The global fight against obesity has intensified. From 1975 to 2016, obesity rates more than tripled. In Russia, up to 30% of the workforce is affected and another 25% are overweight.
Obesity is more than appearance; it poses serious health risks. It raises the likelihood of hypertension, cancer, diabetes, stroke, coronary heart disease, heart attack, atherosclerosis, and damage to the liver and kidneys. Obesity also affects reproductive health, increases disability risk, and shortens life expectancy.
In recent years, an injectable weight loss medication, Ozempic, has become part of some doctors’ armamentarium. It is used to treat patients with type 2 diabetes.
Its mechanism mirrors a natural hormone produced after meals that helps the pancreas release insulin when glucose rises. This helps people feel full longer and also targets the hypothalamus to curb appetite, contributing to rapid weight loss.
Last year this drug exited the Russian market but domestic versions Semavik and Quincenta were quickly introduced. Endocrinologist Marina Berkovskaya, Associate Professor at Sechenov University, notes that both drugs share the active ingredient semaglutide and work similarly to Ozempic. These drugs belong to a class of glucagon-like peptide-1 receptor agonists that first entered markets around 2007. They are glucose-lowering medications for type 2 diabetes but data revealed an additional effect on weight loss, which clinicians welcomed for many patients who are obese with diabetes. Cited source: Berkovskaya, Sechenov University.
According to Berkovskaya, semaglutide-based therapies are a significant breakthrough for modern healthcare because obesity is a major challenge and these drugs show strong potential for effective weight management. Cited source: Berkovskaya.
The head of the Center for Cardiology and Therapy at the National Clinical Center No. 3 in Russia, Akkadian BV Petrovsky, along with cardiologist and nutritionist Konstantin Ivanov, emphasizes the potential of these medications. They stress the need for cautious evaluation of Russian analogues and rigorous evidence-based practice. Cited source: Petrovsky, Ivanov.
Experts agree that while the costs of these drugs may be lower, time is needed to objectively assess their long-term effectiveness and safety through high-quality studies. Ivanov notes that the biggest advantage is that these medications do not cause hypoglycemia in non diabetic patients and may reduce cardiovascular and kidney risks associated with diabetes, while also contributing to weight loss.
Despite these positives, semaglutide-based drugs come with side effects. Endocrinologist Natalya Tanygina from the Central Medical Clinic CMD FBUN Rospotrebnadzor notes that not everyone responds identically. Typical results show modest weight reductions, and some patients experience gastrointestinal symptoms including nausea, vomiting, belching, diarrhea, constipation, and gas. There is also concern about pancreatitis in certain individuals, and treatment tends to be long-term. Tanygina cautions that nausea often diminishes with time, while pancreatitis remains a serious risk. Cited source: Tanygina.
Berkovskaya adds that these medications generally have a favorable safety profile but may impact mental state in some individuals. Initiating therapy without medical supervision can lead to depressive symptoms and, in rare cases, suicidal ideation. For this reason, a doctor must assess all risk factors and tailor treatment. Cited source: Berkovskaya.
Another issue is withdrawal. Ivanov explains that stopping the drug abruptly may lead to weight regain if lifestyle changes are not maintained. Long-term data remain limited. There is also a theoretical concern about thyroid cancer risks based on animal studies; human relevance remains unproven but warrants caution. Cited source: Ivanov.
Other weight loss options
Berkovskaya notes that beyond Ozempic and its variants, other medications show promise. Munjaro, known as tirzepatide, is a dual agonist that influences gut hormones involved in eating behavior and has demonstrated strong results for both diabetes and obesity. New molecules are in development, including retatrutide, which is in early-stage trials and shows weight loss effects similar to metabolic surgery. Cited source: Berkovskaya.
While these drugs can offer beneficial effects when used properly, Tanygina emphasizes careful preparation. Hormonal causes of obesity should be ruled out, especially in postpartum women and those over 45. Pancreas health, a sustainable diet, and ongoing endocrinologist supervision are essential. The aim is to choose methods that can be continued after stopping the drug and to consider safer alternatives when appropriate. Cited source: Tanygina.
Ivanov adds that medication alone does not solve the core problem of lifestyle. The most effective approach combines healthy living, balanced nutrition, and increased physical activity. Bariatric surgery remains a potential option for some patients, but it requires concurrent lifestyle changes to sustain results. Cited source: Ivanov.