Losing Weight With Ozempic: Is It Safe and Does It Work?

You've probably seen commercials on the evening news—you know, the ones promoting “OOO-Ozempic!” to Pilot's catchy 1974 tune “Magic.” The ads highlight a diabetes drug that has recently received a lot of attention for its near-magical ability to help some people lose significant weight.

Essentially, Ozempic makes you eat less, but the exact mechanism isn't clear, explains Dr. Heather Martin, a Tennessee-based family medicine physician. However, this drug keeps the stomach on longer, which reduces appetite.

Ozempic also affects gut bacteria, which can help with weight loss, says Dr. Neil Paulvin, a board-certified physician in family practice and regenerative medicine in private practice in New York City.

Trials of the drug have shown that it can help users lose 10 to 15 percent of their total body weight, he added.

“Ozempic is semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist,” explained Dr. Andres Acosta, Assistant Professor of Medicine, Consultant Gastroenterology and Hepatology, and Nutritional Obesity Research Program director at the Mayo Clinic in Rochester, Minnesota.

Semaglutide and other GLP-1 drugs mimic the function of a hormone called glucagon-like peptide 1. In response to post-meal blood sugar spikes, GLP-1 receptor agonists help the body produce more insulin to keep those blood sugar spikes going.

Martin, who is also the medical director of the primary care program at K Health, a virtual primary care agency based in New York City, said the drug is a weekly injection that you administer. “It might sound scary, but this device makes it easy,” she explained. “You just put the thin needles in the skin, and you press a button, and it's just a pinch, and it's over instantly.”

Martin himself uses Ozempic. “I was the first K Health patient to start Ozempic,” she recalls. “Since I started taking it, I've had a hard time eating everything on my plate and this is a new and welcome change for me.”

There are other drugs in this class, including Wegovy, which is exactly the same as semaglutide, just at a higher dose. Ozempic is approved for the treatment of type 2 diabetes, while Wegovy is for obesity management.

Ozempic's lowering of blood sugar “has nothing to do with its effect on body weight, but its ability to help individuals lose weight makes it attractive to both nondiabetics and diabetics,” said Dr. Joe Barrera, an endocrinologist at Providence Mission Hospital in Orange County Explained, California. “Compared to Wegovy, it's easier and cheaper to get through insurance excess, (which) has resulted in a lot of off-label prescriptions for non-diabetic patients.”

In all cases, you should discuss your options with your doctor. Your doctor “can determine whether an alternative drug such as Ozempic or Wegovy is a more appropriate option,” Barrera added.

Ozempic and other semaglutide drugs work for many people, but your results may differ from others, notes Acosta, who is also co-founder of Phenomix Sciences, a precision obesity biotech based in Excelsior, Minnesota.

“Based on the years of work we've done at the Mayo Clinic and the studies we've done with each of these drugs, we know that not all patients respond to them,” he said. “Therefore, tools must be developed to identify the best responders to each obesity intervention.”

To that end, Acosta said, NIH is supporting ongoing work at the Mayo Clinic to develop real-world evidence on how to identify “best responders to obesity interventions.” We recently found that patients with abnormal postprandial satiety (also known as the ‘hungry gut phenotype') are the best responders. “

Figuring out how to identify the starved gut phenotype before prescribing the drug is the next frontier for their research, he added. “Phenomix Sciences, our Mayo Clinic spin-out company, is working on the first-of-its-kind hunger gut response test,” Acosta explained. “They've been able to develop a test that tells providers ‘yes,' the patient will respond, or ‘no,' the patient will not respond to a given intervention. This is a big step forward because for the first time, patients are being told what type of obesity they have and how it should be treated.”

“As a prescribing physician, I've seen dramatic improvements in my patients' health as a result of the weight loss,” says Martin. Some have seen improvements in blood pressure, cholesterol, and energy, among other benefits. “Obesity is associated with many serious chronic diseases,” she added, “and it is important to be able to treat and manage patients with these diseases in primary care settings.”

In her own life, Martin said, the new drug has been a game-changer. “I've been overweight since medical school and tried different diets and health plans, but even when I managed to lose weight, the weight kept coming back,” she explained. “My blood pressure and cholesterol are elevated, and I have sleep apnea, which means my breathing stops and starts suddenly while I'm sleeping. It's a potentially serious condition that can cause high blood pressure, fatigue and heart problems. problems, and other negative health consequences.”

Because of sleep apnea, “[I]wore a sleep apnea mask every night and was tired every day,” recalls Martin. Back and joint problems from carrying more weight than my 5'4″ frame can easily support. “

But since she started taking semaglutide, Martin has lost 16 percent of her body weight and says she feels better than ever. “My BMI is no longer in the obese or overweight range. I eat healthier, am more active, and play with the kids more easily. I also no longer need to use a sleep apnea mask, which is great for my It's a huge, welcome change in terms of quality of life.”

It is important to know about possible side effects before starting Ozempic or other semaglutide medicines. Even if you're only going to stick with it for a few months, it's important to understand that there are side effects when you start using it, says Paulwin.

Acosta noted that Ozempic has been approved by the FDA because the drug and other similar drugs have been found to be safe in clinical studies. However, every medical intervention has the potential for side effects, and Ozempic has some downsides. The most common side effects of the semaglutide drug include:

Starting with a lower dose and increasing it slowly may help avoid these common side effects. “Sometimes we even reduce the dose if the side effects become unbearable,” Martin said.
Instead of fasting, Paulvin added, people taking Ozempic should switch to eating “two or three small meals a day.” Choosing a low-carb, high-protein meal can also support healthy, sustainable weight loss with Ozempic. “Most people can use about two-thirds of their normal food intake,” he said.

Less commonly, hypoglycemia, or very low blood sugar levels, may occur in some patients who are taking other diabetes medications. If you have diabetes and start taking semaglutide medicine, it is important to check with your doctor regularly to monitor your progress.

Paulvin added that some patients may see some muscle loss as part of their overall weight loss with Ozempic. To counteract this, he instructs patients to eat adequate amounts of protein and do regular weight-bearing exercise to preserve as much muscle as possible.

Patients with a personal or family history of medullary thyroid cancer or a rare condition called multiple endocrine neoplasia 2 should not take these drugs, Acosta said. Those with a history of chronic pancreatitis should also ignore it, Paulvin added.

For her part, Martin said she has not experienced any side effects from Ozempic. “I started on 0.25 mg for my first four weeks. I stepped up to 0.5 mg and was on that dose for four weeks. I'm on 1.0 mg and I'll probably stay on that dose as long as I keep losing weight,” she notes The maximum dose of Ozempic is 2.0 mg.

The so-called “Ozempic face,” in which reduced facial fat leads to a gaunter appearance, sagging skin, and more pronounced wrinkles, isn't officially listed as a side effect of the drug, but some users report looking older after taking Ozempic for a while. Paulvin says this is a natural consequence of losing fat, as the body loses fat from all over the place, not just in specific places. “People who are using it more for cosmetic reasons need to understand the pros and cons,” he notes.

As Ozempic has drawn attention for its weight-loss benefits, demand for the drug has grown among more than 41% of obese Americans. This has led to persistent shortages of the drug, which means some people with type 2 diabetes are struggling to fill their prescriptions.

As of February 2023, Acosta said, “As far as I understand, the supply shortage has been resolved based on communications from Novo Nordisk.”

It may be a while before this improvement trickles down to your local pharmacy, though. “I've heard it will take at least two to three months” to resolve the shortage, Paulvin said. Even that, however, could be a rosy outlook. “Demand is rising and I don't think the shortage will ease anytime soon as summer approaches,” he added.

While another semaglutide drug, Wegovy, is approved to treat obesity, the FDA approved Ozempic specifically for patients with type 2 diabetes. However, weight loss is a secondary effect of the drug, so it is sometimes prescribed off-label to control obesity.

“Obesity is a chronic disease, like type 2 diabetes, and it should be treated as such,” Martin said. Because being overweight is linked to a range of chronic conditions, including type 2 diabetes, high blood pressure and kidney disease, “safe and sustainable weight management is an important part of long-term health,” she explains. “A new class of GLP-1 receptor agonists is a safe and effective approach.”

However, unless you have diabetes, you shouldn't plan to take Ozempic for the rest of your life, says Paulvin. Despite its effect on weight loss, Barrera also recommends reserving the drug for diabetics.

Ozempic should also not be considered a standalone solution. “It's worth mentioning that this drug, and others, need to be part of a multidisciplinary lifestyle program that includes diet, exercise, and physical activity,” Acosta noted. Pharmacological interventions like Ozempic are only a small piece of the puzzle, But they can be a powerful tool “to help counter metabolic adaptations induced by low-calorie diets.”

Ozempic isn't for anyone trying to lose a few pounds for a high school reunion, adds Martin. She said K Health has strict criteria for prescribing GLP-1 agonists to ensure they are only used for patients who really need them.

“Patients must have a BMI over 30, or a BMI over 27, have an associated medical condition, such as high blood pressure or type 2 diabetes, and be unable to lose and maintain weight through lifestyle changes (diet, exercise) alone,” Martin said. We also do a full intake, including blood tests, to make sure you are in good health. ”

Finally, Martin points out, “diet pills are not ‘cheat.'” Obesity is a chronic disease that is linked to many other chronic diseases that can be extremely harmful to your health. Fortunately for us, there are now medications that can help treat it. “