Ozempic for Weight Loss: Who Should Try It and Will It Work?

Ozempic® may be one of the most talked-about medications in recent history. Celebrities are touting it. Social media influencers are shouting its praises. And doctors are hailing it as a research-backed breakthrough medication that could make a big difference.

That’s because semaglutide, the generic name for Ozempic and Wegovy™, is highly effective in treating several chronic diseases.

The U.S. Centers for Disease Control and Prevention (CDC) estimates that 42% of Americans are living with obesity (defined as a body mass index, BMI, of 30 or higher). For them, Ozempic and the class of anti-obesity medications called GLP-1 medications, which includes tirzepatide (Mounjaro®, Zepbound®), are being hailed as a major triumph. And for good reason.

For people with a BMI lower than 30, the old standbys of diet and exercise are the best routes to maintaining a healthy body weight. But for people living with obesity or overweight, it may take more than simple lifestyle modifications and a bit more time to make real headway into weight loss.

Recent studies of the newest anti-obesity medications Wegovy, Mounjaro and Zepbound have shown benefits beyond diabetes and obesity, improving other chronic diseases, like heart disease, kidney disease, fatty liver and sleep apnea. So, they can not only help with someone’s weight loss journey, but they can also improve a person’s overall health and risk for chronic conditions.

When it comes to Ozempic, how does it work for weight loss, who should take it and what are the risks? Obesity medicine specialist W. Scott Butsch, MD, MSC, helps explain why Ozempic has become so popular for weight loss and why new anti-obesity medications are a major victory for people with obesity.

What is Ozempic?

Ozempic is a once-weekly injectable medication used to help manage blood sugar levels for those living with Type 2 diabetes. It’s commonly known by its generic name, semaglutide, and was approved for use as a diabetes medication in 2017.

Dr. Butsch explains that Ozempic is the same medication as Wegovy, which was approved by the U.S. Food and Drug Administration (FDA) in 2021 as an anti-obesity medication. With higher doses of semaglutide, Wegovy became the most effective obesity medication, producing 15% weight loss in a one-year randomized controlled trial.

Although prescribing Ozempic for weight loss is considered “off-label”, there isn’t a difference between the two brand-named medications other than the dose.

Using a medication “off-label” means it’s prescribed for a use other than its stated purpose. And it’s really common across the medical field. For example, you could be prescribed certain heart medications called beta-blockers for situational anxiety or your provider may prescribe anti-seizure medication to treat migraines. In the case of Ozempic, it makes total sense to use it to treat obesity, considering its sister medication, Wegovy, is approved for that use.

How it helps with weight loss

Ozempic is a medication you inject once a week in your thigh, abdomen or upper arm. It’s in a class of medications called “GLP-1 receptor agonists” or “GLP-1 medications” for short. These medications mimic a hormone released from the digestive tract called glucagon-like peptide (GLP-1), which helps lower blood sugar and promotes a feeling of fullness.

“We’ve used GLP-1 receptor agonists for nearly 20 years to manage diabetes and obesity,” Dr. Butsch says.

When you take Ozempic or other GLP-1 medications, your body makes more GLP-1, which naturally decreases your appetite and makes you feel fuller. But Ozempic isn’t simply a tool that suppresses appetite, Dr. Butsch clarifies. Ozempic, like other anti-obesity medications, not only changes how your body responds to weight loss, but also likely has effects beyond the weight loss benefits.

“Obesity isn’t a behavioral problem. It’s not managed by just eating less or exercising more,” he continues. “Obesity is a complex, metabolic disease. It’s a dysfunction of the normal pathways that regulate our body weight or, more specifically, our body fat. Taking anti-obesity medications or other GLP-1s, like Ozempic, may change your body’s reaction to food intake and weight loss.”

In other words, Ozempic and anti-obesity medications work not simply because they’re correcting a “bad” behavior by lowering your appetite and causing you to eat less. They can affect the signaling between your gut and your brain, ultimately changing how your body responds to food.

“These medications allow your body to seek a lower weight range, and this is not solely related to reducing your food intake,” Dr. Butsch says. “At the same time, GLP-1 medications may also lower your risk for a host of obesity-related diseases, like heart disease, chronic kidney disease, fatty liver disease and sleep apnea.”

Think of this common scenario: When we “diet” and increase our exercise, we tend to hit a weight-loss plateau, which is where our bodies actively fight against continued weight loss. This is totally normal and expected. It’s part of what’s called your weight set point.

Your weight set point is not a “point” or a number on a scale. It’s the weight level (or amount of body fat) your body wants to live at. It’s represented by a weight range your body thinks is good for you, even if your BMI says otherwise.

The defense of body weight (or body fat) in humans has evolved to fend off starvation. When we lose weight, our body fears we’re starving because we have decided to “diet.” So, it mounts a defense to keep weight on. It sends in “hunger hormones,” lowers “fullness hormones” and decreases your metabolism, all in an attempt to keep your weight stable. In short, your body will battle tooth and nail against weight loss.

So, rather than simply making you want to eat less, anti-obesity medications like Ozempic change the very functioning of your body in order to help you lose weight and keep it off. It’s that metabolic and biological change that makes these medications appropriate for treating the disease of obesity, rather than providing a quick-fix weight loss “solution” for people who want to slim down to fit into last year’s jeans.

Benefits of Ozempic

You may experience weight loss within the first week or two when starting Ozempic. In fact, research has proven that higher doses of Ozempic — 2.4 milligrams of semaglutide — are very effective for weight loss in people with obesity. In one landmark study, people with obesity who used the medication in combination with lifestyle interventions lost about 15% percent of their body weight in 68 weeks. They lost about 34 pounds on average. Research participants who didn’t take the medication lost about six pounds on average.

But weight loss isn’t the only benefit. When combined with a healthy nutritional plan and regular exercise, Ozempic and the newest GLP-1 medications can:

• Improve blood sugar levels.
• Improve cholesterol levels.
• Improve blood pressure.
• Reduce the risk of major cardiovascular issues like strokes and heart attacks.

Risks of Ozempic

As Ozempic slows down your digestion, you may experience side effects and gastrointestinal issues like:

• Nausea or vomiting.
• Diarrhea.
• Constipation.
• Bloating.
• Increased gas.
• Heartburn.

These side effects tend to go away on their own after a few days or weeks. Paying attention to your diet by decreasing fat and fiber intake for the first few days after the injection and eating smaller portions tend to help improve these symptoms. Other more serious side effects may include:

• Pancreatitis (inflammation of your pancreas).
• Low blood sugar.
• Vision changes like blurred vision or diabetes-related retinopathy.
• Allergic reactions.
• Fatigue or dizziness.
• Gallstones.
• Kidney issues.
• Thyroid tumors or cancer.

Who shouldn’t take Ozempic?

Ozempic isn’t safe for everyone. If any of the following apply to you, you should avoid taking Ozempic for weight loss:

• Pancreatitis or other pancreatic-related issues.
• Kidney disease or other kidney-related issues.
• Type 1 diabetes.
• Diabetes-related retinopathy.
• Are pregnant or breastfeeding (chestfeeding).
• Are under the age of 18.
• Personal or family history of Medullary thyroid cancer (MTC) or other thyroid issues.
• Personal or family history of multiple endocrine neoplasia (MEN) or other endocrine issues.

If you’re interested in taking Ozempic for weight loss and any of the above symptoms or conditions apply to you, talk to your healthcare provider about alternatives that may be appropriate.

Is Ozempic right for you?

Dr. Butsch says that all signs point to the use of an anti-obesity medication as a safe and effective treatment for people living with obesity, yet it’s not being used as often as you’d expect.

“Forty-two percent of people in the United States have the disease of obesity, but only 2% of them are being treated with anti-obesity medications,” he adds.

Compare that with people living with diabetes — researchers say 88% of people who have diabetes use medication to treat their condition.

What’s the difference?

Though anti-obesity medications have been proven effective, there are several reasons people haven’t been able to access them readily:

• It’s expensive. Most commonly, the limited access is related to the lack of insurance coverage. “If you don’t believe obesity is a disease, and you run an insurance company, why would you cover obesity medications?” Dr. Butsch ponders. That then leaves the patient to foot the bill, which can be up to more than $1,000 per month.
• Outdated thinking and stigmas about obesity abound. “Some providers haven’t yet come to understand that obesity is a disease that can (and often should) be treated medically,” Dr. Butsch states. “And many people living with obesity are also biased in their thinking, believing their obesity is their fault. So, they aren’t asking for medication as a treatment option.”

But these tides are turning (and quickly!) with the growing popularity of Ozempic and new GLP-1 medications, available coupon programs that can initially bring down the cost, and an increased willingness for healthcare providers to talk to patients about their obesity.

But Dr. Butsch cautions against obtaining a prescription online from a so-called “diet doctor,” nail salon or any medical clinic offering compounded versions of Ozempic or the newer GLP-1 medications like Wegovy, Mounjaro or Zepbound.

“Proper counseling about the lack of evidence, the unregulated and unclear information on ingredients, and the fact that the effectiveness and safety of these compounded versions of GLP-1 medications have never been formally tested is critically important,” he stresses.

“Understanding that these compounded versions are not the same and may act differently in the body than the FDA-approved semaglutide and tirzepatide and, thus, cause harm, should help people temper their excitement and, in some cases, desperation to get on these medications.”

“Obesity is a chronic disease,” Dr. Butsch continues. “Medications prescribed to treat obesity are used in the same way we treat diseases like high blood pressure or high cholesterol.”

If these newer medications aren’t available, or affordable, there are many other medications to choose from. Not everyone needs to take a GLP-1 medication to lose weight. That’s why it’s important to go to an obesity specialist with experience treating obesity.

“Medications are used in combination with lifestyle modification to increase long-term effectiveness,” he says. “One of the most common misconceptions is that people believe they could take a medication for a few months, then stop and maintain weight. However, you’re likely to regain the lost weight once the medication is stopped.”

Final thoughts

Like any other anti-obesity medication, Ozempic shouldn’t be used for short-term weight loss. In other words: Think of anti-obesity medication as a long-term commitment, not a quick fix for dropping a couple of pounds. You wouldn’t take insulin if you don’t have diabetes and shouldn’t take anti-obesity medication if you don’t have the disease of obesity.

“We finally have medications that are highly effective in treating obesity for the long term, and it’s a game-changer for those who really need it,” reaffirms Dr. Butsch.