Weight loss with medication can lead to a significant transformation. Social media is filled with before-and-after photos of individuals using Ozempic and other weight-loss drugs, showcasing their slimmer figures resulting from curbed appetites and reduced food intake. While Ozempic isn't specifically approved for weight loss, a well-known side effect has led some doctors to prescribe it off-label for this purpose.
Who is Eligible for Semaglutide?
Research published in 2024 in JAMA Cardiology indicates that a substantial portion of American adults are eligible for semaglutide. Specifically, the vast majority-129 million-qualify for weight loss treatment based on their Body Mass Index (BMI) and weight-related complications such as high blood pressure. According to NBC medical contributor Dr. Natalie Azar, "These numbers really are staggering," emphasizing the scale of potential use.
The Cost Factor
A 2024 survey revealed that many employers offer health insurance plans that cover weight-loss drugs like Wegovy. However, semaglutide can be expensive without insurance coverage, with a month’s supply costing approximately $900 for Ozempic and $1,300 for Wegovy. Novo Nordisk, the manufacturer of both drugs, acknowledges that many patients "find it hard to pay for their healthcare, including our FDA-approved products containing semaglutide," and states they "continue to work to obtain broader coverage and greater access." In an effort to address this, the Biden administration proposed a new rule in November 2024 that would require Medicare and Medicaid to cover weight-loss drugs for people with obesity.
The Importance of Long-Term Use and Potential Side Effects
Studies have demonstrated that continued use of semaglutide is necessary for sustained results; otherwise, much of the lost weight is regained. The medication also has potential side effects. Common side effects, as reported by Novo Nordisk, include nausea, diarrhea, vomiting, stomach pain, and constipation. The company also warns of more serious side effects such as pancreatitis, gallbladder problems, and kidney failure.
Real-Life Experiences with Ozempic and Wegovy
Pepper Schwartz: Improved Eating Habits
Pepper Schwartz, a sex and relationship expert, began using Ozempic off-label in 2022 after consulting with her doctor. She lost about 30 pounds, regained 5, and has since maintained her weight. Schwartz notes, "It has changed my eating habits, though, I think permanently… Smaller portions seem ordinary and portions I used to eat look overwhelming." She focuses on the health benefits of weight loss rather than simply fitting into a smaller dress size. The main effect of Ozempic for her is reduced hunger: "It makes food less important." Importantly, Schwartz reports no side effects and plans to continue the medication, hoping to lose a few more pounds.
Read also: Weight Loss with Adderall: What You Need to Know
Jamel Corona: The Need for Discipline
Jamel Corona started taking Wegovy in December 2021 and found it to be a helpful boost in her weight loss journey. Despite social media portrayals of effortless weight loss, Corona emphasizes that it still requires effort. She now injects the medication every two to three weeks instead of weekly. "I’ve gained about 10 pounds, which I’m totally OK with. No clothing size change or anything," Corona says. "I can go about three weeks without the medication before I start to notice my appetite increasing. It’s just been discipline. Knowing how much I should be eating." Doctors caution against skipping doses of GLP-1 weight-loss drugs like Wegovy because patients who discontinue the medication for a few weeks and then restart it are more likely to have side effects.
Jeannine DellaVecchia: Struggling with Side Effects
Jeannine DellaVecchia was prescribed Ozempic for symptoms related to insulin resistance from congenital adrenal hyperplasia and polycystic ovary syndrome. While weight loss wasn't her primary goal, she lost 30 pounds between August 2022 and February 2023. However, she discontinued the drug due to intolerable side effects. DellaVecchia reported "absolutely no appetite," being "completely nauseous," and "vomiting all the time." She says, “You don’t feel like eating… it just wasn’t good for me." DellaVecchia has maintained her weight loss through a keto diet.
Holly Figueroa O’Reilly: A Healthier Relationship with Food
Holly Figueroa O’Reilly, who once weighed 300 pounds, had tried numerous diets and bariatric surgeries without long-term success before losing 105 pounds with Ozempic. She began taking the medication in 2023 after her doctor raised concerns about her becoming prediabetic. Her A1C levels improved, and she reached her goal weight of 145 pounds. O’Reilly also incorporates weightlifting and a high-protein diet into her lifestyle. "(Ozempic) allowed me some space to develop a healthier relationship with food because I don’t ever remember a time when I wasn’t hungry all the time," O’Reilly says. She estimates she now eats a quarter of what she previously consumed and focuses on scheduling meals and ensuring adequate protein intake. While she initially experienced nausea and diarrhea, these side effects subsided after about four weeks.
Barbie Jackson-Williams: Combining Medication with Lifestyle Changes
Barbie Jackson-Williams, 55, has lost 180 pounds through a combination of Ozempic and exercise. Having once weighed over 400 pounds, she started Ozempic in early 2021 to manage her Type 2 diabetes and lose weight. Jackson-Williams has since made better food choices, lowered her blood sugar to prediabetic levels, and become more active. “People are just taking it just to get skinny and that’s not true,” she says. “You have to do the work, and people don’t realize that.”
Weight Loss Expectations and Dietary Considerations
How Much Weight Can You Lose?
Clinical studies provide some data on expected weight loss. One study showed that individuals receiving weekly semaglutide injections lost an average of approximately 15 pounds after three months and about 27 pounds after six months, equating to roughly 5 pounds per month. A 2024 peer-reviewed study funded by Novo Nordisk found that patients maintained an average weight loss of 10% of their body weight four years after starting semaglutide.
Read also: The Goli Gummies Weight Loss Myth
What Foods Should You Avoid?
To minimize nausea while taking semaglutide, registered dietitian Emily Rubin advises avoiding hot, fried, or greasy foods, as well as strong-smelling foods. Other foods to limit include high-roughage fruits and vegetables like pineapple, and gas-forming vegetables such as broccoli. Rubin also recommends avoiding eating too quickly and drinking large amounts of liquids with meals.
How Ozempic Kickstarts Weight Loss
Dr. Leigh Perreault, an endocrinologist at UCHealth, explains that semaglutide "works by making people not hungry." It mimics the GLP-1 hormone, which signals to the brain that the body has been fed. Dr. Louis Aronne notes that this leads to reduced appetite and feeling full sooner. The medication also slows down stomach emptying, which further contributes to the feeling of fullness and reduces calorie absorption. The FDA emphasizes that semaglutide for weight loss should be used in conjunction with a reduced-calorie diet and increased physical activity.
Expert Opinions and Cautions
While Ozempic can help people lose weight and reduce the risk of serious health conditions, experts recommend against using it without a diagnosis of type 2 diabetes. The FDA also cautions against using "generic" versions of Ozempic and Wegovy due to safety concerns.
A Personal Weight Loss Journey with Semaglutide
One individual shared their experience of using semaglutide for weight loss after struggling with weight gain due to hypothyroidism and hormonal changes. After reaching 200lbs, they sought a solution and were prescribed Ozempic by a physician assistant after being deemed a suitable candidate due to being overweight and pre-diabetic. Starting in February, they gradually increased their dosage and, within three months, lost 35lbs in conjunction with a healthy diet and exercise.
The individual emphasized that semaglutide is not a "miracle drug" but rather a tool that aids in slowing digestion, suppressing appetite, and reducing food cravings. They experienced side effects such as nausea, heartburn, and constipation, which were managed through diet adjustments and medication. After coming off semaglutide, they maintained their weight loss through continued healthy eating and exercise habits.
Read also: Guide to Keto Fiber
The Importance of Long-Term Lifestyle Changes
NBC News interviewed seven individuals who had been on Ozempic for between one and a half and two and a half years. They generally agreed that the medication was not a quick fix but rather a catalyst for lifestyle changes. Edward Matias, who lost weight while taking Ozempic for diabetes, emphasized that it "takes work and commitment." Many interviewees noted that Ozempic enabled them to exercise more and make healthier food choices.
Kimberly Tabor, who takes Ozempic for Type 2 diabetes, noted that the medication helped her control snacking and eat smaller portions. Serafina Raskin shared that Ozempic made it easier to manage her weight compared to previous diets, allowing her to eat with more flexibility while still receiving signals from her brain when she had eaten enough.
Challenges to Long-Term Weight Loss
Ozempic and Wegovy are considered long-term treatments, but their effects diminish after discontinuation, often leading to weight regain. Dr. Grunvald noted that many patients mistakenly believe they can stop taking the medication after reaching their goal weight or assume it is no longer effective when their weight plateaus. He emphasized that the medication is still working if it prevents weight regain.
Long-term use can also be challenged by high costs and supply shortages. Wendy Tell, a retired teacher, expressed concern about affording Ozempic due to coverage limits in her Medicare plan.
Jelly Roll's Perspective on Natural Weight Loss
Singer Jelly Roll lost 140 pounds naturally through healthier food choices and exercise. While he supports the use of weight loss injectables like Ozempic, he chose not to use them due to concerns about acid reflux, a potential side effect that could affect his vocal cords. Jelly Roll emphasized that his decision was not out of stubbornness but rather a personal choice based on his specific needs and concerns. He hopes to lose another 100 pounds in 2025 and is doing so publicly to be honest about his struggles and inspire others.