‘Budget Ozempic’: What to Know

With novel weight-loss drugs such as semaglutide (Wegovy) and tirzepatide (Zepbound) in short supply and selling for high prices, an age-old method for trying to shed pounds has taken on a new moniker: “budget Ozempic.”

The term refers to laxatives, which were reportedly in short supply last fall — though there appear to be many contributing factors to the shortages.

The phrase “budget Ozempic” appears to have originated with a Wall Street Journal article in September. The article focused on how surging demand for laxatives was driving a shortage of polyethylene glycol 3350, the main ingredient in popular laxative Miralax.

Among the contributors to the shortage were the fact that most Americans don’t eat enough fiber, which can cause constipation, and that a new “surge in travel and hybrid work schedules are disrupting routines and mealtimes, likely leading to irregularity,” the Journal reported.

Also, “some people are treating laxatives like a budget Ozempic to feel skinnier,” the article stated.

Evidence for the surge in laxative popularity included a tripling in Amazon searches for laxatives, and double-digit sales growth for makers of fiber supplements such as Metamucil and Benefiber, according to the Journal.

While Miralax maker Bayer declined to comment for that story, Dulcolax maker Sanofi told NBC News a few days later that its blockbuster laxative was facing supply issues amid a wave of “unprecedented demand for Dulcolax products.”

Since the Journal story, other media have started to use the phrase, including to describe a recent meta-analysis published in JAMA Network Open that found that almost one in 10 adolescents have used non-prescription products for weight loss, including laxatives, diuretics, and diet pills.

A headline in STAT News read, “Nearly 1 in 10 teens globally have used ‘budget Ozempic’ laxatives and other risky weight loss products, per study.” And a Today headline read, “‘Budget Ozempic’: Doctors warn about health risks of using laxatives for weight loss.”

Physicians interviewed for the Today story warned that laxatives aren’t a proper weight-loss medication.

William Chey, MD, chief of gastroenterology and hepatology at the University of Michigan in Ann Arbor, told Today that laxatives can cause people to lose a little bit of weight in the short-term by forcing them to pass stool that’s in their gut, but this ultimately just sheds water weight, “which is not real weight loss.”

Taking excessive amounts of laxatives can lead to loss of fluids and dehydration, Chey added.

Roshini Raj, MD, a gastroenterologist at NYU Langone Health in New York City, told Today that with laxatives, “the only thing you’re losing is water and electrolytes, and those are both very important things.”

“Abusing laxatives in this way is potentially quite harmful,” she added, “and doesn’t give you any benefit of true weight loss.”

While weight loss has always been a popular topic, the arrival of GLP-1 receptor agonists semaglutide and tirzepatide for shedding pounds has renewed the focus on slimming down. Because of their popularity, the drugs have faced supply issues that have even made them difficult to obtain for their original indication of type 2 diabetes.

Even if patients can find them at a pharmacy, they carry a high price tag — upwards of $1,000 per month — and often are not covered by insurance, leaving patients to pay the full cost out-of-pocket.

Since semaglutide and tirzepatide are officially in shortage, compounding pharmacies are legally allowed to make copies of these drugs to sell to patients, though experts have warned about varying quality with these products.

In addition, counterfeit products abound. In December, the FDA warned consumers not to use counterfeit semaglutide that was discovered in the drug supply chain.

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