What runners need to know about Ozempic

This article originally appeared in Women’s Running

Diabetes drug Ozempic and similar prescription weight-management drugs like Wegovy are getting a lot of buzz, from millions of social media mentions to rumors that celebrities are taking them to drastic weight loss. And that buzz means more people are taking them off the label, potentially just to lose weight, whether they need to or not.

Focusing on weight loss can be problematic for people with eating disorders or who feel pressure about their weight, a population that includes a high percentage of runners. Drugs have brought a renewed emphasis on being thin, potentially undoing the advances in the anti-diet and body acceptance movements in recent years, and that can be triggering for those likely to worry about their weight, says Evelyn Tribole. MS, RD, a registered dietitian with private practice in Newport Beach, California.

“I’ve seen the rhetoric about how diets don’t work and so they use these drugs, so these drugs have co-opted that rhetoric,” she says. “If you’re really interested in health, why would you take something that can actually hurt your health in the long run?”

Injectable drugs work by mimicking the action of the hormone GLP-1, which produces insulin but also makes your body feel less hungry by slowing down your gastrointestinal tract. People who take drugs say they are barely hungry and cannot finish large meals. The buzz around the drugs has caused a shortage of them for people who actually need them, a big concern especially for people with diabetes. And they can be very expensive, upwards of $1,000 a month.

The drugs can have severe side effects, from nausea and vomiting to severe inflammation that can lead to hospitalization. But there are additional considerations runners should take before starting the medications, says Dr. Abisola Olulade, family physician at Sharp HealthCare in San Diego. Because drugs like Wegovy are meant for weight management for people with health complications related to body composition.

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Two ampoules, clear and brown, set in a square frame, with a white back.

He says anyone considering drugs should check with their doctors.

First of all, Olulade says, the drugs actually mimic what running already does to the body. When you run, GLP-1 increases, which increases the release of insulin, which causes blood sugar to drop.

“For someone who exercises regularly, you’d have less resistance to GLP, so you could become hypoglycemic from that,” she says. “The drug has a similar effect, so when you take Ozempic and you run, you may have this exaggerated hypoglycemia. So you may have a worsening effect of lowering blood sugar, which could be potentially dangerous.”

Another impact, she says, is that you don’t experience hunger cues with the drug, which could mean you aren’t getting enough fuel before or after your runs.

“You have a reduced appetite, so you may not be adequately stocking up on food, and hydration status is also a risk,” she says. “So you might get dehydrated, and that would be another risk we can see with this.”

In addition to the direct effects of the drug, there are side effects to consider, including the potential for acute kidney injury and pancreatitis, which worsen with dehydration.

“Then the stomach pain, the diarrhea that you can get with it, might even get worse,” Olulade says. “So if you’re not hydrated and have loose stools, then you can get really dehydrated, which could also be a problem.”

These issues could lead to electrolyte imbalances and potential increased heart rate, he added.

A spokeswoman for Novo Nordisk, the Danish company that makes Ozempic and Wegovy, says the company does not “promote, suggest or encourage off-label use of our medicines”.

“We trust healthcare professionals are assessing a patient’s individual needs and determining which drug is right for that particular patient,” Allison Schneider wrote in a statement. He added that the drugs have demonstrated long-term safety in clinical trials, with common side effects including nausea, diarrhea, vomiting, constipation, stomach pain, headache, tiredness, stomach pain, dizziness, feeling bloated, belching, gas, stomach flu, and heartburn.

Olulade says that with the advice of their doctors, runners can take drugs like Ozempic if they need to.

“You still want to take precautions, which is making sure you’re hydrated, making sure you’re eating, making sure you’re aware that even if you don’t have hunger cues, you should still have an idea of ​​how much you’re eating,” she says. “So that’s enough to fuel your exercise, depending on what you’re going to do.”

Be sure to let your doctor know you’re a runner if you’re talking about taking Ozempic or Wegovy, because your doctor may prescribe a lower dose, Olulade says.

“You could potentially try a lower dose first, see how you react,” she says.

Tribole, who also qualified for the first U.S. Olympic Trials women’s marathon in 1984, says she wouldn’t advise runners to take weight-loss drugs.

“If you’re taking it for intentional weight loss, I think it’s really problematic, not enough is known,” she says. “If you are a diabetic and you are a runner and this will help your blood sugar, then, yes, absolutely, I have no problem with this. If you take it with the intention of losing weight, I think it is really problematic.”

Tribole says running already masks hunger cues, at least for a few hours, so combining it with Ozempic could be especially problematic causing injury from lack of nutrition. And for women who run, conditions like relative energy deficiency syndrome.

“When you exercise intensely, that already temporarily dulls your hunger, and so now you’re adding something else,” she says.

She fears the buzz around drugs and how they’ll make you slimmer could also lead to more eating disorders and convince runners who don’t need to lose weight to try them. Despite these concerns, Olulade says these drugs will likely continue to grow in popularity, and as they gain more attention through celebrities and social media, more people are asking their doctors about it.“We have people calling every single day asking about them and asking about them,” she says. “And so obviously we need to be better at educating people about that and also at reminding people that nutrition is important too.”

He says these drugs should be taken alongside changes in diet and exercise.“They’re licensed to be used in conjunction with nutrition and exercise as a whole,” she says. “They shouldn’t just be used in isolation. They should be something that’s a multi-targeted approach.”

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