Social media is lighting up over what influencers are calling "budget Ozempic". These are drugs normally used as laxatives and stool softeners, but people are taking them to lose weight. The demand is so high in the United States, there are reports this is contributing to shortages in pharmacies.
Authors
Nial Wheate
Associate Professor of the Sydney Pharmacy School, University of Sydney
Jessica Pace
Associate Lecturer, Sydney Pharmacy School, University of Sydney
These laxatives are just the latest alternatives influencers are touting for the blockbuster drug Ozempic.
So, does "budget Ozempic" help you lose weight? Any weight loss is likely to be temporary and using these laxatives long term may be dangerous.
Ozempic is in short supply
Ozempic contains the active ingredient semaglutide. It is a prescription-only drug used to treat type 2 diabetes. One side effect of taking it is significant weight loss. This has led to so many people trying to obtain the drug there have been shortages.
Instead, some people have turned to more easily accessible over-the-counter alternatives to try to lose weight. That includes berberine, which has been dubbed "nature's own Ozempic".
What is 'budget Ozempic'?
"Budget Ozempic" is different to "nature's own Ozempic". It is the polymer polyethylene glycol 3350, or PEG 3350 for short.
Chemically, it's similar to other polymers used as ingredients in cosmetics, drug delivery, archaeological preservative paints, soaps and even missile fuel. It's not to be confused with ethylene glycol, which is used in antifreeze.
Medically, PEG 3350 is mainly sold in Australia through pharmacies in laxative and stool softening products. It is also used to clean out your bowels before a colonoscopy.
The products are referred to as macrogols. Brands include DulcoSoft, Movicol, OsmoLax, ClearLax and ColonLYTELY.
How can it cause weight loss?
PEG 3350 is known as an osmotic laxative. It uses osmosis - how your body manages the balance of electrolytes in your blood serum - to soften your stools and treat constipation.
When you swallow a drink with PEG 3350 the polymer isn't absorbed by the body. Instead, as it passes through your intestines it draws water to it, making your faeces much more watery.
Because it draws more water out of your body than you put into it from the drink, your weight goes down. That is, it just makes you dehydrated.
This means any weight loss is likely to be short-lived; when you next drink, your body will retain more of the water to replace what was lost. To have any significant and sustained weight loss you'd need to take a lot of PEG 3350 every day. And at most, you would only lose a few kilograms.
This is different to how Ozempic works. Ozempic is similar to a family of hormones in your body called incretins. These have a number of actions that control both blood sugar levels and weight. For example, they slow how quickly food is absorbed from the stomach and decrease appetite, both of which help with sustained weight loss.
Dangers and side effects
PEG 3350 can make you dehydrated. You may feel dizzy or light-headed, have a headache and have a dry mouth, lips or eyes.
The concentration of electrolytes in your blood, such as salt, may also be too high (known as hypertonic blood serum).
Hypertonic blood serum can affect the shape of your red blood cells, making it harder for them to carry oxygen around your body. This results in symptoms that include fatigue and tiredness, and those other symptoms of being dehydrated. In extreme cases it can result in death.
Incorrect levels of electrolytes can lead to other serious problems, affecting your heart and muscles. It can also lead to seizures, confusion, and coma.
It can be dangerous to take PEG 3350 if you have heart disease, if your doctor has put you on a sodium-restricted diet, or if you already have an electrolyte disorder, such as hyperkalaemia (high potassium levels).
These products are also dangerous for elderly people, those with kidney problems, and in very young children.
Common side effects include anal irritation, vomiting, diarrhoea, nausea, cramps, pain, and swelling of your abdomen. Some people can have allergic reactions.
If you use laxatives, including PEG 3350-based products, for a long period of time (over a period of weeks or months) then you may experience withdrawal symptoms if you stop taking them suddenly. These include constipation, bloating, weight gain and fluid retention.
In a nutshell
Overall, if you've been struggling with weight loss, then PEG 3350-based products are not a safe and effective solution. Any weight loss you experience will be temporary and may put your health at risk. Safer and more effective solutions are available.
Eating healthily and exercising regularly are important first steps for anyone who wishes to lose weight. Otherwise, your GP or local pharmacist can help you with both lifestyle changes and medication options to help with weight loss.
Nial Wheate in the past has received funding from the ACT Cancer Council, Tenovus Scotland, Medical Research Scotland, Scottish Crucible, and the Scottish Universities Life Sciences Alliance. He is a Fellow of the Royal Australian Chemical Institute, a member of the Australasian Pharmaceutical Science Association, and a member of the Australian Institute of Company Directors. Nial is the chief scientific officer of Vaihea Skincare LLC, a director of SetDose Pty Ltd a medical device company, and a Standards Australia panel member for sunscreen agents. Nial regularly consults to industry on issues to do with medicine risk assessments, manufacturing, design, and testing.
Jessica Pace does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
