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Ozempic and Joint Health: Benefits Beyond Weight Loss

In 2017, the FDA approved semiglutide to treat type 2 diabetes mellitus, and the medication has been at the top of news feeds since. The interest in semiglutide is not suprising considering how effective it has been for weight loss and controlling type 2 diabetes, but new research has shown benefits of semiglutide in the joints of the body as well. Could this medication also be useful in treating osteoarthritis and improving joint health?

What is Ozempic?

Ozempic (known generically as semaglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist class prescription medication.

Three semaglutide products are currently FDA-approved:

  • Ozempic injections and Rybelsus tablets are approved to help lower blood sugar levels in people over 18 with type 2 diabetes mellitus. These medications should be used in combination with diet and exercise. Ozempic and Rybelsus are also approved to reduce the risk of stroke, heart attack, and death in adults with type 2 diabetes and known heart disease.
  • Wegovy injections are approved to treat overweight and obese people over the age of 12 who also have weight-related health issues. This medication should also be used in combination with diet and exercise.[1]

How Does Ozempic Work?

Semaglutide imitates the GLP-1 hormone released from our gastrointestinal tract when we eat. One function of this hormone is to release insulin, which helps our cells use glucose (sugar) and controls blood glucose levels. In greater amounts, GLP-1 communicates with the parts of our brain that control hunger, and can reduce appetite and make us feel full.[1]

In a study published by the New England Journal of Medicine, study participants treated with semaglutide were found to have lost an average of 14.9% of their body weight at week 68, as compared to 2.4% of participants treated with a placebo. Both groups also used diet and exercise measures.[2]

Singh G. et al. gathered data from the STEP (Semaglutide Treatment Effect in People with Obesity), SUSTAIN (Semaglutide Unabated Sustainability in Treatment of Type 2 Diabetes), and PIONEER (Peptide Innovation for Early Diabetes Treatment) trials on semaglutide and weight loss. All three trials found semaglutide to be superior to both placebo and other diabetic medications when it came to overall weight loss.[3]

How Does Weight Loss Affect Joint Health?

The more weight our bodies haul around, the more wear and tear the joints go through. Pain and inflammation caused by joint damage affect daily life, and make even the slightest activity uncomfortable. Orthopedic surgeons understand the risks associated with joint replacement surgery, and are aware that patients with obesity have greater complications after surgery. Often surgeons will have a BMI (body mass index) cutoff between 35-40 to decrease these risks. Surgeons recommend weight loss before surgery to get below the BMI cutoff, and to further reduce post-surgical risks.[4]

Losing even 10 pounds can greatly affect the impact of arthritis on your joints in the following ways[5]:

  • Decreasing pressure on your joints.
  • Reducing joint pain and inflammation.
  • Slowing the advancement of diseases such as osteoarthritis, rheumatoid arthritis, and gout.

What About Ozempic and Inflammation?

Newer research is looking at the role GLP-1 plays in inflammation. GLP-1 binds to receptors in bone cells, fat cells, and on the bone surface. This action prevents the release of inflammatory cytokines into the synovial fluid in the joints, decreasing inflammation. It also decreases subsequent effects, such as the destruction of joint cells and oxidative stress. GLP-1 or GLP-1 analogues (such as semaglutide) can also initiate anabolic processes such as cell proliferation and healing.[6]

Zhu H. et al. found potential benefits of GLP-1 medications in reducing knee osteoarthritis symptoms due to their anti-inflammatory effects. They found lower pain scores in participants treated with GLP-1RA, along with less cartilage damage and a reduced need for surgery. However, these results may be due to weight loss rather than to the GLP-1RA medication sepecifically.[7]

Further research is needed to fully understand GLP-1RA’s effects on joint health.

What Are the Side Effects of Ozempic?

  • Ozempic

    • Common Side Effects
      Nausea, vomiting, diarrhea, stomach (abdominal) pain, and constipation[8]
    • Serious Side Effects
      Thyroid tumor/cancer, pancreatitis, gallbladder problems, low blood sugar, kidney problems, changes in vision, or allergic reactions[8]
  • Reybelsus

    • Common Side Effects
      Nausea, stomach (abdominal) pain, diarrhea, decreased appetite, vomiting, and constipation[9]
    • Serious Side Effects
      Thyroid tumor/cancer, pancreatitis, gallbladder problems, low blood sugar, kidney problems, changes in vision, or allergic reactions[9]
  • Wegovy

    • Common Side Effects
      Nausea, diarrhea, vomiting, constipation, stomach (abdominal) pain, headache, tiredness (fatigue), upset stomach, dizziness, feeling bloated, belching, low blood sugar in people with type 2 diabetes, gas, stomach flu, heartburn, and runny nose or sore throat[10]
    • Serious Side Effects
      Thyroid tumor/cancer, pancreatitis, gallbladder problems, low blood sugar, kidney problems, changes in vision, allergic reactions, increased heart rate, depression, or thoughts of suicide[10]

How much does Ozempic cost?

These medications may cost hundreds of dollars a month or more, depending on where you live, your insurance coverage, and your diagnosis. Some programs help cover costs, which can give more people access to these medications.[11] However, with the increase in Ozempic and Wegovy prescriptions, supply issues have arisen. Access is something to consider when deciding to take these medications.

Conclusion

While semaglutide has excellent success rates for weight loss and blood glucose control, some of its lesser-known benefits may also help those suffering from joint problems. Using any weight loss medication should first start with a conversation with your doctor about goals, options, and side effects. Lifestyle modifications are the foundation of any weight loss effort, and even small changes can be helpful over the long run.

Sources
1
Center for Drug Evaluation and Research. (2024, October 1). Medications containing semaglutide. U.S. Food and Drug Administration. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/medications-containing-semaglutide-marketed-type-2-diabetes-or-weight-loss
2
Wilding, J. P. H., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., McGowan, B. M., Rosenstock, J., Tran, M. T. D., Wadden, T. A., Wharton, S., Yokote, K., Zeuthen, N., & Kushner, R. F. (2021). Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine, 384(11), 989–1002. https://doi.org/10.1056/nejmoa2032183
3
Singh, G., Krauthamer, M., & Bjalme-Evans, M. (2022). Wegovy (SEMAGLUTIDE): A new weight loss drug for Chronic Weight Management. Journal of Investigative Medicine, 70(1), 5–13. https://doi.org/10.1136/jim-2021-001952
4
Tran, J., Nelson, C. L., & Sheth, N. P. (2022, September). Obesity, weight loss, and joint replacement surgery. OrthoInfo. https://orthoinfo.aaos.org/en/treatment/weight-loss-and-joint-replacement-surgery/
5
Arthritis Foundation. (n.d.). Weight loss benefits for arthritis: Arthritis foundation. Weight Loss Benefits for Arthritis. https://www.arthritis.org/health-wellness/healthy-living/nutrition/weight-loss/weight-loss-benefits-for-arthritis
6
Meurot, C., Jacques, C., Martin, C., Sudre, L., Breton, J., Rattenbach, R., Bismuth, K., & Berenbaum, F. (2022). Targeting the GLP-1/GLP-1R axis to treat osteoarthritis: A new opportunity? Journal of Orthopaedic Translation, 32, 121–129. https://doi.org/10.1016/j.jot.2022.02.001
7
Zhu, H., Zhou, L., Wang, Q., Cai, Q., Yang, F., Jin, H., Chen, Y., Song, Y., & Zhang, C. (2023). Glucagon-like peptide-1 receptor agonists as a disease-modifying therapy for knee osteoarthritis mediated by weight loss: Findings from the Shanghai osteoarthritis cohort. Annals of the Rheumatic Diseases, 82(9), 1218–1226. https://doi.org/10.1136/ard-2023-223845
8
Novo Nordisk. (n.d.). Ozempic® (SEMAGLUTIDE) injection for type 2 diabetes. Ozempic® (semaglutide) injection for Type 2 Diabetes. https://www.ozempic.com/
9
Novo Nordisk. (n.d.). Type 2 diabetes medicine: RYBELSUS® (semaglutide) tablets. Once-Daily RYBELSUS® (semaglutide) tablets 7 mg or 14 mg. https://www.rybelsus.com/
10
Novo Nordisk. (n.d.). Weight-loss prescription medication: Wegovy® (SEMAGLUTIDE) injection 2.4 mg. Weight-Loss Prescription Medication | Wegovy® (semaglutide) Injection 2.4 mg. https://www.wegovy.com/
11
Patient assistance program. NovoCare® Savings | Coverage | Support. (n.d.). https://www.novocare.com/diabetes/help-with-costs/pap.html
Last edited on April 17th, 2024 4:48 pm