Ozempic bodybuilders push for open access to weight loss drug

Top bodybuilders can reach just 5 per cent bodyfat. Mike Israetel says Ozempic makes it easier. (ABC News: Margaret Burin)

In the days leading up to a competition, bodybuilders deny themselves nearly every human pleasure.

Food, water and sex are routinely restricted to levels that put immense strain on their physical and mental wellbeing.

“Your body thinks it’s dying,” Mike Israetel, a US masters bodybuilder and exercise physiologist, told triple j Hack.

So when the competition ends and the months-long abstinence is lifted, the reaction can be extreme.

“I was eating so much food that it was making me physically ill. I had to sleep sitting up because otherwise, food would flow … into my windpipe,” Mr Israetel said.

It was at this point he first tried semaglutide, the active ingredient in Ozempic, and – he says – all that hunger went away.

“It was miraculous,” he said.

“I didn’t take it for a long – only a couple of weeks, post-contest.”

“Then for my next series of contest preparations, months later, I began to take it again and saw the incredible effect that it has.”

Goodbye hunger

Semaglutide is part of a class of drug that reduces appetite, and that is now being used to treat diabetes and obesity.

Its popularity has exploded in the past few years, prompting a global shortage.

In Australia, Ozempic is only approved and subsidised for patients with diabetes, but doctors can use their own discretion to prescribe it for patients wanting to lose weight — at full price.

Mr Israetel, who is also a former professor of sports physiology, says the value of drugs like Ozempic for bodybuilders is not about losing more weight – top male performers reach around 5 per cent body fat already, he says – but reducing the profound symptoms of extreme hunger.

“When you get very lean it’s actually very difficult to sleep because you’re hungry all the time,” he said.

“Sleep is probably one of the most powerful effectors of how much body fat and muscle mass you have.

“It’s a huge revolution for folks like myself that use it for physique enhancement purposes.”

Bodybuilders ‘assume’ Ozempic is being used

Needless to say, bodybuilders are an extreme outlier among people using semaglutide, and no Australian bodybuilder has publicly admitted to using the drug to enhance their competition performance.

Melbourne bodybuilder Aaron Curtis says he does not use any drugs for weight loss, but he also told triple j Hack that at least three of his non-bodybuilding clients at his gym do.

“None of the people that I was training that were on semaglutide are obese,” he told Hack.

“They’ve just had it prescribed for weight loss purposes – actually one of them was taking it to help lower their blood sugar, but they literally wanted to take it to lose weight.”

Mr Curtis competes in “natural” bodybuilding competitions, meaning he is subject to drug testing.

However, in so-called “enhanced” competitions, he says drug use is not tested, and using performance-enhancing substances is acknowledged to be widespread.

“In the enhanced comps, I’d say the vast majority of people would use some sort of pharmaceutical that aids in fat loss,” he said.

“Very common ones that are used are clenbuterol and thyroid hormone, often just called thyroxine.

“I would assume that [semaglutide] is being used.”

‘Ozempic ass’

More than any other athlete, bodybuilders explicitly aim to maximise muscle growth while minimising fat in the body.

Nonetheless, Mr Israetel says he doubts the findings of studies that suggest semaglutide causes muscle loss.

“If you don’t go to the gym and train while you’re on these drugs, you just eat less shitty food and you take your already-low levels of muscle mass and dump them even further.”

“There’s a situation people have described called ‘Ozempic ass’ and it’s women who just diet their butts literally off – totally flat.”

“It’s a problem you’ve never seen exposed before because most of those people would have never dieted the weight off to begin with.”

Mr Curtis said, in his experience too, people with personal trainers are able to retain muscle while using semaglutide.

But he was less persuaded by Mr Israetel’s claims of its overwhelming efficacy for fat loss.

“I’d say it’s the same as almost any drug – it will help you do something but if you’re not willing to change your dietary and exercise habits, then it’s not going to be a great help,” he said.

Sydney University pharmacy lecturer Andrew Bartlett says the long-term effects of semaglutide are poorly understood, and research is ongoing.

He also adds that rapid weight loss itself can cause issues.

“If you lose weight quickly it can possibly have effects such as hair loss and problems with your pancreas or your gall bladder,” he told Hack.

“That’s not so much a consequence of the drug [but] this research is still ongoing and we don’t know all the long-term side effects.”

Compounding problems

Earlier this month, a Four Corners investigation exposed Australia’s robust black market for semaglutide and tirzepatide, another GLP-1 agonist sold under the name Mounjaro.

Both drugs are also legally compounded (ie, made to order) by Australian pharmacies to meet demand amid a global shortage – a practice the TGA is trying to ban due to the lack of safety testing.

However, even if compounding were banned, the global shortage is forecast to ease as manufacturing capacity catches up with demand and new, more powerful versions of the drug become available.

Such is the level of international investment in the drugs that Novo Nordisk, the Danish pharmaceutical giant that brought Ozempic to market, is now the world’s 13th most valuable company, more than double the value of Coca-Cola.

Mr Israetel says he supports this expansion of supply and is downplaying the risk of pharmacy-compounded drugs.

“All of the major pharmaceutical companies have turned their eyes of Sauron onto this class of drugs because they are highly effective with an unbelievably high demand to a world market that numbers in the literal billions of people.”

Eating disorders and Ozempic

Despite enthusiastically supporting semaglutide for bodybuilding and general weight loss, Mr Israetel acknowledges there are groups of people who are at serious risk because of them, including people with eating disorders.

“Some of those folks are going to get their hands on anorectic medicine and they’re going to be able to drive their hunger into near non-existence,” Mr Israetel says.

“I think Ozempic and any kind of effective anorectic is going to be a potential enhancer of these people’s ability to hurt themselves.”

Mr Bartlett echoed Mr Israetel’s concerns.

“These drugs work on suppressing your appetite, whether or not you’re obese or underweight,” he said.

“There would be risks of malnutrition and the health consequences that go along with that – not having enough energy for vital bodily functions is obviously a great concern.”