A strange thing! just imagine a medicine or drug which is first made to control type 2 diabetes, but later on it was found that it has a surprising weight loss effect on body . This medicine is Semaglutide, popularly well known by brand names as Ozempic, Wegovy, and Rybelsus.
As more people use Semaglutide for both diabetes and weight loss management, critical ethical questions have arisen: Who should have access to it? How do we manage the costs? And how can we ensure a safe, fair, and transparent process?
Now, it has also opened a lots of challenge of ethical concerns about fairness, safety, and corporate influence.
What Is Ozempic and Why Is Everyone Talking About It?
Ozempic is an injectable drug that mimics a natural gut hormone called GLP-1 (https://www.doylestownhealth.org/blog/how-glp1-medications-like-ozempic-are-revolutionizing-weight-loss It was originally approved to help people with Type 2 diabetes by increasing insulin and controlling blood sugar(https://health.ucdavis.edu/blog/cultivating-health/ozempic-for-weight-loss-does-it-work-and-what-do-experts-recommend/2023/07 )
Mechanism of action
Semaglutide is a glucagon-like peptide-1 receptor agonist{.https://en.wikipedia.org/wiki/Semaglutide#cite_note-Wegovy_FDA_label-15 } ,which is mainly decreased the blood sugar levels by the mimicking of glucagon-like peptide-1 (GLP-1), an incretin. It alsolikely enhance the growth of pancreatic beta cells, which are responsible for insulin production and release.Not only this but also , it inhibits the production of glucagon, the hormone that increases glycogenolysis (release of stored carbohydrate from the liver) and gluconeogenesis (synthesis of new glucose). It reduces food intake by lowering appetite (appetite supression) and slowing down digestion in the stomach,helping reduce body weight.https://en.wikipedia.org/wiki/Semaglutide#cite_note-45.(https://en.wikipedia.org/wiki/Semaglutide#:~:text=Semaglutide%20is%20chemically%20similar%20to,presence%20in%20the%20blood%20circulation. )
The drug’s major side effect—appetite suppression and dramatic weight loss—led to the approval of similar versions like Wegovy (higher-dose semaglutide for obesity). The immense popularity, fueled by social media, has caused a prescription boom:
- Massive Shift: In 2018, over 90% of Ozempic prescriptions were for diabetes; by 2023, that number was down to about 58%, with the majority of new prescriptions for weight management.https://medicine.iu.edu/blogs/bioethics/who-deserves-ozempic-the-ethical-challenges-of-weight-loss-use#:~:text=In%202018%2C%20more%20than%2090,supply%20issues%20for%20this%20drug.
- The Cost Barrier: The monthly price is high, ranging from $900 to $1,400. https://www.columbiapsychiatry.org/news/rise-ozempic-sparks-ethical-concerns Insurance often won’t cover it for general weight loss, making it a drug largely for the wealthy.
- Side Effects: While effective, common issues include nausea and vomiting, and questions remain about potential long-term organ risks.https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/weight-loss-drug-ozempic-approved-for-use-in-india-what-we-need-to-know-about-its-health-benefits-and-risks/articleshow/124259985.cms
The 5 Major Ethical Concerns About Semaglutide (Ozempic/Wegovy)
The race to use this medication has raised five critical red flags:
1,Fairness and The Ozempic Shortage
The biggest question is access. When a limited supply of Ozempic is used “off-label” (for weight loss alone), it creates a shortage for patients who have an urgent medical need, particularly those with Type 2 diabetes.
Expert Insight: “With the finite supply of these drugs, we must prioritize people with diabetes and other serious health conditions,” argues Morgan Rich from the Indiana University Bioethics Blog [Rich, M. (2024, September 30). Who Deserves Ozempic? The Ethical Challenges of Weight-Loss Use. .https://medicine.iu.edu/blogs/bioethics/who-deserves-ozempic-the-ethical-challenges-of-weight-loss-use
The result is that patients who can afford to pay out-of-pocket for cosmetic use may get the drug easily, while diabetic patients in poorer areas face long waits and high costs.
2.Conflicts of Interest in Drug Trials
Drug companies often use private boards to oversee the ethics of their clinical trials. Critics argue this setup prioritizes speed and profit over safety.
- A recent investigative report raised alarms about how private companies oversee drug trials for Ozempic and similar medicines, noting potential conflicts of interest and patient protection risks [The New York Times. (2025, October 4). How Private Equity Oversees the Ethics of Drug Research.https://www.nytimes.com/2025/10/04/health/drug-trials-ethics-ozempic.html .
- This pressure for quick approval can compromise the process of informed consent—where patients must fully understand the risks and unknowns before joining a trial.
3,Unknown Long-Term Safety and Weight Regain
We lack clear data on the effects of taking these GLP-1 drugs for many years.
- Weight Regain: Long-term studies show that the weight loss benefits are often only maintained while taking the drug; most people experience significant weight regain after stopping.https://pmc.ncbi.nlm.nih.gov/articles/PMC9542252/
- New Risks: Over 2,300 lawsuits claim the manufacturer failed to warn about severe side effects like intestinal issues. Robust post-market surveillance is needed to mitigate these unknown risks.
4.Cosmetic Use vs. Medical Necessity
This controversy centers on whether the drug should be used for illness or enhancement.
The Debate: Bioethicists Nanette Ryan and Julian Savulescu argue that Ozempic is ethically okay for weight loss if access is fair, emphasizing the potential to enhance patient autonomy [Ryan, N., & Savulescu, J. (2025). The Ethics of Ozempic and Wegovy. Journal of Medical Ethics. https://pubmed.ncbi.nlm.nih.gov/39848681/
The Counter-Argument: Critics like Joona Räsänen and Johanna Ahola-Launonen counter that this view is too narrow, arguing that it ignores how structural issues (inequality, stigma) shape treatment choices [Räsänen, J., & Ahola-Launonen, J. (2025). Weighty matters: Ozempic, autonomy and the ethics of health reform. Journal of Medical Ethics .https://www.researchgate.net/deref/https%3A%2F%2Fdoi.org%2F10.1136%2Fjme-2025-111117?_tp=eyJjb250ZXh0Ijp7ImZpcnN0UGFnZSI6InB1YmxpY2F0aW9uIiwicGFnZSI6InB1YmxpY2F0aW9uIn19
5.Ignoring Society’s Role in Health
Over-relying on a drug may overshadow the need for deeper societal changes. Obesity is tied to factors like food access, stress, and environment, not just personal choice.https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
Structural Reform: Dr. Robert Klitzman of Columbia University highlights that the high cost of anti-obesity drugs “could worsen health disparities” and risks shifting resources away from crucial prevention efforts [Columbia Psychiatry. (2024, October 16). The Rise of Ozempic for Weight Loss Sparks Ethical Concerns. A truly ethical solution must integrate medication with policy reforms like improving access to healthy foods and promoting anti-stigma education.https://www.columbiapsychiatry.org/news/rise-ozempic-sparks-ethical-concerns
Moving Forward: Practical Steps for Ethical Use
To ensure that innovations like Ozempic benefit everyone fairly and safely, we must:
- Prioritize Medical Need: Establish clear frameworks to prioritize patients with diabetes and severe obesity during periods of drug shortage.
- Strengthen Oversight: Require fully independent ethical audits for all drug trials and mandate full transparency on corporate ties.
- Ensure Fair Access: Use government subsidies and price negotiations to make the drug affordable for medically necessary use, and increase efforts to fight dangerous counterfeit versions.
- Boost Monitoring: Require long-term post-market studies (5-10 years) to fully understand the effects of lifelong use, including risks like weight regain.
Ozempic provides genuine hope for improved health, but in order to prevent this invention from increasing already-existing inequality in health, its application must be guided by ethics and data.
Conclusion: Hope with a Warning
Ozempic is an important new medicine that can truly change lives, but it is not a perfect or risk-free solution. To use it wisely, we must balance our excitement for new discoveries with honesty, fairness, and equal access for all.
By understanding both the good and the challenges of Ozempic — the balance between profit and patients, and between rich and poor — we can help build a healthcare system that cares more about people than profit.
Hi…! Currently, I am working as an Professor at Department of Pharmaceutical Chemistry(H.O.D),The Pharmaceutical College, Barpali, Odisha. I have more than 19 years of teaching & research experience in the field of Chemistry & Pharmaceutical sciences.