Ozempic (semaglutide) is a prescription medication primarily used for adults with type 2 diabetes to help lower blood sugar levels (A1C). It belongs to a class of drugs called GLP-1 receptor agonists, which mimic the effects of a natural hormone in the body called glucagon-like peptide-1 (GLP-1). While Ozempic is not specifically FDA-approved for weight loss, it has been shown to aid in weight management and is sometimes prescribed off-label for this purpose. It's important to understand both the benefits and potential side effects associated with Ozempic, especially when considering it for weight loss.
How Ozempic Works
Ozempic is a GLP-1 agonist that mimics a natural hormone called GLP-1, which is released after eating to help regulate blood sugar and promote a feeling of fullness. Ozempic works through several mechanisms:
- Increased Insulin Production: It helps the pancreas produce more insulin when blood sugar levels are high. Insulin helps the body use sugar for energy, preventing it from building up in the bloodstream.
- Reduced Glucagon Secretion: It prevents the pancreas from releasing a hormone called glucagon, which prompts the liver to release glucose (sugar) into the bloodstream.
- Slowed Gastric Emptying: It slows down the rate at which food leaves the stomach and enters the intestines. This leads to a feeling of fullness for a longer period, which can help curb appetite.
- Reduced Sugar Production: It reduces the amount of sugar produced and released by the liver.
Ozempic and Weight Loss
Semaglutide, the active ingredient in Ozempic, was shown to be effective for weight loss in a clinical trial. Though Ozempic helped with weight loss and weight loss maintenance when used with diet and exercise in clinical trials, however, it is not FDA-approved for weight loss. Wegovy is the brand of semaglutide approved for weight loss.
GLP-1 drugs, including Ozempic, trick the brain and stomach into making you feel less hungry and fuller, faster. This can result in significant weight loss - for people with or without diabetes.
Common Side Effects of Ozempic
The most common side effects of Ozempic are gastrointestinal issues, which tend to be mild to moderate and often resolve within a few weeks. These include:
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- Nausea: This is the most common side effect, affecting about 1 in 5 people. It is often worse when starting the medication or increasing the dose.
- Diarrhea: Occurred in about 1 in 12 people in clinical trials.
- Constipation: Affected about 1 in 20 people.
- Stomach Pain: About 1 in 14 people experienced belly pain, which could include cramps, bloating, and gas.
- Vomiting: Almost 1 in 10 people threw up when taking Ozempic.
- Upset Stomach
- Loss of appetite
- Excessive Burping
- Heartburn
- Flatulence
- Gastroesophageal reflux disease
- Headache
- Fatigue
Tips to Manage Common Side Effects:
- Nausea: Take Ozempic with food, sip water throughout the day, eat frequent small meals, and ask your doctor about the best time of day to take the medication.
- Stomach Pain: Eat slowly, eat frequent small meals, choose bland foods, avoid greasy and fried foods, and drink clear liquids.
- Diarrhea: Stay away from sweet drinks, caffeinated drinks, alcohol, and full-fat dairy. Drink plenty of water.
- Constipation: Drink plenty of fluids, exercise regularly, add fiber to your diet, and consider an over-the-counter laxative.
- Ozempic Burps: Cut back on sulfur-rich foods like cruciferous vegetables, allium vegetables, dried fruits, red meat, fish, and eggs. Drink plenty of water and add probiotics to your diet.
Serious Side Effects of Ozempic
While less common, Ozempic can cause more serious side effects that require medical attention:
- Pancreatitis: Inflammation of the pancreas. Symptoms include severe stomach pain that spreads to the back, fever, nausea, and vomiting.
- Gallbladder Problems: Can include gallstones (cholelithiasis) or inflammation of the gallbladder (cholecystitis). Symptoms include severe stomach pain, nausea, vomiting, and fever.
- Kidney Injury: May result from dehydration due to nausea, vomiting, and diarrhea. Symptoms include decreased urination, swelling in the ankles, hands, or feet.
- Hypoglycemia: Low blood sugar, especially when used with insulin or other diabetes medications. Symptoms include dizziness, weakness, confusion, irritability, anxiety, excessive sweating, trembling, rapid heartbeat, and hunger.
- Vision Changes: Can affect the shape of the lens of the eye and lead to blurry vision.
- Bowel Obstruction: A rare but serious risk of slow movement of food through the digestive system.
- Thyroid Tumors: Ozempic has a boxed warning for the risk of thyroid C-cell tumors.
- Serious Hypersensitivity Reactions: May occur, including anaphylaxis and angioedema.
- Pulmonary Aspiration: During general anesthesia or deep sedation has been reported in patients receiving GLP-1 receptor agonists undergoing elective surgeries or procedures.
- Stomach Paralysis: Muscle contractions in the stomach become so weak that the stomach can’t digest food and push it forward into the intestines.
Ozempic Face and Body Changes
"Ozempic face" is a term used to describe the noticeable facial changes seen in some people who are prescribed this medicine. This refers to the cosmetic effects of the rapid weight loss produced by any of the GLP-1 medications. Losing fat from the face quickly can have a pronounced effect on appearance. The faster you lose weight, and the more you lose, the more likely you are to notice facial changes. People using GLP-1 drugs report seeing cosmetic changes to their faces, such as:
- Hollowed, sunken look, especially around the cheeks and eyes
- More visible lines and wrinkles
- Sagging, loose skin
- Thinning lips
Fast weight loss can cause skin to hang and sag in places that it didn’t before. It might make you look older, too. That’s what the terms “Ozempic face” and “Ozempic butt” describe. Similarly, weight loss on Ozempic can cause sagging “Ozempic breasts.”
Managing "Ozempic Face":
- Losing weight more gradually is the best way to prevent it.
- Using a lower dose of medication will slow weight loss, but it may cause fewer cosmetic side effects.
- Eating lots of protein to help prevent muscle loss
- Protecting your skin with daily sunscreen
- Staying well-hydrated
- Using skincare products (such as retinoids) that encourage production of collagen to reduce wrinkles and sagging
Precautions and Warnings
Before taking Ozempic, it's important to inform your healthcare provider if you have any of the following conditions:
- Eye disease caused by diabetes
- Gallbladder disease
- History of pancreatitis
- Kidney disease
- Personal or family history of MEN 2 (a condition that causes endocrine gland tumors)
- Personal or family history of thyroid cancer
- Stomach or intestine problems
- Allergic reaction to semaglutide or other medications
Other Important Considerations:
- 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.
- 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.
- Surgery: Tell your doctor that you take GLP-1 drugs if you are having surgery or a procedure that involves general anesthesia.
Ozempic and Eating Disorders
Ozempic is commonly prescribed for people with type 2 diabetes, and type 2 diabetes is associated with eating disorders, especially binge eating disorder (BED). In this case, while being prescribed Ozempic or Wegovy may help people lose weight, it won’t address the underlying factors that can lead to binge eating disorder in the first place. This medication may also perpetuate weight cycling since research has shown that stopping use tends to result in regaining the lost weight.
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The popularity of Ozempic can be triggering for those who have struggled with disordered eating or full-blown eating disorders. Media exposure, such as the trend and glorification of taking Ozempic as a weight loss drug, can increase the risk of disordered eating behaviors and symptoms.
Dosage and Administration
Ozempic is administered via injection under the skin of your upper leg (thigh), stomach area, or upper arm. It is given once every week (every 7 days). You will be taught how to prepare and give this medication. Use exactly as directed. Take your medication at regular intervals. Do not take it more often than directed.
The Ozempic injection pen contains multiple doses. 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.
Alternatives to Ozempic for Weight Loss
Other options available for the treatment of obesity. Previously, effective medical treatments for obesity were limited, with most medications offering modest weight loss. Ozempic and similar drugs now yield an average weight loss of 15 to 20 percent, significantly higher than previous options.
Wegovy and Zepbound can all lead to long-term weight loss, but only Wegovy and Zepbound are approved by the FDA for this use.
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