- Glucagon-like peptide 1 (GLP-1) drugs like Ozempic, commonly known as semaglutide, could help obese patients lose weight, experts say.
- Ozempic is not FDA-approved for weight loss. Another brand, Wegovy, is also semaglutide.
- Experts agree that people who are not diabetic or obese should not use Wegovy or Ozempic for any reason, including losing a small amount of weight.
The glucagon-like peptide 1 (GLP-1) drug Ozempic won FDA approval in late 2017 for adults with type 2 diabetes. But lately, it's been making headlines for other reasons: purported weight-loss benefits and shortages.
“People are talking about them because celebrities and influencers are increasingly turning to off-label GLP-1 drugs, such as Ozempic, to help people who are not obese or diabetic lose weight,” said Dr. Rekha Kumar of the New . York City Endocrinologist and Head of Medical Affairs, Found Weight Loss Program.
For example, comedian Chelsea Handler recently revealed that her doctor prescribed Ozempic in case she wanted to lose 5 pounds when she appeared on a podcast call her papa.
But Kumar says stories like Handler's are problematic.
“The trend of medical spas, boutique weight loss practices and illegal telehealth businesses prescribing heavily to people who don’t meet their standards is not only irresponsible prescribing, but can interfere with getting medicines to those who need them most,” Kumar said.
Kumar and other experts separate fact from fiction by answering these frequently asked questions about Ozempic.
Ozempic is the brand name for a drug called semaglutide, explained Dr. Angela Fitch, FACP, FOMA, president of the Obesity Medicine Association and chief medical officer of knownwell, a weight-inclusive healthcare company .
Kumar noted that Ozempic is a weekly injectable drug for people with type 2 diabetes. It was originally FDA-approved in doses of 0.5 mg or 1 mg. In 2022, the FDA approved a higher dose of 2 mg.
“It lowers blood sugar by helping the pancreas make insulin,” Kumar said.
No.
“Ozempic is only approved for diabetes,” said Dr. Charlie Seltzer of Philadelphia, a board-certified physician in obesity and internal medicine.
But this is where some confusion comes from.
“The active ingredient semaglutide is approved for weight loss under the trade name Wegovy,” Seltzer said.
October 2022, Elon Musk tweets Wegovy helped him lose weight.
Ozempic and Wegovy are both brand names for semaglutide and injections. But they are not quite the same.
“Wegovy is FDA-approved for the treatment of overweight and obesity,” Kumar said. “Wegovy contains a higher dose of semaglutide, [2.4 mg], than Ozempic was developed specifically for the treatment of overweight and obesity. “
Kumar noted that studies surrounding semaglutide and weight loss have used Wegovy's dose, including a 2021 study showing that a once-weekly dose of 2.4 mg semaglutide combined with lifestyle changes reduced weight.
“[In the] The study showed that those who took the drug and made lifestyle changes lost an average of nearly 15 percent of their body weight, compared to 3 percent in the placebo group,” Kumar said.
So yes, semaglutide – at least at the higher 2.4 mg dose – may help with weight loss. Although it's not clear whether the difference in the 0.4 mg dose of Ozempic versus Wegovy matters, Seltzer noted that both work the same.
“Ozone causes … appetite suppression and increases the time it takes food to exit the stomach, leading to a longer feeling of fullness,” Seltzer said. “It doesn't do anything magical for metabolism.”
Despite what Handler's doctors reportedly said, the drugs aren't for people looking to lose a few pounds, Kumar noted.
“Normal weight patients without diabetes may lose weight if they take GLP-1, but the risks of the drug outweigh the benefits of losing weight just for the sake of being thin compared to treating the disease,” Kumar said. In studying GLP-1, we may see more side effects from this inappropriate use.”
Experts share that the answer to this question varies from person to person.
“Generally, it takes a few weeks for Ozempic weight loss to work,” says Kumar.
This is partly because people don't take all 2.4 mg of Wegovy at once. Instead, they start at a weekly dose of 0.25 mg and increase every four weeks to a maximum of 2.4 mg.
“Gradually increase the dose every four weeks to reduce the possibility of side effects,” Seltzer says. “Once an appetite-suppressing dose sufficient to cause a calorie deficit is reached, rapid weight loss occurs.”
Dosing instructions from your healthcare provider must be followed to reduce the risk of side effects.
Ozempic is generally considered safe in doses up to 2mg. For adults with type 2 diabetes, but experts say some people shouldn't take it.
“It should be avoided in many populations, including but not limited to people with a history of pancreatitis, people with medullary thyroid cancer or those at increased risk of medullary thyroid cancer,” Seltzer said.
Your doctor can help you decide if Ozempic is right for you. Also, some people may experience side effects. Common ones, according to Fitch, include:
- nausea
- constipate
- Dizziness
- loss of appetite
- diarrhea
“Once the drug is discontinued or loses its potency, the problems that got people stuck in the first place remain, and the weight returns immediately,” Seltzer said.
Fitch agrees,
“Whatever you do as a person to help you lose weight, you have to keep doing it or the weight will come back,” Fitch says. “That's how the human body is designed. It's built to protect its weight at all costs.”
Long-term care is essential.
“Because obesity is a chronic disease, you have to treat it long-term, in a coordinated and comprehensive way,” Fitch said. “Patients must work with their physicians for a holistic approach to metabolic health, weight management, and primary care.”
Kumar said semaglutide is safe for long-term use, and Fitch said continuing to take it may help a person maintain their weight loss.
“If it's helping you lose weight, you have to keep taking the medication you're on, just like you keep taking cholesterol medication once your cholesterol is down. If you stop it, your cholesterol will go back up,” Fitch says.
First, Fitch noted that any obesity treatment should be nonjudgmental and favor shared decision-making.
“Obesity is a lifelong chronic condition for most people and should be managed in a compassionate and holistic patient-centred manner, such as making shared decisions about taking medications or undergoing surgery that consider risks and benefits, ’ said Fitch.
Lifestyle modifications such as diet and exercise are often recommended as first-line treatment, but they don't work for everyone.
“Obesity is a complex disease with many factors,” Fitch said. “When lifestyle changes aren't enough … we add other treatments to help patients live longer, healthier lives with a higher quality of life.”
