Ozempic, a diabetes medication, has been getting a lot of attention lately because of its nearly magical ability to help some people lose significant amounts of weight.
Essentially, Ozempic makes you eat less, though the exact mechanism isn’t clear, explains Dr. Heather Martin, a family medicine physician based in Tennessee. The medication, however, keeps the stomach full for longer, which reduces appetite.
Ozempic also affects gut bacteria, which can help with weight loss, says Dr. Neil Paulvin, a board-certified doctor in family practice and regenerative medicine in private practice in New York City.
Trials of this class of medication have shown it can help users shed 10% to 15% of their total body weight.
What Is Ozempic?
Ozempic is a once-weekly injectable medication that was developed and FDA-approved to help people with Type 2 diabetes manage their blood sugar.
“That may sound a little scary, but the device makes it easy,” explains Martin, who is also medical director of the primary care program at K Health, a virtual primary care practice headquartered in New York City. “You just put the tiny needle against your skin and press a button, and it’s over in an instant with just a little pinch.”
More technically, ozempic is “semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist,” explains Dr. Andres Acosta, who is an assistant professor of medicine, a consultant in gastroenterology and hepatology and the director of the nutrition obesity research program at Mayo Clinic in Rochester, Minnesota.
Semaglutide and other GLP-1 medications mimic the function of a hormone called glucagon-like peptide 1. In response to the rise in blood sugar you experience after eating a meal, GLP-1 receptor agonists like Ozempic help the pancreas produce more insulin to keep blood sugar levels from spiking.
There are GLP-1 receptors in the brain that when stimulated result in a decrease in appetite. There are also GLP-1 receptors in the gut, which when stimulated delay gastric emptying. GLP-1 agonists stimulate these GLP-1 receptors.
Ozempic and drugs like it lead to weight loss in two main ways: decreased gut motility so you feel full longer and decreased appetite thus reducing food cravings.
There are other medications in this class of drugs, including Wegovy, which is the exact same compound, semaglutide, just at a higher dose. While Ozempic is approved for the treatment of Type 2 diabetes, Wegovy is specifically approved for the treatment of obesity.
Because these types of drugs have gotten so much attention for their weight loss results, there’s been an ongoing shortage of these medications, particularly of Wegovy.
[READ: Why Eating Fewer Calories Won’t Necessarily Help You Lose Weight.]
How Does Ozempic Work for Weight Loss?
Weight loss from semaglutide is due to an overall decrease in one’s intake of calories from food and drink. The less calories you consume, the more weight you lose. On average, those taking semaglutide lose between 10% to 15% of their total body weight.
Martin uses Ozempic herself: “I was the first K Health patient who started on Ozempic,” she recalls. “Since I started taking it, it’s hard for me to finish all the food on my plate, which is a new and welcome change for me.”
Martin says that “as a prescriber, I’ve seen patients’ health improve dramatically because of their weight loss.” Some have seen improvement in blood pressure, cholesterol and energy, along with other benefits. “Obesity is correlated to a lot of serious chronic diseases,” she adds, “and being able to treat and manage patients for these conditions in the primary care setting is important.”
In her own life, Martin says this new class of medications has been a game changer. “I have been overweight since medical school and have tried different diets and health programs, but even when I managed to lose weight, it always came back,” she explains. “My blood pressure and cholesterol were elevated, and I had sleep apnea, meaning my breathing would stop and start without notice while sleeping. It’s a potentially serious condition that can contribute to high blood pressure, fatigue and heart problems, among other negative health outcomes.”
But since she started taking semaglutide, Martin has lost 16% of her body weight and says she feels better than ever. “My BMI is no longer in the obese or overweight range. I’m eating a healthier amount and staying more active, and I have an easier time playing with my kids. I also have stopped having to use my sleep apnea mask, a huge, welcome change to my quality of life.”
Ozempic and other semaglutide medications work for many people, but your results may not be the same as someone else’s, notes Acosta, who is also the co-founder of Phenomix Sciences, a precision obesity biotechnology company based in Excelsior, Minnesota.
Nor will semaglutide help you lose weight forever. Weight loss from the medication generally plateaus around three to six months. In order to avoid weight regain, you must also follow a strict diet and lifestyle change. In addition, research shows that if you stop take semaglutide, it’s likely you will regain the weight you lost.
Therefore, Ozempic shouldn’t be viewed as a stand-alone solution to weight loss. It needs “to be part of a multidisciplinary lifestyle program that includes diet, exercise and physical activity,” says Acosta.
Martin adds that Ozempic is not for someone who wants to try to drop a couple pounds for their high school reunion. She says K Health, for example, has strict criteria for prescribing GLP-1 agonist medications to ensure they’re only going to patients who really need them. “Patients must have a BMI over 30, or a BMI over 27 with one associated condition like hypertension or Type 2 diabetes, and have been unable to lose and keep off weight with lifestyle changes alone (diet, exercise),” says Martin. “We also do a full intake, which includes blood tests, to ensure you’re a good fit.”
Semaglutide treatments can be used as an alternative to bariatric surgery for some patients who have obesity. The degree of weight loss achieved with surgery, however, is usually much greater and lasts longer than with medications.
[READ: How to Calculate Weight Loss Percentage.]
Is Ozempic Safe?
Paulvin says that even if you’re just going to be on it for a few months, it’s important to understand that there will be side effects when you start it.
Acosta notes that Ozempic has been approved by the FDA because this medication and others like it have been found to be safe during clinical studies. However, every medical intervention brings the potential for side effects.
Side effects of Ozempic
The most common side effects of semaglutide medications include:
— Nausea.
— Vomiting.
— Diarrhea.
— Constipation.
Starting at a lower dose and slowly increasing the dosage could help ward off some of these common side effects. “Sometimes we even decrease dosage if the side effects become unbearable,” Martin says.
Paulvin adds that people taking Ozempic should shift to eating “two or three smaller meals a day,” rather than fasting. Opting for lower-carb, higher-protein meals can also support healthy, sustainable weight loss with Ozempic. “Most people can use about two-thirds of the amount of food they normally would,” he says.
Less commonly, some patients who are taking other medications for diabetes may experience hypoglycemia, or very low blood sugar levels. If you have diabetes and start taking a semaglutide medication, be sure to check in with your doctor regularly to monitor your progress.
Some patients may see some muscle loss as part of their overall weight loss on Ozempic. To offset this, Paulvin instructs patients to consume adequate amounts of protein and to engage in weight-bearing exercise regularly to maintain as much muscle as possible.
For her part, Martin says she has not experienced any side effects from Ozempic. “I started at 0.25 milligrams for my first four weeks. I increased to 0.5 milligrams and was at that dosage for four weeks. I’m taking 1.0 milligrams and will probably stay on this dose for as long as I continue to lose weight.” She notes that the maximum dose of Ozempic is 2.0 milligrams.
So-called “Ozempic face,” or a loss of fat in the face that can lead to a gaunt appearance, sagging skin and more obvious wrinkles, is not officially listed as a side effect of the medication, but some users have reported looking older after taking Ozempic for a while. This is a natural consequence of losing fat, Paulvin says, because the body sheds fat from all over, not in just specific places. “People who are using it more for cosmetic reasons need to understand the pluses and minuses there,” he notes.
Who should not take Ozempic?
Ozempic isn’t safe for everyone. According to the company, people with the following conditions should avoid using Ozempic:
— History of pancreatitis.
— Type 1 diabetes.
— Under 18 years of age.
— Pregnant or breastfeeding.
— Diabetic retinopathy.
— Problems with the pancreas or kidneys.
— Personal or family history of medullary thyroid cancer.
— Multiple endocrine neoplasia 2, a rare endocrine system condition.
In animal studies involving Ozempic, the drugs can lower bone density or raise the risk of thyroid cancer.
[READ: Do Weight-Loss Pills Work?]
How to Get Ozempic
Several commercial weight loss companies are now offering programs that allow qualified candidates to receive weight loss medications like Wegovy, Ozempic and Mounjaro. WeightWatchers and Noom have for years promoted diet and exercise as the primary ways to lose weight, but both recently debuted plans to offer prescriptions for Wegovy and similar drugs.
WeightWatchers announced the change in March when it purchased Sequence, a telehealth company that offers prescriptions for obesity drugs.
Noom launched its own telemedicine platform in June, called Noom Med, which provides access to the drugs. With Noom Med, customers get bloodwork done before their first appointment, then a clinician evaluates their health and weight history. If the person is offered medication, they can message the clinician through an app to report side effects, and the doctor can adjust their dosage accordingly.
Ozempic Alternatives
In addition to Wegovy, Mounjaro and Ozempic, Saxenda (liraglutide) and Trulicity (dulaglutide) are other weight loss options that work similarly. If you don’t have diabetes or obesity, you’re probably not going to get insurance to cover your prescription for these drugs, however, which can cost over $1,000 a month. Enter the word of cheaper alternatives to Ozempic and other semaglutide-type medications.
Generic versions
The FDA warns people of the dangers of using “generic” Ozempic and Wegovy. There are no approved generic versions of these drugs. However, versions of the drug have been seen at compounding pharmacies, and the FDA has received reports of adverse events after patients used these “generic” versions of semaglutide.
Natural supplements
Many people are calling berberine “nature’s Ozempic.” Berberine, a naturally occurring compound that’s found in several types of plants, is commonly used in Chinese, East Asian and Ayurvedic medicine. In the U.S., it’s sold over the counter as an oral supplement. While studies indicate it may help manage blood sugar and lower cholesterol, there’s little evidence to support weight loss.
Some have promoted aloe vera as another natural alternative to Ozempic to support weight loss, but there’s no evidence to demonstrate that claim.
In all instances, you should discuss your options with your doctor.
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Update 09/05/23: This story was published at an earlier date and has been updated with new information.
