This subject of semaglutide (e.g. Ozempic) is appearing regularly in my private Facebook group, and I can see there might be some confusion out there.
But first, I wanted to state that this post is not about me saying semaglutide (or whatever brand names are included in this post) is something you should be taking or not. That is the responsibility of your doctors, in conjunction with you, the patient. Nor is this post to be considered in any way a promotion for the drug or the manufacturer, I have no relationship or communications with the manufacturer, nor am I taking this drug.
I merely wanted to point out some facts about this drug, mainly from the manufacturer’s website and hopefully provide some context for those who may be confused. That said, clearly you should clarify any concerns with your doctor.
It’s relevant because many people already have diabetes before being diagnosed and there may be potential overlap issues with NET plus some people may become diabetic through treatment for NET. I’ve already written about Diabetes and NET – click here to read.
I focused on Ozempic because it is the most common drug mentioned in my group, but my research found that the drug is called generically called semaglutide but there are different brand names with different approvals. You will see the different approvals below. e.g. The approval for Type 2 diabetes does not mean it’s prescribed as a weight loss drug, (or an anti-diarrhea drug), it’s only approved for those with Type 2 diabetes.
For warnings about GLP-1 and some NETs – see below for an article from the NET Research Foundation.
A once-weekly injectable prescription medicine for adults with type 2 diabetes used to improve blood sugar, along with diet and exercise, and reduce the risk of major cardiovascular events such as heart attack, stroke, or death in adults with type 2 diabetes and known heart disease. According to the manufacturer, Ozempic® is proven to lower A1C (HbA1c).
It is not known if Ozempic® can be used in people who have had pancreatitis. Ozempic® is not for use in people with type 1 diabetes. It is not known if Ozempic® is safe and effective for use in children under 18 years of age. Ozempic® may help you lose some weight. But the manufacturer emphasises that Ozempic® is not for weight loss (but see next section) which happens partly due to its effect on reducing your appetite, so you eat less; and slowing down the movement of food in your gut meaning you stay full for longer.
This type of medication works by increasing the levels of hormones called ‘incretins’. These hormones help the body produce more insulin only when needed and reduce the amount of glucose being produced by the liver when it’s not needed. They reduce the rate at which the stomach digests food and empties and can also reduce appetite. It is known as a “GLP-1 analogue”. GLP-1 breaks down to glucagon-like peptide-1 receptor agonist. Other GLP-1 analogues approved to treat type 2 diabetes include (but not limited to):
| Exenatide (twice-daily injection) | Byetta |
| Exenatide (once-weekly injection) | Bydureon |
| Liraglutide (once-daily injection) | Victoza |
| Lixisenatide (once-daily injection) | Lixumia |
| Tirzepatide (once-weekly injection) | Victoza |
| Dulaglutide (once-weekly injection) | Trulicity |
There is a tablet form of semaglutide for those unable to tolerate injections. This is branded as “Rybelsus“.
Please note these indications are being released and updated, so this list is not exhaustive and there may be changes – always seek advice from your doctor.
For warnings about GLP-1 and some NETs – see below for an article from the NET Research Foundation.
The situation regarding weight loss has been in the media in UK this year (2023) because the National Institute for Health and Care Excellence (NICE) has recommended the use of semaglutide (Wegovy), alongside a reduced-calorie diet and increased physical activity to adults who have at least 1 weight-related comorbidity and a body mass index (BMI) of at least 35kg/m2. People with an BMI of between 30-34.9 kg/m2, with 1 weight-related comorbidity who are eligible for referral to specialist weight management services could also be prescribed the drug. A weight-related comorbidity could be one of: dysglycaemia (prediabetes or type 2 diabetes mellitus), hypertension, dyslipidaemia (in which disturbances in fat metabolism lead to changes in the concentrations of lipids in the blood), obstructive sleep apnoea or cardiovascular disease. NICE stipulated “Semaglutide won’t be available to everyone. Their committee has made specific recommendations to ensure it remains value for money for the taxpayer, and it can only be used for a maximum of two years”.
A similar announcement was made in US in June 2021 – i.e. Wegovy was approved by US FDA for chronic weight management in adults with obesity or overweight with at least one weight-related condition (such as high blood pressure, type 2 diabetes, or high cholesterol), for use in addition to a reduced calorie diet and increased physical activity. There doesn’t appear to be a two-year restriction as per UK above but will update if found to be the case.
Something similar probably happened in many countries where these announcements made the headlines in many national newspapers and other media sources.
Although Ozempic and Wegovy are made by the same company (Danish pharmaceutical company Novo Nordisk), there are differences between the different semaglutide brand names in terms of what they are recommended for:
Note – Ozempic, Wegovy and Rybelsus are all GLP-1 analogue brand names based on the Semaglutide product. The approvals are different, but the patient insert leaflets containing warnings/contraindications etc, appear to be the same as Ozempic but always check the information with your doctor.
See latest NHS UK guidance dated August 2025. Click here – this is info only and not intended to be advice for Neuroendocrine Neoplasms which is covered elsewhere in this blog post.
For warnings about GLP-1 and some NETs – see below for an article from the NET Research Foundation.
I wanted to ensure this bit is clear after one misleading comment was made in my group. There is a potential overlap with certain types of NET.
Ozempic® may cause serious side effects, including:
(author’s note: Familial MTC (FMTC) and MEN2 are both heavily associated with Neuroendocrine Tumours such as Pheochromocytoma and Paraganglioma)
Tell your health care provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, herbal supplements, and other medicines to treat diabetes, including insulin or sulfonylureas.
Note – Ozempic, Wegovy and Rybelsus are all GLP-1 analogue brand names based on the Semaglutide product. The approvals are different, but the patient insert leaflets containing warnings/contraindications etc, appear to be the same as Ozempic but always check the information with your doctor.
For warnings about GLP-1 and some NETs – see below for an article from the NET Research Foundation.
A team of researchers from the University of Iowa has unveiled concerns about the use of semaglutide, a widely prescribed GLP-1 receptor agonist for type 2 diabetes and obesity, in patients with neuroendocrine neoplasms (NENs). Read more by clicking here.
From what I’ve been seeing online, including in my own patient group, and on twitter (X), some of this these findings have been misunderstood/misquoted. I believe the issue surrounds which patients express GLP-1. At NANETS 2025, Dr Dillion from the University of Iowa explained as follows (ampflified by Dr Hagen Kennecke).
1. First, the tweet from Dr Kennecke:
2. Then the two powerpoint slides attached to the tweet:
3. Now see this published follow up in medical journals. Click here to read that.
4. And here is a video plus the script from Dr Dillon – click here to listen or read that.
I cannot really advise you further on this except to say that you should have discussions with your specialist, and I hope the attachments above can help.
I was concerned (but not surprised) to read that supply shortages of Semaglutide have been exploited by companies producing “compounded products” (complicated but essentially something that has not gone through the formal clinical trial processes)
MedPage Today stated that obesity specialists warn against using compounded semaglutide since its quality and safety cannot be guaranteed (their headline used the term “bootlegged”.
See US FDA warnings click here
Please ensure you’re getting the right drug.
1. Ozempic® (semaglutide) Injection 0.5 mg or 1 mg for Type 2 Diabetes
2. Weight-Loss Prescription Medication | Wegovy® (semaglutide) Injection 2.4 mg
3. Type 2 Diabetes Medicine | RYBELSUS® (semaglutide) tablets 7 mg or 14 mg
4. FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014 | FDA
5. FDA approved package insert leaflet – Ozempic
6. FDA Approved package insert leaflet – Wegovy
7. FDA Approved package insert leaflet – Rybelsus
8. “The facts behind the headlines” Diabetes UK – information on Ozempic®
9. News from UK – NICE news (Wegovy)
10. Wegovy: The key facts to know about the weight loss drug (diabetes.org.uk)
11. “Bootlegged” compounded versions warning.
12. Research Reveals Potential Risks of Popular GLP-1 Medications for Some with Neuroendocrine Cancer
13. Dr Dillon on Considerations for GLP-1s in the Neuroendocrine Tumor Space
I am not a doctor or any form of medical professional, practitioner or counsellor. None of the information on my website, or linked to my website(s), or conveyed by me on any social media or presentation, should be interpreted as medical advice given or advised by me.
Neither should any post or comment made by a follower or member of my private group be assumed to be medical advice, even if that person is a healthcare professional. Some content may be generated by AI which can sometimes be misinterpreted. Please check any references attached.
Please also note that mention of a clinical service, trial/study or therapy does not constitute an endorsement of that service, trial/study or therapy by Ronny Allan, the information is provided for education and awareness purposes and/or related to Ronny Allan’s own patient experience. This element of the disclaimer includes any complementary medicine, non-prescription over the counter drugs and supplements such as vitamins and minerals.
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