Who doesn’t love the promise of any quick and easy fix in life, and there was no disguising such lusty enthusiasm in the voice of Sarah McInerney as she wrapped up the latest conversation around Ozempic on RTÉ‘s Drivetime on Thursday.
“It does seem to be a miracle drug though, doesn’t it,” she said. “It seems to do everything.”
McInerney is certainly not alone in that way of thinking, especially after the study published by the American Medical Association on Wednesday presented strong evidence that one of the potential side effects of semaglutide, the active ingredient in the diabetes and weight-loss medication sold under the brand names Ozempic and Wegovy, was a significantly reduced craving for alcohol.
It was a randomised controlled trial, following just 48 adults who met criteria for alcohol-use disorder. By the second month those taking semaglutide were drinking nearly 30 per cent less alcohol, on average, compared to a reduction of about 2 per cent in the placebo group. Probably beats going to rehab.
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Given there’s more anecdotal evidence that Ozempic can also help reduce cravings for other addictions, including nicotine and cocaine, plus reduce the risk of a stroke or a heart attack, there may well be this “miracle” element – although Drivetime might want to consider another conversation around some of the potentially health-damaging side effects of semaglutide, including increased risk of thyroid tumours and loss of vision.
In the meantime, the World Anti-Doping Agency (Wada) has taken note. These are already testing times for the protectors of all things fair and unfair in sport, given Wada’s future funding is under threat over its supposed soft handling of the 23 Chinese swimmers who tested positive for a banned substance before the Tokyo Olympics.
Wada understands well the potentially performance-enhancing benefits of any fast weight-loss medication, miraculous or not, while also allowing the athlete to retain power, especially approaching competition. Which is why it has long banned several weight-control medications, mainly stimulants and diuretics, last year adding the substance 2,4-Dinitrophenol (DNP), an extremely dangerous compound often marketed for weight loss, and Rev-Erb-a agonists, also advertised as a weight-loss peptide, although not approved for human therapeutic use.
For now, Wada has placed Ozempic on its watch-list for this year, which means it’ll be monitoring how much semaglutide is showing up in its global testing network of 30 Wada accredited anti-doping labs, and whether there are any patterns of use and abuse in certain sports. Put miracle and drug in the same sentence and there’s no doubt some elite athletes already have taken note, too. The gains only need to be marginal.
To be added to the Wada banned list, the substance or method needs to meet at least two of the following three criteria: it has the potential to enhance or enhances sporting performance; it represents an actual or potential health risk to the athlete; it violates the spirit of sport (as outlined in the Wada Code).
Dr Olivier Rabin, Wada’s senior director of medicine and science, told triathlon.com last month that Ozempic “goes beyond a simple drug for obesity” and “opens up a lot of reflections, not only in sport in our environment but also in society in general”. So, is it fair or unfair?
“If you can improve your weight-to-power ratio, you’re going to have a benefit in cycling, running, and possibly in swimming as well,” Rabin added, suggesting Ozempic at least meets the first criteria. Whether Ozempic is ultimately a health risk to the athlete or violates the spirit of sport is more open to interpretation. And even if Wada does ban its use, who’s up for some therapeutic use exemption?
Wada is also known to be considering the banning of another so-called marginal gain in sport, with cycling once again leading the way here around the performance-enhancing potential of carbon-monoxide inhalation. That’s not a misprint.
While the obvious health risk to the athlete here is ending up dead, carbon-monoxide inhalation – or “rebreathing”, as they prefer to say in cycling – has been in use for many years, a well-worn technique applied across endurance sport to measure total haemoglobin mass and blood volume, particularly when it comes to the effectiveness of altitude training.
It’s not like we’re breathing exhaust fumes from cars every day
— Tour de France winner Tadej Pogacar
However, some of those in the peloton also realised that more frequent rebreathing of carbon monoxide could potentially boost the blood’s oxygen-carrying capacity, that expensive practice linked with three teams in last year’s Tour de France: UAE Emirates, Visma-Lease a Bike and Israel-Premier Tech.
Although quickly played down – race winner Tadej Pogacar from UAE Emirates saying “it’s not like we’re breathing exhaust fumes from cars every day” – the Union Cycliste Internationale (UCI), the governing body of world cycling, clearly got worked up about it, and earlier this month applied its own ban on carbon-monoxide inhalation, and in this case advising Wada to take note too.
“The UCI takes a bold and necessary stance by banning the repeated use of carbon-monoxide inhalation on medical grounds,” UCI chief David Lappartient said. “Our priority is to protect the health and safety of our athletes and the decision is another significant step in this direction.”
The UCI said: “The ban is independent of the Wada and the UCI Anti-Doping Regulations, however the UCI has officially requested Wada to take a position on the repeated use of carbon monoxide in and out of competition.”
UAE Emirates have recently said they’ve already moved on from carbon-monoxide use anyway. Whatever about the potential performance-enhancing qualities, few riders or teams could stand over the use of a toxic gas otherwise known as the silent killer, strictly medically supervised or otherwise.
The swift addition of Ozempic to any banned list may not be as straightforward, even if Wada does discover it’s being used and potentially abused beyond its intended purposes. But even if Ozempic may prove a miracle drug for some people, that alone should be reason enough to ensure it has no place in any sport.
