all, he's sure happy they finally did.
HOLST: It started back in the 80s, but it has developed through the help of a lot of people and it's been really great to be part of it.
GUPTA (voice-over): Part of a weight loss revolution.
UNIDENTIFIED FEMALE: Ready?
GUPTA (voice-over): And the lives now being changed might surprise you, that when we come back.
(COMMERCIAL BR EAK)
UNIDENTIFIED FEMALE: I lost 50 pounds in six months.
UNIDENTIFIED FEMALE: I was fat and that's when I decided to go to Jenny Craig.
GUPTA (voice-over): It was the early 1990s and Rasheeda Bush was a teenager being bombarded by these kinds of messages to lose weight.
RASHEEDA BUSH, OZEMPIC USER: I think there was just something internal or hormonal that just was not clicking right. I was exercising and limiting my food intake. I was doing everything that they said that you should do.
GUPTA (voice-over): For her the pounds came and stayed.
BUSH: It would not budge at all. And so it makes you feel like a failure.
GUPTA (voice-over): Rasheeda's story is sad and increasingly too familiar.
BUSH: I just wanted to the invisible so it made me more quiet, more shy.
GUPTA: As a teenage girl that I have three of them. It must have been really, really hard.
BUSH: Yes, it was difficult. It was difficult.
GUPTA (voice-over): Even more difficult as she watched her then 15- year-old son Brian deal with these very same issues.
BUSH: There was one time where he had just come home from school and had a rough day. He just started crying and just saying that they were, like, picking on him, talking about his weight. And I'm just telling him, like, you're beautiful, Brian. You're handsome. And he said, I'm not handsome. And I just broke my heart. That broke my heart.
[22:15:17]
GUPTA: Breaks my heart to hear that. I'm sorry.
BRIAN BUSH, RASHEEDA BUSH'S SON: I was like 370 at 13 years old.
GUPTA: 370 pounds?
BUSH: Yes.
GUPTA: How did you feel when you weighed that much?
BUSH: I actually felt bad for myself. I wouldn't want to go outside. I didn't want to play with people. I just wanted to stay in the house. It was just like a little bit of depression, really. I also have social anxiety, too.
R. BUSH: They make assumptions about what you're eating, how you're exercising, the choices that you make. It's an acceptable way to judge someone, and I think that's unfair.
GUPTA (voice-over): The stigma is something Dr. Giles Yeo has been fighting his whole career.
YEO: I was at a dinner and someone asked me, what do you do? What do you do? And I told him this. I said, I studied the genetics of obesity in children. And he said, do you know what your problem is? And he went, you give fat people an excuse. And that was and actually still, by and large, is the response I get.
GUPTA: They're fat shaming, essentially.
YEO: Pretty much. The problem with body weight is that people think it's some kind of choice. If I said, I'm studying the genetics of cancer, no one is saying you're giving people with cancer an excuse, right? Never. GUPTA (voice-over): Over the years, the evidence has become
increasingly clear on this. For so many people, obesity is not a choice.
YEO: We now know of over 1,000 genes that play a role in our body weight. It's sort of like a thermostat, OK? Where for some people, a thermostat is set at whatever temperature it is in a house, whereas for other people, that thermostat is set slightly higher, slightly lower. And so, if it's set higher and you end up having to eat more, you're going to be larger than someone else.
GUPTA (voice-over): It's why obesity is now considered a disease not of the intestines or your stomach, but of the brain. It's a huge shift in the way that we think with huge implications for treatment. But these are still early days. And remember, at one time, even depression and addiction were seen as failures of willpower instead of a brain disease, changing the perception of obesity. That's going to take time.
SKOVRONSKY: It's definitely true that there are people out there who said time and again, obesity is not really a disease. All you need to do is eat better and exercise more and you'll be OK.
GUPTA (voice-over): Rasheeda was one of them. It has taken her years to see past the promise of those weight loss ads, to see her weight as a disease in and of itself. Especially since she never had the serious health issues associated with a high body mass like diabetes or high blood pressure, fatty liver disease, heart disease, stroke.
BUSH: I was 355.6 pounds. I didn't have like traditional health issues that you would have being overweight.
GUPTA: If somebody has a high BMI, but they have no other comorbidities, is it still a disease?
CONDE-KNAPE: Some of the scientists in the field like to call it the happy obese. I am not necessarily believing in that concept. When you're looking at the individual, all the other parameters seem to be in check. That does not mean that this individual may not be in a progression towards developing these other comorbidities or other indications.
GUPTA (voice-over): It's that progression. Rasheeda's doctor, John Venuti started to see in her, so he recommended Ozempic.
JOHN VENUTI, RASHEEDA BUSH'S DOCTOR: She was starting to get pre diabetes and I thought it was a perfect opportunity to get her started.
BUSH: I looked at all the side effects and I said, no.
GUPTA: You thought not for me.
BUSH: No way. Not at all.
GUPTA (voice-over): But then in 2020, everything changed. BUSH: If you were black, you were overweight, you had a greater risk
to die from COVID.
GUPTA: So you went back to your doctor and said, let's try this.
BUSH: Yes. I was like, I'm ready.
GUPTA (voice-over): Rasheeda started with a low dose of Ozempic. She had no side effects, but no positive effects either. So her doctor increased the dose.
BUSH: I couldn't keep anything down. I was throwing up water. I went to the hospital and got some fluids in me because I was dehydrated.
GUPTA: That sounds kind of scary.
BUSH: It was pretty scary. But I had a different mindset at that point because I said, I want to try it one more time and see if I'm still having the same side effects.
[22:20:03]
GUPTA (voice-over): And this time, something very different happened. Something she had never experienced before in all those years of dieting.
BUSH: What it did help me was not have a whole lot of thoughts about food. My cravings went away.
GUPTA (voice-over): Those voices in her head that had made her crave food. Experts call it food chatter. They were silenced. And that is part of the magic of these new medications.
GLP-1 seems to act in a way that no other known hormone can. Here's how it seems to work. Every time you eat, all sorts of hormones are released. Like GLP-1. They are called post-nutrient hormones.
They travel here to the hypothalamus and the brain to tell you that you are full or satiated. They also travel over here to the pancreas to kick out more insulin to help absorb the energy you just consumed, and also over here to your gut to slow down the emptying, allowing you to better digest your food.
In so many ways, it seems like the perfect hormone to help you stop eating as much. Seemed perfect for Rasheeda. In that first year, she lost 100 pounds. It changed her life. And then in December of 2022, the FDA approved the weight loss medication called Wegovy for adolescents.
Brian's doctor, a pediatric obesity specialist, recommended it. Now, to be clear, it did not come without concerns.
BUSH: I have family members that don't think it's a wise choice. They just don't feel like it's a good thing.
GUPTA: Do you have any concerns about this medication? BUSH: The only concern, I'll say, is there any other side effects
besides my stomach cramps? There's probably only one.
GUPTA: How has your lifestyle changed on these medications, your diet, your activity?
BUSH: I used to get seconds and thirds, so I don't get that no more. My mom, she tried to take away the processed foods and all that.
GUPTA: Do you miss those foods?
BUSH: Not really.
GUPTA (voice-over): It was a reset, as Dr. Yeo would say, a reset of Brian's body and his mind, a reset of that thermostat. And this probably won't surprise you. As more young people have struggled with obesity and diabetes, the number of prescriptions in this age group for these new weight loss and diabetes drugs has skyrocketed nearly 600 percent since 2020.
BUSH: It's like a new start for me. Basically, I feel like I can just do anything now.
GUPTA (voice-over): Brian and his mother have together lost more than 200 pounds. It was something they never thought possible. And I wish we could end the story there. But mother and son were about to embark on another fight.
BUSH: The prior authorization was denied.
GUPTA: That when we come back.
(COMMERCIAL BREAK)
[22:27:51]
GUPTA (voice-over): As the sun sets on a beautiful spring night in Williamstown, New Jersey, we arrive for another visit with Rasheeda and Brian Bush. We're just in time for their weekly shots.
BUSH: He stings, but it goes right away.
GUPTA (voice-over): This is a routine which has helped them lose more than 200 pounds. They have never felt better. That is, until tonight.
BUSH: Last shot.
GUPTA (voice-over): Last shot of a drug that she credits with changing their lives.
BUSH: I've made a lot of progress and I can't turn back now. This was just emails.
GUPTA (voice-over): You see, after losing her job and her insurance, Rasheeda can no longer afford her monthly supply. Keep in mind these are wildly expensive drugs. For her, $1,600 every month. GUPTA: Does it feel like the clock is sort of running on these
medications?
BUSH: It does.
GUPTA (voice-over): It's not the first time this has happened. Last year, her insurer stopped paying for Ozempic. That's the medication she initially had so much success with. It was why she switched to Mounjaro, a drug similar to Ozempic that's made by Eli Lilly. But now she's at risk of losing that as well.
BUSH: I think it's utterly ridiculous.
VENUTI: And last one, it's been extremely hard. At least 10 patients a day cannot get these medications.
GUPTA (voice-over): Here's the problem. Private coverage varies from company to company, and even Medicare can vary from state to state, making it all very confusing and hard to navigate. And a lot of this disproportionately affects the black community.
You see, black people are more likely than white people to have diabetes or obesity, but they're also about four times less likely than white people to get a prescription for these medications.
BUSH: I'm angry at the system. I think anyone who wants the meds should be able to have access to the meds.
GUPTA (voice-over): But there's another reason that so many people all over the world were unable to access these drugs.
You see, when they were first introduced, there was actually little fanfare. But starting in 2021, celebrities, a tech mogul, social media influencers, they all began talking and tweeting and posting about these drugs. On TikTok, the hashtag Ozempic was viewed hundreds of millions of times, whether 5 or 50 pounds. People looking to lose weight were desperate for these medications, even if they weren't diagnosed with diabetes or obesity.
[22:30:20]
So doctors began increasingly prescribing them for what's called off label use. Demand skyrocketed and drug companies could not keep up.
GUPTA: It's ironic because we're here in Denmark, Novo Nordisk is here in Denmark and you are still dealing with shortages.
SOERUP: Three times I had to -- in a short period of time, only take half the dose.
GUPTA: That's crazy.
SOERUP: Yes.
GUPTA: I mean it's right here. SOERUP: The doctors were allowed to prescribe Ozempic to people
without diabetes so that they could lose weight and there wasn't enough for both of the groups.
GUPTA: How did you feel about that?
SOERUP: There's no point in blaming people wanting to lose weight. They still have a problem.
GUPTA: Did you anticipate how big a deal this was going to be, the demand?
CONDE-KNAPE: We didn't.
GUPTA: How much of the shortage is sort of being driven by people who don't necessarily qualify?
SKOVRONSKY: I think even if there was no use outside of that population, we still wouldn't be able to make enough.
GUPTA (voice-over): Why not? Well, first the medications. Now remember we told you that harvesting enough hormones from nature that would be impossible. So Novo Nordisk created a GLP-1 like ingredient or a mimic that's called semaglutide. It's what they use in their diabetes medication Ozempic and their weight loss medication Wegovy.
And at Eli Lilly, they formulated a mimic of two gut hormones, GLP-1 and GIP. It's called tirzepatide and that's what they use in their versions, Mounjaro and Zepbound.
Here's the thing, mimics of semaglutide and tirzepatide. They are readily available, but experts estimate that it takes months for the drug companies to purify them and then mix them to the right strength and potency to be an FDA approved medicine.
Now, even if they could speed up that process, they still have to make enough of these special pens that dispense a pre measured amount of medication. And that takes time. The Eli Lilly pen, for example, has 14 unique parts. Each one of them has to be molded, snapped together and then quality tested.
SKOVRONSKY: All we know is essentially the more we make, the more gets used.
GUPTA: I've made my way to a pharmacy outside of New York City here on Long Island. It's probably going to look a little different than any pharmacy that you've seen before.
This is called a compounding pharmacy. And one of the goals here is to provide alternatives for medications that are currently in shortage.
Let's take a look at how they do it.
GUPTA (voice-over): Pharmacist Joe Navarra has been compounding medications for decades and lately his business has been booming. He takes me into the sterile lab where it's all done. JOE NAVARRA, COMPOUNDING PHARMACIST: This is what a product with
semaglutide or semaglutide would look like. So it comes packaged on ice.
GUPTA (voice-over): It comes from an FDA approved wholesaler with a certificate of analysis.
NAVARRA: This is what it is. So it's literally one gram of powder.
GUPTA (voice-over): That powder is then diluted, sterilized, packaged and quality tested. Now that's not the actual FDA approved product, but it is thought to have a similar effect.
GUPTA: So this is what comes in as the active pharmaceutical ingredient. And this is what your final product --
NAVARRA: Is a final product is out to the patient.
GUPTA: Along with a syringe.
NAVARRA: Syringe.
GUPTA: So instead of a pen, you got this and this.
NAVARRA: That's correct.
GUPTA (voice-over): A monthly supply costs anywhere from 250 to $500. But I want to be clear about something. Compounding pharmacists like Navarra are only allowed to make these copies when there is an official shortage. These drugs cannot just be thought of as low cost alternatives.
But as long as the FDA calls it a shortage, consumers with limited finances can benefit. Consumers like Rasheeda. After a lot of research and a virtual doctor's visit, she got compounded semaglutide from an online pharmacy.
GUPTA: You didn't even want to take Ozempic initially. You wanted to be very careful. How are you feeling about compounded version of this?
BUSH: That's a band aid. I wouldn't want to do that long term.
GUPTA (voice-over): It's a band aid and incidentally, it's a band aid Brian can't use.
UNIDENTIFIED FEMALE: So I think step one is we --
GUPTA (voice-over): This doctor won't prescribe the compounded version for him. She wants the FDA approved version. So he's going to have to wait until Rasheeda can get new coverage.
[22:35:03]
BUSH: Yes, he's been saying he's hungrier this week.
UNIDENTIFIED FEMALE: Yes, we need to get you back on as soon as possible.
GUPTA (voice-over): A week after taking her final dose of Mounjaro, we arrived back in time for her first shot of the compounded drug. Rasheeda is worried about drawing up the right amount of medication with the syringe. Those pens are so much easier.
Will it work? Is it safe? We will investigate when we come back.
(COMMERCIAL BREAK)
[22:40:25]
MICHELLE SWORD, OZEMPIC USER: The first time I ever took Ozempic, I was really scared and really reluctant, but I was really excited as well.
GUPTA (voice-over): Our next stop, Oxford, England, to investigate the unbelievable story of Michelle Sword. In late 2020, she was newly divorced and a few pounds heavier after COVID lockdown. Michelle's close friend, a nurse, told her about a then relatively unknown drug, Ozempic, that she said was pretty easy to get and could help her lose weight.
SWORD: And I was able to have it sent to my house through proper pharmaceutical company. Don't forget to say, Uno, when you're on your last card. Kyle, you'll go.
GUPTA (voice-over): And it worked. In just four months, Michelle lost 30 punds.
SWORD: I ended up being really quite petite at 112 pounds. I felt great.
VICKY BLISSETT, MICHELLE SWORD'S BESTFRIEND: Ozempic worked well for her the first time, definitely.
GUPTA (voice-over): But her best friend, Vicky Blissett, was worried about her.
BLISSETT: I've got pictures of her birthday in 2020. She did look too skinny.
SWORD: Friends and family pointed out, you've lost too much weight. You don't look healthy.
GUPTA (voice-over): So Michelle stopped taking Ozempic. But like a lot of people who stopped the meds, Michelle regained most of the weight within a year.
SWORD: I felt much bigger. So it created that sort of like a dark thought in your mind.
UNIDENIFIED FEMALE: I have lost 27.8 pounds.
UNIDENTIFIED FEMALE: I've been down 50 pounds since March. GUPTA (voice-over): It was winter 2023 and miracle weight loss stories
were everywhere. So Michelle was tempted once again. But this time it wasn't as easy to get.
SWORD: I just picked a company online. The silliest thing that you could probably do.
GUPTA (voice-over): When the box arrived, it looked like the Ozempic pen she had used years earlier. So Michelle tried it.
SWORD: The clicker turned different to how the clicker on the end of an Ozempic pen would turn. Within about 10 minutes, I couldn't hold myself up.
GUPTA (voice-over): Michelle's daughter panicked and called Vicky to come help.
BLISSETT: Michelle was completely unresponsive on the floor. We were really lucky, actually that night, the ambulance was with Michelle. I think within seven minutes.
GUPTA (voice-over): These images may be a little hard to see. The paramedics trying everything, an IV, glucose tablets, nothing worked. Michelle's veins had collapsed. She couldn't even swallow. Unable to stabilize her, they raced her to the hospital.
BLISSETT: I truly thought that I was going to watch my best friend die.
SWORD: They just fought very hard to save my life. They later found fast acting insulin in my body and it was just killing me.
GUPTA (voice-over): Fast acting insulin that the doctors would later learn came from that fake Ozempic pen Michelle had used. It's what caused her blood sugar to plummet.
SWORD: And that was when it hit me. My poor little family. If they lost me, I don't know what would have happened. When I was so angry at myself. I was so angry and so ashamed. Sorry.
GUPTA: I got to tell you. Michelle's story is not at all surprising to the man I'm about to introduce you to. We're heading to this secret location outside of London to meet the Director of Criminal Enforcement for all counterfeit drugs in the UK.
He tells me that so far his team has seized upwards of a thousand pens of fake Ozempic, or Foxempic as it's called. That's the most of any country in Europe.
I did not know what to expect, Andy. This is a full warehouse of problem drugs.
ANDY MORLING, DEPUTY DIRECTOR AT MEDICINES AND HEALTHCARE PRODUCTS REGULATORY AGENCY: It's more than fools, Sanjay.
GUPTA (voice-over): In Andy Morling's decades of experience, he has never seen anything happen like he has with these weight loss drugs.
MORLING: Criminals were buying up or somehow getting hold of insulin pens and then crudely relabeling them.
GUPTA: These people who are buying these.
MORLING: And potentially harm, they think they're buying the real thing. Sure.
I don't know if you can tell.
GUPTA (voice-over): And with good reason.
MORLING: But which one would you say is the genuine and which one is the fake?
[22:45:03]
GUPTA: I'm going to -- and it's funny because they always say, check with your doctor. Right. I'm a doctor.
MORLING: So we're now doing that.
GUPTA: I'm going to say this is the real thing.
MORLING: Yes. Well done. You can see years of medical training have enabled you to make that judgment. The label has not been put on particularly.
GUPTA: Yes, that's what I noticed. Right. The label sort of overlapped.
MORLING: And patients don't have the benefit that we have been able to compare one with the other. You know, if you receive this through the post, it's on its own, you know, and it looks like a genuine product because it is a genuine product. It's just not genuine Ozempic.
GUPTA: Across the pond back here in the United States, at the nation's capital, the dangers of these counterfeit products, it's troubling. The FDA says in 2023 it seized thousands of units of phacozempic. America's Poison Control Center said they saw a 1500 percent increase in calls related to injectable weight loss drugs. People are accidentally overdosing.
MARYANN AMIRSHAHI, CO-MEDICAL DIRECTOR, NATIONAL CAPITAL POISON CONTROL CENTER: So anytime you have an increase in the prescribing of any medication, the number of overdoses is going to go up.
GUPTA: Dr. Maryann Amirshahi is the co-medical director at the National Capital Poison Control Center.
AMIRSHAHI: Now you have people that are not diabetic, they're using it for weight loss, and all of a sudden they're giving themselves injections with something that is a lot less familiar to them. And then to make matters even harder, you could just dial up as much as you want. You were losing weight and you're like, this is great. If a little bit is good, more is.
GUPTA (voice-over): Sometimes that happens intentionally. People will dial up more medication like this. With the compounded drugs, though, it can happen accidentally. You could draw up too much medication into the syringe. But whether intentional or accidental, these overdoses can lead to side effects. They could be mild nausea, vomiting, dehydration. They could be severe.
AMIRSHAHI: Your stomach doesn't empty at all or it becomes paralyzed and you get something called gastroparesis. Everything gets backed up. You can damage your kidneys. And we even had somebody have a small tear in their esophagus from retching. And then finally, some people also get pancreatitis as well.
UNDIENTIFIED FEMALE: Do you know approximately how much your child weighs?
GUPTA (voice-over): And just like we saw with Michelle Sword, some of the poisonings also involve counterfeits. They are tracking those reports here, as are the drug manufacturers.
SKOVRONSKY: It's been a while since we've seen any medication that we made subject to this degree of counterfeiting. This is the most insidious one I've seen. This is a box of Mounjaro that Lily sells.
GUPTA: You can also just even looking at.
SKOVRONSKY: The somebody bought this on the Internet. There's pens that look pretty similar.
GUPTA: So this is the counterfeit?
SKOVRONSKY: Yes.
GUPTA: And this is the real medication?
SKOVRONSKY: Yes.
GUPTA: Real medication, counterfeit.
SKOVRONSKY: Yes.
GUPTA (voice-over): It's a lesson Michelle had to learn the hard way.
SWORD: If this one saves one more person or stops one more person from doing it, that's got to be a winner. That's got to be good.
GUPTA (voice-over): When we come back, could these medications take away your joy for food?
HOLST: It's not fun to eat the way it was. And I think that may be a problem. Yeah.
GUPTA (voice-over): And for life.
(COMMERCIAL BREAK) [22:52:50]
GUPTA: Professor.
HOLST: Hello.
GUPTA: Good to see you again.
HOLST: Good to see you. You feeling hungry?
GUPTA: Yeah.
GUPTA (voice-over): I'm back with Dr. Jens Juul Holst in Copenhagen.
HOLST: Thank you.
GUPTA (voice-over): For a tasty treat and a dose of reality about these medications.
GUPTA: I have tremendous joy for food.
HOLST: But you have not had to go. If I was, would I enjoy this as much? I don't think so.
GUPTA: No.
HOLST: No, most people do not feel a lot.
GUPTA: Cheers.
HOLST: Cheers.
SOERUP: My passion for food started with me making food with my father, but it just has no interest in me anymore.
GUPTA (voice-over): Scientists have mapped the neural pathways of these medications and found that they do disrupt the brain's reward system. That means they could take away your joy. Yes, for food, but maybe also for drugs and cigarettes and alcohol.
SKOVRONSKY: We see a lot of reports of patients who are drinking less or quit smoking. Maybe there could benefits. So there's a lot of work to do to study these.
GUPTA (voice-over): One common questions. Could losing the pleasure in things lead to depression or suicidal thoughts? Dr. Holst doesn't think so.
HOLST: There are very good now data suggesting that showing that this is not something to worry too much about.
GUPTA (voice-over): In fact, a brand new study shows that adolescents treated with GLP-1 drugs had a lower risk of suicidal thoughts as compared to those treated with behavioral interventions like diet and exercise. But Holst does worry about that loss of enjoyment of food. He thinks that might be a heavy price to pay. HOLST: It's not fun to eat the way it was and I think that may be a
problem.
GUPTA: Yes.
GUPTA: You and I both enjoy food. I know you're a foodie.
YEO: I love food.
GUPTA: But potentially losing that part of my joy, that would bother me.
YEO: So these drugs are very effective, but they're not going to be for everyone. And I think that's the point we have to drive home.
SOERUP: I got antisocial because if you are invited to eat with friends and you can't eat, it's like, well, I'll just stay at home.
[22:55:11]
GUPTA (voice-over): It's part of why Line stopped Ozempic. It's a critically important thing to consider. One study shows that for a variety of reasons, more than half the people who go on these medications stop taking them within just 12 weeks.
The point is that for most people, these are not turning out to be lifelong drugs. Line ultimately quit because she got too skinny too fast and she was just tired all the time. She started to look different as well. She was dealing with a new phenomenon called Ozempic phase that's sagging loose skin.
YEO: Because the weight loss that we're getting, akin to some fasting that you're actually getting, then you end up losing lean mass and fat mass.
GUPTA (voice-over): And that's a problem as well. Especially for older people. Losing too much muscle can lead to falls. It's been associated with a shorter lifespan. It's why the next generation of these drugs could be coupled with other drugs to build muscle at the same time you are losing fat.
It's all happening so fast and at the same time we have to proceed with caution. We still have a lot to disentangle about the long term effects of these medications, where most of the research does seem to point in. One clear significant benefits on the heart and the brain.
SKOVRONSKY: If these medicines can do that, they can probably improve brain health with aging. We know, for example, even in Alzheimer's disease, most patients eventually will have both Alzheimer's pathology but also vascular pathology in their brain. So maybe these drugs could have a role there.
GUPTA (voice-over): The potential is huge and so is the payday. Novo Nordisk, for example, is now worth more than the entire country of Denmark where it is based. And that is largely due to the success of Ozempic and Wegovy. It's why so many companies, more than 45 are now trying to make their
own drugs. Something that's better, something that's stronger, something that has fewer side effects. Maybe it's easier to take a once monthly injection or even once a year. Maybe it's a pill.
GUPTA: Is that a good thing to have all these companies?
HOLST: Oh yes. More brains to solve the problems and competition to lower the prices, which would be fantastic.
GUPTA (voice-over): It's late fall in New Jersey. The leaves are Changing color outside Rasheeda and Brian Bush's home. Seven months after my first trip here, we've come back for an update.
BUSH: I was hoping for continued results and I wanted to lose like 20 more pounds.
GUPTA (voice-over): But it stalled. The compounded tirzepatide that she turned to when insurance wouldn't pay for her pharmaceutical medications did not work.
BUSH: It was very frustrating because when you're trying to reach a goal, you want to get there. Like, you can see it, you can taste it, you can feel it. And now it's like, come on, hurry up.
Feeling a lot better. So we'll see.
GUPTA (voice-over): So for months now, Rasheeda has been working with her doctor to try and get those prescription meds back. And she gets some good news at last.
BUSH: So it came in this box here and it has four different little mini boxes inside.
GUPTA (voice-over): Eli Lilly recently introduced a new, less expensive Zepbound.
B. BUSH: Do you have to change out the needle all the time or just --
R. BUSH: Yes.
GUPTA (voice-over): No pen. But a single use weekly vial and syringe does make the price more affordable. It's still not cheap enough though, for Rasheeda. For now, she can only afford for Brian to use it.
R. BUSH: How'd that feel?
B. BUSH: That actually hurts.
GUPTA (voice-over): A little bit of pain, but also a lot of relief that he's now back on the medications that helped him lose more than 50 pounds.
R. BUSH: I actually was very worried, like, I thought I was going to be back at where we started, which I didn't want to do that. So I told myself that I was not going to give up.
GUPTA (voice-over): Rasheeda is not giving up either. While she waits to start the medications again, she is exercising, she's eating right, she is hoping to maintain the hundred plus pounds of weight loss.
It's what Line also credits with keeping the weight off since she stopped Ozempic a year ago.
GUPTA: So you've made some significant lifestyle changes.
SOERUP: Yes.
GUPTA: Do you regret having gone on Ozempic?
SOERUP: Oh, no. Oh no. I needed to lose the weight. And I needed the process. I would never do it any other way.
R. BUSH: I feel seen. I feel seen. And that's knowing that I am enough, knowing that I am capable, knowing that I'm a rock star.
[23:00:00]
GUPTA: You look really happy and healthy. Do you feel happy and healthy?
R. BUSH: I do, I do.
