'Budget Ozempic': Costs and shortages are driving your patients to misuse laxatives

By Julia Ries | Fact-checked by Jessica Wrubel
Published September 21, 2023

Key Takeaways

  • There are nearly 60,000 new prescriptions being written for Ozempic each week, leading to shortages. Some individuals are resorting to compounded semaglutide or even riskier weight-loss alternatives.

  • Individuals are turning to laxatives in an attempt to lose weight, a phenomenon dubbed "Budget Ozempic."

  • Laxatives cause immediate water loss in the body, not fat loss, and do not aid in sustained weight management.

It’s no secret that semaglutide drugs, like Ozempic and Mounjaro, have become extremely popular this year. Recent data from Ozempic showed that providers are writing nearly 60,000 new prescriptions for the medication every week. The growing demand has continued to trigger medication shortages nationwide, driving some patients to take compounded semaglutide and, in certain cases, resort to riskier weight-loss options. Meanwhile, the high cost of semaglutide drugs and prescription requirements have others looking for cheap weight-loss pills they can easily buy over-the-counter (OTC).[]

The result: people are turning to laxatives to shed excess weight—a trend the internet has dubbed “Budget Ozempic.” Some users on TikTok, for example, are sharing recipes for laxative-based drinks and foods, such as the “Miralax Mango Miracle.” Meanwhile, supermarkets and pharmacies across the country have recently reported laxative shortages.[] []

Taking an OTC drug may seem harmless to some, but the side effects—such as electrolyte imbalance, dehydration, and intestinal damage—can be life-threatening and, in severe cases, irreversible. “As these products are not formulated as weight-loss agents, they have not been studied for these purposes for safety or effectiveness in terms of weight loss, and may be associated with other risks that have not yet been reported,” Kelly Johnson-Arbor, MD, a medical toxicology physician from Washington, DC, told MDLinx.

Ozempic and laxatives have vastly different effects on the body

Ozempic and similar semaglutide-based weight-loss medications work by regulating blood sugar and insulin levels in the body. This can decrease appetite and increase early fullness, ultimately contributing to weight loss.[] 

Laxatives, on the other hand, soften stools and stimulate bowel movements to flush waste and water out of your system. That said, research shows some people believe laxatives will prevent their bodies from absorbing calories. This misconception has caused people, often those with eating disorders, to utilize laxatives to flush unwanted calories out of their bodies, lose weight, and prevent bloating.[][] 

The weight loss people experience from taking laxatives is due to the immediate loss of water in the body—not fat. “Any weight lost comes right back once you hydrate,” Steven Batash, MD, a board-certified gastroenterologist at the Batash Endoscopic Weight Loss Center, told MDLinx. Real, sustained weight loss can only be achieved and maintained through the reduction of body fat, and laxatives do not help with that. And Dr. Batash adds: “They're just a risky and potentially harmful measure.” 

These drugs should not be used interchangeably. “Making a connection between the two different processes can confuse individuals and encourage a misinformed method for weight loss,” says Dr. Batash.

Laxative misuse can lead to serious health complications

Dr. Johnson-Arbor says some patients might presume that OTC drugs like laxatives are safe when used for weight loss, but inappropriate and excessive use can be dangerous. 

Misuse of laxatives can lead to dehydration, affect the body's mineral balance, and even contribute to heart problems or muscle cramps, according to Dr. Batash. Some people may develop low levels of potassium, magnesium, or calcium. Drugs like MiraLAX, psyllium, and carboxymethylcellulose can also cause gastrointestinal problems, including abdominal pain, vomiting, and diarrhea. Electrolyte imbalances can disrupt heart rhythm.[][]

It’s also crucial to take laxatives alongside fluids, as there have been reports of certain laxatives, such axc, says Dr. Johnson-Arbor. Carboxymethylcellulose may have a similar effect, she added. 

Prolonged use may cause one’s intestines to become reliant on the laxative’s effect, impairing their ability to digest food and produce bowel movements. “This could lead to constant constipation, a messed-up gut, and potential long-term damage to the intestines,” says Dr. Batash. In extreme cases, laxative abuse can result in severe dehydration, life-threatening electrolyte abnormalities, and death, says Dr. Johnson-Arbor. In such instances, medical stabilization is necessary.[][] 

When it comes to weight loss, quick fixes like laxatives do more harm than good. There are other safe, effective weight-loss medications for those who have difficulty accessing or affording the in-demand semaglutide medications. In addition, the benefits of a healthy diet and regular exercise in weight management cannot be overstated. The message is clear and simple, according to Dr. Batash: “Laxatives should be for occasional constipation, not weight loss.”[][]

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