Exploring Elon Musk’s Skinny Jab: A potential solution for obesity in South Africa?

Semaglutide, a drug marketed as Wegovy or Ozempic, was initially developed for diabetic patients to control blood sugar levels but has gained attention for its potential weight loss effects. Elon Musk, the South African-born technology entrepreneur, has credited his transformed physique to the use of Wegovy. Muhammed Vally, Head of the Division of Clinical Pharmacy and Lecturer at Wits University told BizNews that clinical trials have demonstrated that non-diabetic individuals taking Semaglutide experienced an average weight loss of 14.9%, compared to 2.4% in the placebo group. However, Vally stresses that Semaglutide should not be considered a standalone solution, cautioning that it may cause side effects. Former British Prime Minister Boris Johnson revealed that he discontinued the drug due to its adverse effects. Despite these considerations, Vally believes that exploring the potential of this medication is worth considering for obesity. It is a growing problem with obesity rates doubling in Sub-Saharan Africa from 2009 -2019. – Linda van Tilburg

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Excerpts from the interview

Clinical trial showed weight loss of 14.9% on average

There was a clinical trial that was done in 1961 participants, which was published in the New England Journal of Medicine in 2021, wherein they did a double-blind trial where they randomised participants to either be in the placebo group or to be alternatively in the Semaglutide group. Now I just want to make something very clear. The dose that they gave here was higher than the dose you would normally give to a diabetic patient. So, the standard diabetic dose is roughly about a milligram once a week at its maximum dose. In this case, they gave 2.4 milligrams once a week. So, it is a higher dose basically and also what they did is for this specific trial, they wanted to see whether or not it would work in non-diabetic patients.

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So, they only took non-diabetic patients in this particular trial. The inclusion criteria were that you needed a BMI of 30 or more or alternatively you needed a BMI of 27 or more with one co-morbid condition, so having cardiovascular diseases is an example of a co-morbid condition that goes with obesity or being overweight. So what they did then is they basically randomised these two groups and they looked at them for a period of time. But the length, the entire duration of the trial, the last time they looked at them or followed them up was at 6 to 8 weeks, which is roughly about a year and four months, give or take. And they found that in the people who took Semaglutide, they on average lost 14.9% of their weight compared to baseline versus 2.4% of the weight versus baseline in patients who were taking the placebo. So, if you minus the patients who were taking Semaglutide from the patients who just took the placebo, there was a 12% reduction. This is quite large. It’s much larger than the 4% for something like Liraglutide, for example. It’s a much bigger amount of weight loss that we’re talking about here.

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Side effects, risks of cancer, pancreatitis

In the clinical trial in 1961 participants were looking at both safety and efficacy. So, the most commonly reported side effects were nausea and diarrhoea. This goes without saying because of how the drug works, it’s more likely to have gastrointestinal side effects. The thing that everybody gets concerned about with these particular groups of drugs is the chances of it causing pancreatitis. There were three cases of pancreatitis, out of, I think it was roughly about 1300 people who took Semaglutide. So, if you work that out in percentage terms and they do this kind of thing, they say it’s 0,2% of an event per 100 patient-years. In other words, the risk is very low. These are risks and if you end up being one of those people, the risk is there. But essentially it’s, I don’t want to use this word just willy nilly, it’s safer than you would think and it’s certainly more tolerable when you compare it to other weight loss agents which are available.

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Solution for SA obesity problem?

Like with anything that you use for weight loss, if the person themselves is not motivated and they don’t want to change their lifestyle, do the exercise, all of those kinds of things, then definitely the weight is going to come back. The proportion may not be the same, but it will come back. Unfortunately. It’s now considered a problem when you’re trying to shame people. I’m just explaining that it’s difficult. Life is difficult, to begin with, and people eat and don’t exercise for a variety of reasons, some of which are related to their lifestyle and the stress and all of that. So, I think that motivation is extremely important if you’re going to use these kinds of agents. The problem that I’ve seen, particularly with patients who are obese, is that they want to actually lose weight. But what happens is that they just need that little bit of a boost or a little bit of a kick to try and help them to lose the weight and this might be how that happens. So, I don’t think it’s something we can, as the famous saying goes, throw the baby out with the bathwater. I don’t think we should just completely dismiss this idea. I think it’s something that you do have to look at.