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Lose some, win some
Reviewed by Craig Primack, MD, FACP, FAAP, FOMA
Written by Vanessa Gibbs
Ozempic® has taken TikTok by storm. It’s hailed as a miracle weight loss drug that helps you shed the pounds without even really trying.
Sound too good to be true? Well, it could be.
There’s lots of misinformation about Ozempic for weight loss on social media, and there are a few safety concerns you need to know about. But the drug can help you lose weight — if it’s a good fit for you.
Let’s dive right in. We’ll cover how Ozempic works, whether the drug is safe and the common side effects (beyond fitting into your favorite jeans again).
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Ozempic is a once-a-week injection FDA-approved for people with type 2 diabetes — not weight loss.
When used alongside diet and exercise interventions, Ozempic can help lower blood sugar levels in patients with type 2 diabetes. It can also reduce the risk of heart attack, stroke and death in patients with type 2 diabetes and heart disease.
Some healthcare providers are also prescribing Ozempic off-label as a weight loss medication.
Ozempic is one brand name for a drug called semaglutide. You can also get semaglutide in tablet form — the brand name for that is Rybelsus®, which is also approved for type 2 diabetes.
A higher-dose injection of semaglutide is available under the brand name Wegovy® — this one is FDA-approved for weight loss.
When used alongside diet and exercise, Wegovy is FDA-approved to help with weight management in:
Adults who have obesity
Adults who are overweight and also have at least one weight-related condition, such as high blood pressure, type 2 diabetes or high cholesterol
Children 12 and older who have obesity
Keep reading to learn how semaglutide works for weight loss.
Ozempic is a glucagon-like peptide 1 (GLP-1) receptor agonist. This mouthful of a medication is used to treat diabetes and obesity.
The several types of GLP-1 receptor agonists include:
Exenatide
Lixisenatide
Liraglutide
Albiglutide
Dulaglutide
Semaglutide (the active ingredient in Ozempic and its obesity-fighting cousin Wegovy)
But how does Ozempic work for weight loss exactly?
Quick science lesson: When you eat, your digestive tract releases the GLP-1 hormone. One of this hormone’s jobs is to prompt your body to make more insulin, which reduces your blood sugar levels.
High levels of GLP-1 can reduce your appetite and trigger feelings of fullness.
Where does Ozempic come into this? Well, Ozempic works by mimicking the GLP-1 hormone, lowering blood sugar and making you feel full.
The active ingredient in Ozempic, semaglutide, is linked to:
Less hunger
Fewer food cravings
Better control of eating
Lower preference for high-fat foods
All this can lead to you eating fewer calories and, therefore, losing weight.
There are studies to back this up.
A 2021 study looked at almost 2,000 adults without diabetes taking either a weekly semaglutide injection or a placebo for 68 weeks (over a year!). They also made some lifestyle changes, like improving their diet and getting regular physical activity.
After 68 weeks, the group taking semaglutide lost an average of almost 15 percent of their body weight. The group taking the placebo wasn’t quite as successful — they lost an average of 2.4 percent of their body weight.
Semaglutide wasn’t all good news for participants in the study, though.
Gastrointestinal disorders — like nausea, diarrhea, vomiting and constipation — were the most common side effects. This caused some people to stop taking the drug. And serious adverse events were reported in almost 10 percent of participants taking semaglutide.
One thing to note about this study is that participants received a 2.4-milligram (mg) dose of semaglutide. Ozempic is usually prescribed at a lower dose than this, starting at 0.25 milligrams and increasing to 0.5 to 1 milligrams a week for patients with diabetes.
Another thing to be aware of? The study was funded by Novo Nordisk, the manufacturer of Ozempic and Wegovy — so we should probably view these particular results with a healthy skepticism.
Other research has found similar results, though. One study, this time from 2022, compared a weekly semaglutide injection with a daily liraglutide injection — another GLP-1 receptor agonist. Besides taking the injections, participants made those all-important diet and exercise interventions.
Both groups lost weight, but participants taking semaglutide lost more weight than those taking liraglutide.
This is the question of the hour. We can’t say for sure whether Ozempic is safe for weight loss. More research needs to be done.
Here’s what we know so far.
Most clinical trials on Ozempic were done on people with type 2 diabetes. So it’s not clear what the risks could be for people without the condition who are just looking to lose weight.
There are also no long-term randomized controlled trials on Ozempic for weight loss. So if you’re taking it for the long run, the risks are unknown there, too.
Wegovy (that’s the higher-dose version of Ozempic) is approved for weight loss, but it’s still a relatively new drug. While FDA approval means they’re relatively confident in its safety, these newer drugs don’t have the decades of research to back them up as other weight loss medications like metformin.
As with any medication, Ozempic comes with risks.
One of those is the potential risk of thyroid C-cell tumors. In studies on mice and rats, semaglutide was shown to increase the incidence of thyroid C-cell tumors. It’s not clear whether semaglutide could have this effect in humans.
Liraglutide has been linked to cases of medullary thyroid carcinoma, a type of thyroid cancer. But more research is needed to draw a guilty verdict against this class of drug.
Ozempic isn’t safe for people with a personal or family history of medullary thyroid carcinoma or those with multiple endocrine neoplasia syndrome type 2 — another type of thyroid cancer.
Beyond cancer, there are other health risks you should know about.
In clinical trials, some participants developed pancreatitis while taking Ozempic. And in trials on people with type 2 diabetes and high cardiovascular risk, there were some cases of diabetic retinopathy (vision loss).
As for GLP-1 receptor agonists as a whole, there may be a risk of:
Acute kidney injury
Worsening of chronic renal failure
Hypersensitivity, such as swelling and anaphylaxis
Plus, it’s not clear whether Ozempic is safe for those who are pregnant or breastfeeding. Let your healthcare provider know if you’re pregnant, breastfeeding or planning to be soon.
There are a few drug interactions to know about.
You shouldn’t take Ozempic if you’re taking insulin or an insulin secretagogue drug, like sulfonylurea. This can up your odds of hypoglycemia (low blood sugar).
You also want to watch out for any oral medications you’re taking — that’s right, any oral medications.
Ozempic causes a delay in gastric emptying, which means food is kept in your stomach for longer. This delay may impact how oral medications are absorbed by your body.
Tell your healthcare provider about any oral medications you take (or may start taking) if you’re considering adding Ozempic to the mix.
Ozempic comes with health risks, but so does obesity.
Almost 42 percent of adults over 20 have obesity, and a whopping 73.6 percent are either overweight or have obesity.
Obesity can lead to a whole host of medical conditions, including heart disease, stroke, type 2 diabetes and cancer — to name just a few.
So while Ozempic isn’t approved for weight loss, it can be beneficial for those struggling to manage their weight. But it isn’t the only option. Hers offers access to clinically proven medications including metformin as part of a holistic weight loss program, no injections required.
Common Ozempic side effects include:
Nausea
Vomiting
Diarrhea
Stomach pain
Constipation
These side effects are reported in more than five percent of people taking Ozempic.
That’s not all, though. Other potential side effects of Ozempic include:
Low blood sugar
Redness or discomfort at the injection site
Increased amylase and lipase (enzymes that break down carbs and fats)
Gallstones
Increased heart rate
Fatigue
Changes in taste (foods could taste bad to you)
Dizziness
Ozempic weight loss may not be forever. Once you stop taking the drug, there’s a chance you’ll regain some (or all) of the weight you lost.
Research from 2022 looked at what happened when people stopped taking semaglutide after 68 weeks of treatment. One year later, study participants had regained an average of two-thirds of the weight they’d lost.
As it’s a relatively new drug, there are no long-term trials on Ozempic. So it’s unclear whether it’s safe to take the medication long-term to keep the weight off.
Plus, GLP-1 receptor agonist drugs like Ozempic are expensive – up to $1000 a month, and typically not covered by insurance, which can be enough to put some people off.
Ozempic is a diabetes drug, but it can be prescribed off-label for weight loss. Its higher-dose cousin, Wegovy, is FDA-approved as an anti-obesity medicine.
But does that mean the drug is right for you? Maybe, but not necessarily.
Here are the key facts:
Ozempic can help you lose weight. Semaglutide (the active ingredient in Ozempic) can help you feel less hungry and more full. When combined with diet and exercise changes, it can help you lose weight.
Ozempic comes with potential side effects. Nausea, vomiting and diarrhea — oh my! More serious adverse reactions include low blood sugar and gallstones. The cost of Ozempic (and similar drugs) is also a barrier for many.
More research needs to be done into safety. Ozempic is a relatively new drug, so we don’t have long-term studies or research on patients without diabetes who used it to lose weight.
The final verdict? Ozempic may help you lose weight, but speak to a healthcare provider to find out if it’s suitable for you or whether other weight loss methods might be a better fit.
We get that this might just be the beginning of your exploration into weight loss treatments. If you’re feeling “on the fence” about Ozempic, there are plenty of other safe and effective treatments for weight loss for you to explore.
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Dr. Craig Primack MD, FACP, FAAP, FOMA is a physician specializing in obesity medicine.
He completed his undergraduate studies at the University of Illinois and subsequently attended medical school at Loyola University — The Stritch School of Medicine.
He completed a combined residency in Internal Medicine and in Pediatrics at Banner University- Phoenix, and Phoenix Children's Hospital. He received post-residency training in Obesity Medicine and is one of about 7,000 physicians in the U.S. certified by the American Board of Obesity Medicine.
In 2006, Dr. Primack co-founded Scottdale Weight Loss Center in Scottsdale, Arizona, where he began practicing full-time obesity medicine. Scottsdale Weight Loss Center has grown since then to six obesity medicine clinicians in four locations around the greater Phoenix Metropolitan area.
From 2019–2021, he served as president of the Obesity Medicine Association (OMA), a society of over 5,000 clinicians dedicated to clinical obesity medicine. He has been on the OMA board since 2010, currently serving as ex-officio trustee.
Dr. Primack routinely does media interviews regarding weight loss and regularly speaks around the country educating medical professionals about weight loss and obesity care. He is co-author of the book, “Chasing Diets.”
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