Ozempic, known generically as semaglutide, has gained recognition as a medication initially developed for type 2 diabetes but has quickly become popular as one of the most effective medications for medical weight loss. Many individuals considering Ozempic for weight loss are keen to understand the potential timeline and amount of weight they can expect to lose, particularly within the first few months of treatment. Weight loss with Ozempic can be transformative, especially when combined with expert care and sustainable lifestyle changes.
What is Ozempic?
Ozempic is the brand name of a medication known as semaglutide, approved by the FDA in 2017 to treat type 2 diabetes in adults. While Ozempic has gone viral on social media for its weight loss side effects, weight loss is an off-label use of Ozempic, meaning it is not an indication approved by the FDA. It is administered via a once-weekly injection.
How Ozempic Works for Weight Loss
Semaglutide, the active component of Ozempic, suppresses and regulates appetite by imitating a natural hormone, enabling patients to lose weight. Semaglutide functions similarly to glucagon-like peptide-1 (GLP-1), a naturally occurring hormone that is essential for controlling hunger and food consumption. The medication also slows down stomach emptying, which slows down the absorption of calories and may contribute to the feeling of fullness, Semaglutide also influences the part of the brain which allows us to feel hunger and satiety. As a result, patients eat less because they don’t feel as hungry and remain fuller longer.
Factors Influencing Weight Loss on Ozempic
Weight loss results vary based on several factors:
Starting Weight: Individuals with a higher initial body weight may see more significant initial weight loss.
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Dosage: Ozempic treatment typically begins with a low dose, gradually increasing over several weeks to reach a maintenance dose. Weight loss may be more pronounced at higher maintenance doses. Higher maintenance doses of Ozempic have been associated with more significant weight loss than lower doses. The maximum Ozempic dosage is 2 mg per week, according to the drug label.
Lifestyle Modifications: Combining Ozempic with a healthy, calorie-controlled diet and regular physical activity can significantly enhance weight loss outcomes. Semaglutide for weight loss should be used in addition to a reduced calorie diet and increased physical activity, the FDA says.
Individual Metabolism and Response: People respond differently to medications based on their unique physiology and other health conditions.
Other prescription drugs: Trying to drop excess pounds while taking medication with a side effect of weight gain can be an uphill climb.
Average Weight Loss Timeline on Ozempic
Initial Phase (First Month)
According to data from randomized controlled trials, Ozempic supports weight loss of around 1kg or around 1.1% of body weight after one month. Interestingly, this initial weight loss is no different to other weight loss treatments or the impact of diet interventions on weight loss. Weight loss may not be immediate as the medication dosage gradually increases.
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Three-Month Period
Another study analyzing weight loss outcomes in individuals with overweight or obesity treated with semaglutide (the active ingredient in Ozempic) showed an average three-month weight loss of around 5.9% of body weight. In one clinical trial that studied 175 patients, the average weight loss was about 15 pounds in three months. While individual results can vary, clinical studies show that patients may lose an average of 5-6% of their body weight-or approximately 10 to 15 pounds-within the first three months of Ozempic treatment. A study found people who received weekly semaglutide injections lost an average of about 15 pounds after three months, which translates into about a 5-pound weight loss per month.
Long-Term Weight Loss
Research suggests that Ozempic supports average weight loss of around 6kg after 40 weeks. Four years after starting semaglutide, patients maintained an average weight loss of 10% of their body weight, a peer-reviewed 2024 study funded by Novo Nordisk found. In studies published by Novo Nordisk, the manufacturer of Ozempic, people who took the 2-milligram (mg) dose experienced an average of 14 pounds lost over 10 months of treatment. The mean weight reduction in the STEP 5 experiment, which used a maximum dose of 2.4 mg, was between 14 and 16 percent by week 52. The weight was maintained for the duration of the two-year research. Results showed a 14.9% and 16% decrease in body weight after 68 weeks, respectively, are comparable to this.
Ozempic vs. Wegovy
Ozempic and Wegovy are two brand names for the same medication - semaglutide. When Ozempic’s weight-loss benefits became apparent, the pharmaceutical company developed Wegovy to specifically target weight management. The FDA approved the new drug in 2021 for use in adults and children aged 12 and up. The only difference is that Wegovy is a higher dose. Wegovy is for those with a body mass index (BMI) of 30 (obese) or 27 (overweight) with one or more weight-related conditions, for example high blood pressure. While Wegovy also starts at a low dose of 0.25 mg once weekly, it has a higher maximum dose of 2.4mg per week and follows a more gradual dose escalation over several months. Participants in one study using Wegovy experienced an average weight loss of about 15-18% of their initial body weight over 68 weeks. By comparison, participants taking Ozempic lost about 6-10% of their body weight, according to the study.
Ozempic Dosing
Ozempic dosing starts at 0.25 mg weekly to allow your body to adjust. After four weeks, the dose typically increases to 0.5 mg. Doctors typically prescribe Ozempic at a low dose of 0.25 milligrams (mg) for four weeks to help the body adjust. After that, they may increase the dose by 0.5mg per week.
Practical Guidance for Ozempic Use
The instructions for taking Ozempic are the same whether you have been prescribed this medication for Type 2 diabetes or weight loss. Ozempic comes as a prefilled weekly injection pen, not a pill, regardless of intended use.
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- Always check that the medication in your pen is clear and colorless.
- Inject Ozempic on the same day every week.
- Inject Ozempic under the skin in an area with some fat-your stomach region, upper thigh, or upper arm. Do not inject it into a muscle or vein.
- Always dispose of the needle in a sharps container, and cap the pen with the pen cap (but not the inner needle cap) before storing your Ozempic.
- Prioritize regular physical activity. Cardio and weight-bearing exercise three to five days a week are the most successful.
- Focus on healthy eating habits. Patients who eat keto or Mediterranean-style diets are the most successful at weight management.
- Manage stress. Chronic high stress can contribute to high blood pressure, insulin resistance, and weight gain.
What to Do If You Don't Lose Weight in the First 3 Months
It’s important to discuss your progress with your healthcare provider. They can assess your dosage, adherence to the treatment plan, and other factors that may be influencing your weight loss.
Potential Side Effects
The most common include nausea, diarrhea, vomiting, stomach pain, and constipation, according to Novo Nordisk, the company that makes both Ozempic and Wegovy. The most common for both are nausea, vomiting, diarrhea, constipation and abdominal pain. Many times in patients who are on multiple medications for diabetes, once they start a GLP-1 agonist, their physician may lower the dose of some of their other medications to help avoid the side effects of low blood sugar.
Here are some other potential side effects of Ozempic:
- Injection site reactions: Reactions like itching, redness, swelling or a small lump at the injection site may occur. Rotate injection sites and ensure proper injection technique. Consult a healthcare provider if irritation persists or worsens.
- Pancreatitis: Defined as inflammation of the pancreas, this side effect is rare but serious.
- Kidney Problems: Some have reported kidney-related issues due to severe dehydration resulting from prolonged vomiting or diarrhea. Symptoms of kidney problems may include reduced urine output; swelling in the legs, ankles, or feet; fatigue and shortness of breath. Stay well-hydrated and contact a healthcare provider if issues persist.
- Hypoglycemia: Defined as low blood sugar, the risk may increase when these drugs are used in combination with other diabetes medications like insulin or sulfonylureas. Patients should monitor their blood sugar levels regularly, especially when starting or adjusting doses of GLP-1 drugs. Carrying glucose tablets or a fast-acting carbohydrate source can help quickly manage symptoms if hypoglycemia occurs.
- Allergic Reactions: Although rare, all medications carry some risk of an allergic reaction, which could include rash or hives, itching, swelling of the face, lips, or throat, or difficulty breathing. If signs of an allergic reaction develop, stop the medication and seek immediate medical attention.
- Hair Loss: This phenomenon is common after rapid weight loss, which can put the body under stress and lead to a condition known as telogen effluvium. This condition causes more hairs to enter the resting phase of the hair cycle, leading to increased shedding. Ensure adequate nutrition, particularly protein and essential vitamins like biotin.
To reduce nausea while on semaglutide, registered dietitian Emily Rubin recommends skipping hot, fried or greasy food; and avoiding eating or cooking strong-smelling food. Other foods to avoid on Ozempic include fruits and vegetables that contain significant roughage such as pineapple, and gas-forming vegetables like broccoli. Don’t eat too quickly and don’t have a large drink with meals.
Ozempic face and Ozempic butt
This describes the appearance of facial aging or gauntness that some users experience after significant weight loss on GLP-1 drugs. This is not a medical term and can occur with any weight-loss method. Gradual weight loss and maintaining a healthy diet can help minimize the effects. Strength training exercises focusing on the gluteal muscles can help maintain muscle mass and improve the shape of the buttocks.
Potential Drawbacks
People have to keep taking semaglutide for the drug to keep working - otherwise, they’ll regain much of the weight, studies have shown. You can gain weight after stopping Ozempic, particularly if you do not maintain sustainable habits. According to the European Association for the Study of Obesity, abruptly discontinuing Ozempic could result in an intense, hard-to-avoid desire for food. The effects last only as long as you’re taking them. Trial participants regained two-thirds of the weight they had lost one year after stopping Wegovy. The sudden weight loss, then weight gain also wreaks havoc on your metabolism.
Cost
Semaglutide is expensive when not covered by insurance: The list price for a month’s supply is about $900 for Ozempic and $1,300 for Wegovy. There are some of these compounding pharmacies that do a generic version of it for a lot less money.