Ozempic Nation – Canadian Affairs

Read: 5 min

It took Alexis Adebanke Ladejobi more than a year to try the weight loss drug Ozempic due to fears about its side effects.

“I was very skeptical at first,” said Ladejobi, who lives in Toronto. “I had a nurse practitioner that would tell me, ‘Don’t take it, they all have side effects’.”

But after the 46-year-old finally started taking Ozempic in July, it changed her life.

In just five months, she shed 26 pounds, developed a new relationship with food and regained confidence she thought she’d lost.

“Now I want to show my figure eight,” she said.

Ladejobi joins a growing number of patients and physicians who are touting the benefits of Ozempic and its competitor drugs, Wegovy and Mounjaro.

But while doctors say these GLP-1 drugs can be life-changing for some, there is also a need for careful medical oversight and realistic expectations.

“They’re like any other medication. They will work for a lot of people [but] they don’t work for every person,” said Jennifer Lake, a pharmacy professor at the University of Toronto.

“Your regular health-care provider … knows you the best.”

How it works

GLP-1s, short for glucagon-like peptide-1, were first approved by Health Canada in 2018 to treat Type 2 diabetes. In 2021, the agency approved Wegovy for weight management; a year later, it approved Mounjaro for diabetes.

Today, all three drugs are widely used for weight loss, with Ozempic and Mounjaro often prescribed off label. 

Dr. Stephen Glazer, an obesity medicine specialist and medical director at Humber River Regional Hospital in Toronto, says GLP-1s slow how quickly the stomach empties, helping people feel full on smaller meals.

“Centrally, it works within the brain, activating centres that are responsible for control of our eating,” said Glazer, who prescribed Ozempic to his patient Ladejobi. “So that would include hunger, satiety, cravings.”

GLP-1s blunt the dopamine hit from high‑fat, high‑sugar foods, making meals feel more satisfying and junk food less tempting.

Ladejobi, who is not diabetic, has experienced this firsthand. “Before, when I’m stressed, I binge eat,” she said. “Now, I don’t anymore, because the noise of the food … just went away.”

Glazer says he is cautiously hopeful the drugs could also improve brain health and cognition, and offer other multi-organ benefits. “[T]here’s some suggestion that it may lower the risk of dementia,” he said. “[But] the jury is out.” 

GLP-1s in Canada

Uptake of Ozempic in Canada has been rapid and significant.  

“We believe that close to two million Canadians are actually using a GLP-1 drug to lose weight,” said Sylvain Charlebois, a professor and director of Dalhousie University’s Agri-Food Analytics Lab, which conducted a 2024 survey on GLP-1 use in Canada.

“That’s like Manitoba and New Brunswick combined.”

And this number is expected to grow. The lab’s survey showed one in five Canadians are considering taking the drug. And nearly two-thirds of Canadian adults are either overweight or obese, according to a 2024 government study.

Glazer, who is also president of the Canadian Association of Bariatric Physicians and Surgeons, says obesity is a chronic, biologically driven disease. He sees GLP-1s as far more than a cosmetic weight loss tool.

“This is a very exciting opportunity for us because now we can have further legitimacy, not only for the medication, but even in the management of treating people with obesity,” he said.

On Dec. 1, the World Health Organization released its first global guideline on the use of GLP-1s, recommending them for long-term treatment of obesity. 

In Canada, most people pay out-of-pocket or rely on private insurance to cover their GLP‑1 drugs, which are self-administered by an intravenous shot once a week. The drugs cost about $200 to $600 a month, depending on factors such as brand, dose and location. Currently, public drug plans generally only cover GLP-1s to treat Type 2 diabetes.

However, generic drugmakers plan to sell semaglutide — the unbranded, lower-cost version of Ozempic — in Canada by June 2026, after its patent expires.

“I wouldn’t be surprised by 2030 to see anywhere between three to five million Canadians using some of these drugs,” said Charlebois.

Side effects

GLP-1 drugs have been studied for years in people with diabetes. But there is no long-term human data on the effects of taking them for weight loss. The longest large clinical trials of GLP-1 drugs in humans follow patients for about four to five years.

The drug’s side effects can be another concern. 

Experts say gastrointestinal side effects are common, including constipation, reflux, belching, nausea and extreme fullness. In some patients, this can progress to severe conditions such as gastroparesis, where the stomach takes too long to empty.

“The worst form of that is people tasting or feeling like they have fecal matter [in their mouth] … when they belch,” said Lake, of the University of Toronto.

And the side effects likely affect more people in practice than the clinical trials suggest, as trials typically exclude older or medically complex patients.

“About 10 to 15 per cent of people can’t tolerate these drugs,” said Lake. Among older patients or those with complex conditions, the percentage is likely higher, she says.

Risks

GLP-1s have also been known to cause rare but severe complications, including bowel obstruction. 

“In the extremes of constipation, you can have poor motility within the GI tract, which can lead to very serious constipation and even emergency room visits,” said Glazer.

Physicians also monitor for risks such as pancreatitis, or inflammation of the pancreas, which presents as the more common side effects of nausea and vomiting. Emerging evidence suggests a rare optic nerve problem in some diabetic patients on GLP-1s, which can cause permanent vision loss.

For Ladejobi, the early side effects were mild. These included a headache after her first meal and delayed bowel movements that caused no discomfort. 

“If it doesn’t work for you, then it doesn’t,” said Ladejobi. “It’s something that is retractable. It’s not a permanent thing.

For some, the impermanence is a negative. Studies have shown many people regain weight after stopping GLP-1s, which can take a mental health toll.

Lake warns Canadians not to be swayed by social media hype or pop-up online services for GLP-1 prescriptions.

“It is very unusual for medication to go from medication to social phenomenon,” she said, citing Viagra and Botox as two other drugs that, like Ozempic, have become social phenomena.

She stresses that GLP-1 drugs should only be used under the care of a trusted health-care provider, who can guide patients on side effects and when to seek emergency care.

Glazer plans to switch Ladejobi to Wegovy after her Ozempic trial ends. Glazer says he often starts patients on the lower-cost Ozempic to see how effective it is, before switching them to the pricier Wegovy, which is marketed for obesity in non-diabetics. 

Galzer views it as unfair that public plans currently only cover GLP-1s for diabetics.

“What is the message that you’re giving to an [obesity] patient?” he said. “You’re less deserving.”

He views it as a win that lower cost generic versions will soon be available.

“[T]he world’s divided into the haves and the have‑nots,” he said. “Either patients have diabetes and they’re covered… or you have a good private insurance plan, and if not, you’re out of luck. 

“That’s discriminatory.”

Ladejobi, who pays for the medication out-of-pocket, sums up her experience positively. “So far, it’s been an awesome journey,” she said. “Most of my clothes are now two sizes down.”

Related Posts