‘Ozempic alternatives’ are everywhere. Here’s what you should know

Drugs such as Ozempic have had a big impact on the weight-loss industry. But amid shortages and high costs, copycat over-the-counter and direct-to-consumer “natural” supplements promising similar results have emerged.

In September, Kourtney Kardashian launched her supplement brand, Lemme, while on TikTok, videos promoting “nature’s Ozempic” are hard to miss.

Many of these supplements, which can be easily ordered online, claim to mimic the GLP-1 stimulating property that makes drugs such as semaglutide, which is marketed as Ozempic, so successful with weight loss, while others simply claim to help users shed kilos.

However, the Therapeutic Goods Administration, Australia’s regulatory authority for medicines, has warned many of these copycat supplements are not TGA-approved.

“The TGA is concerned about the health and safety of Australian consumers accessing unregistered or unapproved therapeutic products or information about these products online,” said a spokesperson for the agency.

Kourtney Kardashian’s supplement brand is one of many Ozempic alternatives being spruiked on social media.Credit: Aresna Villanueva; Getty Images

What is GLP-1?

The main claim made by so-called Ozempic alternatives or “dupes” is that they stimulate the secretion of GLP-1, a hormone humans naturally produce.

Professor Nial Wheate, a pharmaceutical chemist at Macquarie University, says GLP-1 serves several purposes in the body, including regulating insulin and slowing down digestion, keeping our appetites at bay.

Food and nutrition scientist Dr Emma Beckett explains that a healthy diet rich in GLP-1-stimulating nutrients like fibre, fermented food, healthy fats and lean protein will naturally keep us fuller for longer. However, genetic differences, and the impacts of dieting and food restriction can affect the secretion of GLP-1, meaning different people have different hunger levels.

Drugs such as Ozempic, which is often prescribed to diabetics, mimic this mechanism with a synthetic formulation of GLP-1. Beckett says these drugs have a “very long half-life”, meaning they take longer to break down in the blood and keep people full for longer.

What do the Ozempic alternatives contain?

Natural supplements claiming to be “dupes” for Ozempic contain various ingredients.

Kardashian’s Lemme “GLP-1 Daily Capsules” contain lemon, saffron and red orange extract, while other supplements making claims about GLP-1 contain prebiotics. Berberine, an ingredient found in plants such as golden seal and barberry, is included in others.

Given these supplements are concentrated forms of food extracts, Beckett says they may be able to stimulate GLP-1 but “are not likely to do so in any way above and beyond actually eating food”.

She says the clinical trials cited by brands such as Lemme are unreliable. Many rely on animal trials, have small sample sizes or manipulate findings to exaggerate the effects of a certain ingredient.

Berberine is the ingredient with perhaps the most scientific research to date, but the jury is still out. There is some evidence to show it might have a modest effect on weight loss, Wheate says.

One meta-analysis found that taking berberine daily for three months resulted in a modest reduction of about three kilograms, with the most significant results present in women with a body mass index over 30. But the evidence looks only at its effect on overweight or obese people, so we don’t yet know its total impact.

Wheate points out that some of these supplements contain caffeine, which can increase the metabolic rate in the short term and increase fat burn, and may result in weight loss.

What are the risks?

Supplements which are not TGA-approved have not been assessed for safety or effectiveness, making it harder to know what is in them and how they are manufactured.

“Products the TGA does not regulate may not meet Australian manufacturing quality standards, and could contain undisclosed harmful ingredients or be fake,” said a TGA spokesperson.

“The TGA urges consumers to exercise extreme caution when purchasing therapeutic goods from unknown websites, social media or other digital platforms or when relying on information from these sites to make healthcare decisions.”

These unregulated supplements, while illegal to export, import, manufacture or distribute, can be purchased online under the Personal Importation Scheme.

Wheate says Berberine has similar side effects to GLP-1 agonists such as Ozempic, including diarrhoea, constipation and bloating, he explains.

“There is no medicine that is 100 per cent safe,” says Wheate. “Even the most common medicines, like paracetamol and aspirin, have side effects.”

Beckett says because these supplements are marketed as natural extracts, they can have an “air of safety”. But there is a lack of regulation around supplements and risks that come from processing natural ingredients.

“Once it’s extracted and processed into tablet form, that’s where you can overdo the effects and something that you couldn’t normally get a toxic dose of in food, you could get a toxic dose of from pills.”

Beckett says risks also need to be considered in the context of people’s lifestyles.

“If you’re taking these supplements in a quest not to eat food, then you need to consider beyond the weight-loss ‘benefits’. You need to think about the malnutrition harms.”

Some of these supplements can also interact poorly with other medications or medical conditions, cautions Beckett.

Royal Australian College of GPs specific interests integrative medicine chair Tamara Nation says to seek medical advice before starting any supplements, while the TGA says to always consult your GP before taking unregulated supplements.

Beckett is concerned about the psychological harms of weight-loss supplements and what they say about diet and eating disorder culture.

“This continuous pursuit of manipulating our biology into this perfect diet and the harm that that does long term, I think definitely needs to be considered in the marketing of those products.”

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