Ozempic For Weight Loss: Side Effects, Risks And More | Alyssa Northrop , Updated: Aug 22, 2023, 3:57pm

What Is Ozempic?

Ozempic is an FDA-approved prescription medication for the treatment of type 2 diabetes in adults. It helps improve blood sugar in adults with type 2 diabetes and is proven to lower hemoglobin A1C, a measure of blood glucose over time, according to research cited on Ozempic’s site. It also helps adults with type 2 diabetes and known heart disease lower their risk for cardiovascular events like stroke or heart attack.

The active compound in Ozempic, semaglutide, is a glucagon-like peptide-1 (GLP-1) receptor agonist. It works by activating GLP-1 receptors throughout the body and enhancing the effects of the naturally occurring hormone GLP-1.

“GLP-1 serves multiple key functions in the body,” explains Christopher McGowan, M.D., a gastroenterologist specializing in obesity medicine and endobariatrics, and founder of True You Weight Loss in North Carolina. “It boosts the release of insulin by the pancreas in response to food intake, which helps to control blood sugar. Likewise, it reduces the release of glucagon—a hormone that increases blood glucose—thereby also helping to control blood sugar.”

Ozempic is a once-weekly self-administered injection of semaglutide. It comes in 0.5 milligrams, 1 milligram or 2 milligram dosages.

Is Ozempic Insulin?

Ozempic is not insulin. It helps your pancreas produce more insulin when your blood sugar is high. “Unlike insulin, Ozempic rarely causes low blood sugar,” notes California-based Lydia Alexander, M.D, a board certified obesity medicine specialist and president-elect of the Obesity Medicine Association, the largest organization of clinicians dedicated to preventing, treating and reversing the disease of obesity.

How Does Ozempic for Weight Loss Work?

While Ozempic is not specifically labeled as a weight loss drug, studies sponsored by Novo Nordisk, the company that makes Ozempic, suggest people who take semaglutide—the active compound in Ozempic—may lose weight[1][2]. In fact, the FDA approved semaglutide for weight loss in 2021 under the brand name Wegovy. However, Wegovy provides a higher dose of semaglutide than Ozempic—2.4 milligrams of semaglutide in Wegovy compared with 0.5 milligrams, 1 milligram or 2 milligrams of semaglutide in Ozempic.

As a GLP-1 receptor agonist, semaglutide enhances the effects of the naturally occurring hormone GLP-1. Dr. McGowan explains that in addition to its effects on blood glucose and diabetes, GLP-1 also impacts weight via two key mechanisms:

  • Affects the hunger centers in the brain (specifically, in the hypothalamus), reducing hunger, appetite and cravings
  • Slows the rate of stomach emptying, effectively prolonging fullness and satiety after meals

“The net result is decreased hunger, prolonged fullness and ultimately weight loss,” adds Dr. McGowan.

In one large clinical trial sponsored by Novo Nordisk, 1,961 adults with excess weight or obesity who did not have diabetes were given 2.4 milligrams of semaglutide or a placebo once a week for 68 weeks, along with lifestyle intervention. Those who took semaglutide lost 14.9% of their body weight compared with 2.4% for those who took the placebo[1].

It’s important to note that the dose of semaglutide used in this study was higher than the dose provided by Ozempic. However, 2.4 milligrams is the dose of semaglutide in the FDA-approved weight loss drug Wegovy.

“Ozempic is FDA approved for the treatment of diabetes only. It is not a weight loss medication,” explains Dr. McGowan. “Its sister medication, Wegovy, is specifically approved for the treatment of weight,” he adds.

Even though Ozempic and Wegovy are essentially the same medication (just available in different doses), it should be noted that while Ozempic is typically covered by insurance, often, Wegovy is not.

High demand and subsequent inventory and supply chain strains have severely impacted the availability of Wegovy, notes Dr. McGowan. As a result, Wegovy has been repeatedly unavailable since its introduction and many people are turning to off-label use of Ozempic for weight loss. Dr. McGowan notes that this is interfering with the availability of Ozempic for those with diabetes.

While taking semaglutide may help you lose weight while you are on the drug, most people will regain much of that weight if they discontinue using it. “Studies show that stopping Ozempic completely will likely lead to regaining most of the weight lost within several months,” notes Rekha Kumar, M.D., head of Medical Affairs at evidence-based weight care program Found, and practicing endocrinologist at an academic medical center in New York City.

“GLP-1 medications [like Ozempic] are designed to be taken long-term,” explains Dr. McGowan. “They are chronic medications for the treatment of chronic conditions (both diabetes and obesity).”

Is Ozempic Safe?

“Ozempic is a safe medication with a variety of benefits,” notes Fatima Cody Stanford, M.D., an obesity medicine physician-scientist at Massachusetts General Hospital, associate professor of Medicine and Pediatrics at Harvard Medical School Unit and advisory board member at Sweetch. “Approximately 80% of patients with type 2 diabetes also have concurrent obesity. So, these patients garner dual benefit for the treatment of their diabetes and obesity.”

Ozempic has also been shown to reduce major adverse coronary events, including heart attacks and strokes, and offers a host of other benefits, adds Dr. Cody Stanford.

However, Ozempic isn’t safe for everyone. According to the company, people with the following conditions should avoid using Ozempic:

  • Pancreatitis
  • Type 1 diabetes
  • Under 18 years of age
  • Pregnant or breastfeeding
  • Diabetic retinopathy
  • Problems with the pancreas or kidneys
  • Family history of medullary thyroid carcinoma (MTC)
  • Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), an endocrine system condition

As with any prescription medication, it’s important to consult your doctor or other qualified health care provider on whether this medication is safe for you, and what dosage is appropriate.

Common Side Effects of Ozempic

“Overall, Ozempic is a very safe medication,” explains Dr. McGowan. “The most common side effects are gastrointestinal in nature: nausea, vomiting, diarrhea and constipation.” While the majority of people who take Ozempic will most likely experience these symptoms at some point during their treatment, they should subside over time, continues Dr. McGowan.

“Since Ozempic slows down gastric emptying, there may be a feeling of early satiety [fullness],” adds Dr. Alexander, who recommends individuals eat slowly to help improve these and other gastrointestinal side effects of Ozempic. “These side effects are usually short-term and improve a few days to a few weeks after starting Ozempic or changing the dose,” she adds.

Taking Ozempic may cause other less common, but more serious, side effects, according to the company. These include:

Should I Use Ozempic to Lose Weight?

Dr. McGowen advises people with type 2 diabetes, especially those with a lot of extra weight or obesity, to consult with their doctor to see if Ozempic may be a good fit for helping to control their blood sugar and lose weight. “For the primary treatment of obesity, Wegovy is likewise an excellent option for any patient who has struggled to lose weight through diet and exercise alone, has a BMI of 30 and above (or 27 and above with an obesity-related comorbidity) and is willing to use a once-weekly injection long-term,” he adds.

He notes, “the GLP-1 medications are far more effective for the treatment of weight than prior anti-obesity medications and should be considered first-line pharmacotherapy for the treatment of obesity.”

However, using Ozempic for short-term, cosmetic weight loss is not something Dr. McGowan recommends. “While this has received significant attention in the media, Ozempic and related GLP-1 medications are not designed to be used in this way, can lead to potential adverse events and ultimately the weight that is lost will be regained. Further, this off-label use of Ozempic is greatly impacting availability of the medication for those who need it most—individuals with type 2 diabetes (or in the case of Wegovy, individuals with obesity),” he explains.

Additionally, anyone with contraindications like a history of medullary thyroid cancer, multiple endocrine neoplasia or a history of pancreatitis should not use Ozempic, adds Dr. Cody Stanford.

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