Ozempic for Weight Loss: How It Works and What You Need to Know

Ozempic is a brand name for semaglutide, a prescription medication primarily used to help individuals with type 2 diabetes manage their blood sugar levels. It functions by reducing glucose production in the liver and increasing insulin production in the pancreas. While Ozempic is Food and Drug Administration (FDA) approved for use by people with type 2 diabetes, it has gained popularity as a weight loss drug, mainly fueled by social media trends. This article aims to provide a comprehensive overview of Ozempic, its mechanisms, potential benefits, side effects, and appropriate use, especially concerning weight loss.

How Ozempic Works

Ozempic is administered as an under-the-skin injection in liquid form. It belongs to a class of drugs known as GLP-1 (glucagon-like peptide-1) receptor agonists. Ozempic stimulates the production of a hormone called GLP-1 that causes the body to produce more insulin. At the same time, GLP-1 limits glucose production in the liver. It also slows the digestive process, decreasing the risk of blood sugar spikes after a meal. By mimicking the naturally occurring GLP-1 hormone, Ozempic effectively lowers blood sugar levels in individuals with type 2 diabetes.

Ozempic for Diabetes Management

Ozempic has been shown clinically effective in managing glucose and is properly used by persons with type 2 diabetes to help regulate their blood sugar levels. These individuals would have been diagnosed by their healthcare provider, based on symptoms such as excessive thirst, frequent urination, and fatigue. The American Diabetes Association recommends that a reasonable goal for most adults with type 2 diabetes is an A1C less than 7%. Ozempic is also approved to lower the risk of a major cardiovascular event (like a heart attack or stroke) in patients with type 2 diabetes, as well as to reduce the risk of worsening kidney disease and heart-related death in patients with type 2 diabetes.

The Weight Loss Connection

Ozempic® may also help you lose weight. When using Ozempic to treat diabetes, weight loss is a common side effect. The active ingredient in Ozempic, semaglutide, does work for weight loss, according to research. Ozempic works by mimicking a naturally occurring hormone. As those hormone levels rise, the molecules go to your brain, telling it you're full. It also slows digestion by increasing the time it takes for food to leave the body. Its ability to promote weight loss has led to its off-label use as a weight management tool for individuals without diabetes.

Ozempic vs. Wegovy

It's important to distinguish between Ozempic and Wegovy. Both are made by the same company and contain the same active ingredient, semaglutide. However, Ozempic is approved by the Food and Drug Administration (FDA) for treating type 2 diabetes but not for weight loss. Wegovy, on the other hand, contains higher doses of semaglutide and is specifically designed and approved by the FDA in 2021 for chronic weight management. Taraneh Soleymani, director of Obesity Medicine at Penn State Health Medical Group, notes that both Wegovy and Ozempic are Semaglutide but at a different dose, with Wegovy being approved by the FDA for treatment of obesity.

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Considerations for Weight Loss

Despite its effectiveness, experts still recommend that people avoid using Ozempic unless they have type 2 diabetes. Ozempic is only intended and approved for people with type 2 diabetes. You should not take it solely for weight loss. Doing so may prevent patients who require the medication for blood sugar management from getting it. If you find it hard to achieve and maintain a healthy weight, talk with your doctor; there are medications approved for weight loss and weight management (such as Wegovy).

Potential Side Effects

Like other drugs, Ozempic can have a range of side effects, some common and relatively minor, others less common but potentially more serious. The most common Ozempic side effects with Ozempic include stomach problems, like nausea, vomiting, diarrhea, stomach pain and constipation. These tend to be mild-to-moderate and usually clear up in a few weeks in most people. Low blood sugar (hypoglycemia) is also a common side effect (when used with certain other diabetes treatments) and it can be serious.

The long-term side effects of using Ozempic are still under study. Taking Ozempic can also lead to low blood sugar in persons with type 2 diabetes. It is also possible to have an allergic reaction to Ozempic. Symptoms would include rapid heartbeat, disorientation, hives, labored breathing, and facial swelling. The most common long-term side effects of Ozempic are stomach-related, including nausea, vomiting, and associated symptoms. If you experience gastrointestinal issues like these for more than a few weeks, contact your physician. Long-term usage may also be implicated in more serious medical issues, including the development of pancreatitis, thyroid tumors, or gallstones. Ozempic has a boxed warning for the risk of thyroid C-cell tumors.

Other potential side effects include:

Severe gastrointestinal adverse reactions, including stomach paralysis. Postmarketing data have shown an association between semaglutide and ileus (stomach paralysis).
Acute pancreatitis has been observed in patients being treated with medicines like semaglutide.
Serious hypersensitivity reactions may occur, including anaphylaxis and angioedema.
Acute kidney injury due to volume depletion has been reported in postmarketing reports occurring in patients who experienced nausea, vomiting, or diarrhea, leading to dehydration.
Acute gallbladder disease may occur, including gallstones within the gallbladder (cholelithiasis) or inflammation of the gallbladder(cholecystitis).
Pulmonary aspiration during general anesthesia or deep sedation has been reported in patients receiving GLP-1 receptor agonists undergoing elective surgeries or procedures.

It is crucial to discuss these potential risks with your doctor before starting Ozempic.

What Happens When You Stop Taking Ozempic?

If you stop taking Ozempic, you will likely see a return to your previous health status. You should expect your appetite to increase, your glucose levels to rise, and to possibly gain weight. Weight loss drug trials have shown discontinuation of medication leads to weight regain. That’s because the brain pathways that regulate the weight are no longer treated by the medication.

Off-Label Use and Compounded Versions

Some doctors prescribe Ozempic for weight loss, though it isn’t approved by the FDA for that purpose. Some doctors may prescribe Ozempic for persons with prediabetes, especially if they have been diagnosed as obese (meaning a body-mass index of 30 or more).

The FDA is aware that some patients and health care professionals may look to unapproved versions of GLP-1 (glucagon-like peptide-1 (GLP-1) receptor agonists) drugs, including semaglutide and tirzepatide, as an option for weight loss. This can be risky for patients, as unapproved versions do not undergo FDA’s review for safety, effectiveness and quality before they are marketed. Improper storage during shipping may lead to quality issues Injectable GLP-1 drugs require refrigeration as indicated in their package inserts. FDA has received complaints that certain compounded GLP-1 drugs have arrived warm or with inadequate ice packs to keep the drug at recommended storage temperatures.

FDA is aware of one reported adverse event associated with a product labeled as compounded tirzepatide from a pharmacy that did not actually compound the product. The adverse event report included symptoms such as redness, site swelling, pain, and a red lump at the injection site. The agency encourages patients to be vigilant and know the source of their medicine. Carefully check labels of compounded GLP-1 drugs for warning signs such as spelling errors or incorrect addresses and ensure your medicine is provided by a licensed pharmacy and prescribed by a licensed health care provider.

Future of Obesity Treatment

“Semaglutide and Tirzepatide have been game changers in treatment of obesity. “Obesity is an epidemic. Seven out of 10 Americans are struggling with overweight or obesity. And this is not a disease that only affects Americans. It is a worldwide struggle,” Soleymani said. Looking down the road, there are more drugs in the later phase of clinical trials that mirror the results of bariatric surgery.

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Important Considerations

Consult Your Doctor: If you have type 2 diabetes, your doctor can help you decide if Ozempic is right for you. If you’re experiencing type 2 diabetes symptoms, such as increased thirst, frequent urination, fatigue, blurred vision, unintended weight loss, frequent infections, and slow-healing wounds and sores, contact your doctor.
Approved Alternatives: There are medications approved for weight loss and weight management (such as Wegovy).
Age Restrictions: You must be 18 years or older to take Ozempic.
Not a Diuretic: Ozempic is not a diuretic, so it won’t increase urination.
Drug Interactions: Tell your doctor about all your other prescription and over-the-counter medicines, especially insulin or other diabetes medicines, such as dulaglutide, exenatide, liraglutide, Byetta, Trulicity, Victoza, and others. There is an increased risk of hypoglycemia (low blood sugar) when Ozempic is used in combination with insulin or other diabetes medications such as glyburide, glipizide, glimepiride, or gliclazide. Other drugs, including prescription and over-the-counter medicines, vitamins, and herbal products, may affect this medicine.
Pregnancy and Breastfeeding: It is not known if Ozempic will harm an unborn baby. Talk to your healthcare provider before you become pregnant because it is recommended you stop using this medicine at least 2 months before you get pregnant. It is not known if Ozempic passes into your breast milk.
Storage: After your first use, store the pen with the needle removed in a refrigerator or at room temperature. Protect from heat and light. Keep the cap on when you are not using it. Do not reuse a needle. Place it in a puncture-proof "sharps" container and dispose of it following state or local laws. Store unopened injection pens in the original carton in a refrigerator, protected from light. Do not use past the expiration date.

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