“When I look around this room, I can’t help but wonder,” Academy Awards host Jimmy Kimmel joked at last year’s ceremony. “Is Ozempic right for me?”

Celebrities’ use of a type 2 diabetes drug to lose weight had sparked both backlash and fascination by the time of last year’s Oscars. As this year’s ceremony approaches on Sunday night, the maker of a competitor set of medicines in Ozempic’s class has a message for people trying to use the drugs to slim down quickly for cosmetic reasons: These aren’t for you.

“Some people have been using medicine never meant for them,” begins one ad from drugmaker Eli Lilly, called “Big Night,” which will debut on TV this weekend. “For the smaller dress or tux, for a big night, for vanity.”

A red carpet is rolled out; paparazzi cameras flash.

“But that’s not the point,” the voiceover continues as the images transition from a glitzy event to a woman dressed in ordinary clothes riding public transit. “People whose health is affected by obesity are the reason we work on these medications. It matters who gets them.”

The ad doesn’t specifically mention Lilly’s drugs – Zepbound for obesity and Mounjaro for diabetes – and thus it doesn’t include the litany of safety information that US TV-watchers have become accustomed to at the end of pharmaceutical commercials.

But it delivers a message Lilly’s been trying to convey since the beginning of this year.

“We have a point of view about how these drugs are being used,” CEO David Ricks told CNN. “These medicines were invented for people with a serious health condition; they were not invented just to have someone who’s famous look a little bit better.”

‘This is a disease’

Zepbound and Mounjaro are part of a class of medicines broadly referred to as GLP-1 receptor agonists, which also includes Novo Nordisk’s Ozempic and its sister drug, Wegovy. Both sets of drugs mimic a hormone known as GLP-1 that reduces appetite, causes people to feel full longer and affects insulin secretion. Lilly’s drugs mimic a second hormone, GIP, involved in those processes, as well.

Ozempic and Mounjaro are approved by the US Food and Drug Administration for diabetes, and Wegovy and Zepbound are approved for chronic weight management; in clinical trials, they were shown to help people lose 15% to 20% or more of their body weight, on average, and guidelines for their use revolve around patients’ body mass index.

They’re indicated for people who have a BMI of 30 or more, who are considered to have obesity, or who have a BMI of 27 – considered overweight – or higher and at least one “weight-related” health condition, like high blood pressure or cholesterol.

“This is a disease,” Ricks said. “It’s a metabolic disorder that, for most people, won’t go away without serious medical treatment. … So I don’t think we’re going to make much progress on this topic, that affects 100 million-plus Americans, unless we treat it like a health condition just like we do hypertension or arrhythmia or anything else.”

Ricks detailed three reasons his company is trying to draw a line on who should get access to these drugs: insurance coverage, shortages and the people in whom they’ve been studied.

“We’ve only studied it in a population that had overweight or obesity, and we’ve focused it on people with chronic complications from obesity,” he said. “We can’t speak to benefits and risks outside the population, so we think it’s only responsible to point the light here, where the drug is most needed.”

Would Lilly ever study the drug for cosmetic weight loss?

“It’s not in our roadmap right now,” Ricks said. “It’s not really our mission. I think people come to work in my company and they want to solve tough health problems, not just make money in healthcare.”

Trouble finding, paying for meds

Ricks also pointed out the medicines are already in shortage, and he noted the World Health Organization reported last week there are more than 1 billion people globally with obesity.

“We’re a long way from being able to supply a billion people with these medications with obesity, let alone the people who may want to lose some weight cosmetically,” Ricks said. “So we need to prioritize, and that’s what this ad’s about, is prioritizing those who need it most.”

Lilly didn’t say how many people may be using its drugs inappropriately, but the short supply of both sets of them has left people with type 2 diabetes scrambling to find their medicines. Novo Nordisk had to limit the lower starting doses of Wegovy so it could keep supplying patients already on higher maintenance doses of the drug.

Both companies are racing to increase production, building and acquiring manufacturing plants, but Novo Nordisk’s CEO told CNN last year that it could take years to catch up to demand.

And insurance coverage is poor, particularly for medicines for weight loss. They cost between $960 and $1,350 per month before insurance or discounts, and “half the people in America who have obesity” don’t have insurance coverage for them, Ricks said – including those covered by Medicare, which prohibits coverage of drugs for weight loss.

“That’s wrong to us,” he told CNN. “We would call on all the decision-makers in the health-payment world, starting with the federal government which doesn’t reimburse these in Medicare, to really reconsider that position – that obesity is a serious condition that leads to other serious conditions, and it likely cannot be resolved for many people without medication.”

Pressed on whether Lilly should reduce the price of the medicines to increase accessibility, Ricks pointed to discount programs the company has put in place to provide the drugs for as much as half off.

But, he said, “that’s not the same as insurance. And again, we don’t think that a health product we’ve made for a serious health condition should be uninsured. We don’t accept that in any other condition.”

A goal of empathy

The way obesity is viewed is the subject of a second new ad from Lilly, twice as long as “Big Night,” called “Shame.”

“It showed up when I was young and stayed like a shadow, living in glances of people I loved and ones I didn’t even know, always reminding me of my body’s supposed value,” the voiceover says. “But what good is shame when it comes to health? Health is not about what weight we lose; it’s about all the things a body can gain.”

Ricks said the ad is a result of years his team spent with people with obesity, and its goal is to engender more empathy for them, particularly within the health-care system.

Lilly said the ads, which are part of a series that began this year with a focus on different diseases – including Alzheimer’s, where the company expects FDA approval of a new medicine this month – would run nationally starting this weekend.

Will “Big Night,” the ad admonishing celebrities and others who use the drugs for “vanity,” air during the Oscars broadcast itself? Ricks said he didn’t know. But, he noted, the week leading up to it is focused on advocacy, around World Obesity Day on March 4 and Obesity Care Week.

“It just so happens at the end of the week is a big award show, the Oscars,” he said. “And so we’re kind of seizing that moment to juxtapose those two ideas, that this is a serious condition with a serious medication.”

“We have to use language to talk about the condition beyond just what, you know, size dress you fit into or whatever,” Ricks said. “It’s not for that.”