Hundreds of thousands of people worldwide are taking drugs like Ozempic to lose weight. But what do we actually know about them? This month, The Conversation’s experts explore their rise, impact and potential consequences.

You’ve no doubt heard of Ozempic but have you heard of Wegovy? They’re both brand names of the drug semaglutide, which is currently in short supply worldwide.

Ozempic is a lower dose of semaglutide, and is approved and used to treat diabetes in Australia. Wegovovy is approved to treat obesity but is not yet available in Australia. Shortages of both drugs are expected to last throughout 2024.

Both drugs are expensive. But Ozempic is listed on Australia’s Pharmaceutical Benefits Schedule (PBS), so people with diabetes can get a three-week supply for A$31.60 ($7.70 for concession card holders) rather than the full price ($133.80).

Wegovy isn’t listed on the PBS to treat obesity, meaning when it becomes available, users will need to pay the full price. But should the government subsidise it?

Wegovy’s manufacturer will need to make the case for it to be added to the PBS to an independent advisory committee. The company will need to show Wegovy is a safe, clinically effective and cost-effective treatment for obesity compared to existing alternatives.

In the meantime, we asked five experts: when supplies resume, should governments subsidise drugs like Ozempic for weight loss?

Four out of five said yes

This is the last article in The Conversation’s Ozempic series. Read the other articles here.

Disclosure statements: Clare Collins is a National Health and Medical Research Council (NHMRC) Leadership Fellow and has received research grants from the National Health and Medical Research Council (NHMRC), the Australian Research Council (ARC), the Medical Research Future Fund (MRFF), the Hunter Medical Research Institute, Diabetes Australia, Heart Foundation, Bill and Melinda Gates Foundation, nib foundation, Rijk Zwaan Australia, the Western Australian Department of Health, Meat and Livestock Australia, and Greater Charitable Foundation. She has consulted to SHINE Australia, Novo Nordisk (for weight management resources and an obesity advisory group), Quality Bakers, the Sax Institute, Dietitians Australia and the ABC. She was a team member conducting systematic reviews to inform the 2013 Australian Dietary Guidelines update, the Heart Foundation evidence reviews on meat and dietary patterns and current co-chair of the Guidelines Development Advisory Committee for Clinical Practice Guidelines for Treatment of Obesity; Emma Beckett has received funding for research or consulting from Mars Foods, Nutrition Research Australia, NHMRC, ARC, AMP Foundation, Kellogg and the University of Newcastle. She works for FOODiQ Global and is a fat woman. She is/has been a member of committees/working groups related to nutrition or food, including for the Australian Academy of Science, the NHMRC and the Nutrition Society of Australia; Jonathan Karnon does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment; Nial Wheate in the past has received funding from the ACT Cancer Council, Tenovus Scotland, Medical Research Scotland, Scottish Crucible, and the Scottish Universities Life Sciences Alliance. He is a fellow of the Royal Australian Chemical Institute, a member of the Australasian Pharmaceutical Science Association and a member of the Australian Institute of Company Directors. Nial is the chief scientific officer of Vaihea Skincare LLC, a director of SetDose Pty Ltd (a medical device company) and a Standards Australia panel member for sunscreen agents. Nial regularly consults to industry on issues to do with medicine risk assessments, manufacturing, design and testing; Priya Sumithran has received grant funding from external organisations, including the NHMRC and MRFF. She is in the leadership group of the Obesity Collective and co-authored manuscripts with a medical writer provided by Novo Nordisk and Eli Lilly.

Fron Jackson-Webb, Deputy Editor and Senior Health Editor, The Conversation

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It’s one of the most pervasive messages about technology and sleep. We’re told bright, blue light from screens prevents us falling asleep easily. We’re told to avoid scrolling on our phones before bedtime or while in bed. We’re sold glasses to help filter out blue light. We put our phones on “night mode” to minimise exposure to blue light.

But what does the science actually tell us about the impact of bright, blue light and sleep? When our group of sleep experts from Sweden, Australia and Israel compared scientific studies that directly tested this, we found the overall impact was close to meaningless. Sleep was disrupted, on average, by less than three minutes.

We showed the message that blue light from screens stops you from falling asleep is essentially a myth, albeit a very convincing one.

Instead, we found a more nuanced picture about technology and sleep.

What we did

We gathered evidence from 73 independent studies with a total of 113,370 participants of all ages examining various factors that connect technology use and sleep.

We did indeed find a link between technology use and sleep, but not necessarily what you’d think.

We found that sometimes technology use can lead to poor sleep and sometimes poor sleep can lead to more technology use. In other words, the relationship between technology and sleep is complex and can go both ways.

How is technology supposed to harm sleep?

Technology is proposed to harm our sleep in a number of ways. But here’s what we found when we looked at the evidence:

• bright screen light – across 11 experimental studies, people who used a bright screen emitting blue light before bedtime fell asleep an average of only 2.7 minutes later. In some studies, people slept better after using a bright screen. When we were invited to write about this evidence further, we showed there is still no meaningful impact of bright screen light on other sleep characteristics including the total amount or quality of sleep
• arousal is a measure of whether people become more alert depending on what they’re doing on their device. Across seven studies, people who engaged in more alerting or “exciting” content (for example, video games) lost an average of only about 3.5 minutes of sleep compared to those who engaged in something less exciting (for example, TV). This tells us the content of technology alone doesn’t affect sleep as much as we think
• we found sleep disruption at night (for example, being awoken by text messages) and sleep displacement (using technology past the time that we could be sleeping) can lead to sleep loss. So while technology use was linked to less sleep in these instances, this was unrelated to being exposed to bright, blue light from screens before bedtime.

Which factors encourage more technology use?

Research we reviewed suggests people tend to use more technology at bedtime for two main reasons:

• to “fill the time” when they’re not yet sleepy. This is common for teenagers, who have a biological shift in their sleep patterns that leads to later sleep times, independent of technology use.
• to calm down negative emotions and thoughts at bedtime, for apparent stress reduction and to provide comfort.

There are also a few things that might make people more vulnerable to using technology late into the night and losing sleep.

We found people who are risk-takers or who lose track of time easily may turn off devices later and sacrifice sleep. Fear of missing out and social pressures can also encourage young people in particular to stay up later on technology.

What helps us use technology sensibly?

Last of all, we looked at protective factors, ones that can help people use technology more sensibly before bed.

The two main things we found that helped were self-control, which helps resist the short-term rewards of clicking and scrolling, and having a parent or loved one to help set bedtimes.

Why do we blame blue light?

The blue light theory involves melatonin, a hormone that regulates sleep. During the day, we are exposed to bright, natural light that contains a high amount of blue light. This bright, blue light activates certain cells at the back of our eyes, which send signals to our brain that it’s time to be alert. But as light decreases at night, our brain starts to produce melatonin, making us feel sleepy.

It’s logical to think that artificial light from devices could interfere with the production of melatonin and so affect our sleep. But studies show it would require light levels of about 1,000-2,000 lux (a measure of the intensity of light) to have a significant impact.

Device screens emit only about 80-100 lux. At the other end of the scale, natural sunlight on a sunny day provides about 100,000 lux.

What’s the take-home message?

We know that bright light does affect sleep and alertness. However our research indicates the light from devices such as smartphones and laptops is nowhere near bright or blue enough to disrupt sleep.

There are many factors that can affect sleep, and bright, blue screen light likely isn’t one of them.

The take-home message is to understand your own sleep needs and how technology affects you. Maybe reading an e-book or scrolling on socials is fine for you, or maybe you’re too often putting the phone down way too late. Listen to your body and when you feel sleepy, turn off your device.

Chelsea Reynolds, Casual Academic/Clinical Educator and Clinical Psychologist, College of Education, Psychology and Social Work, Flinders University

This article is republished from The Conversation under a Creative Commons license. Read the original article.