WHAT IS OZEMPIC (SEMAGLUTIDE)? AND CAN IT HELP YOU LOSE WEIGHT?

Originally Authored by Dr. Mersad Alimoradi - March 14, 2023

Medically Reviewed and Updated by Dr. Sony Sherpa (MBBS) - September 24, 2024

Ozempic (semaglutide) is an antidiabetic medication that regulates blood glucose levels. When paired with a low-calorie diet and increased physical exercise, it can also assist overweight and obese people who do not have diabetes to lose considerable weight and keep it off.

Many weight-loss drugs were originally developed to treat a medical condition, such as diabetes or opioid dependence. Doctors later discovered that these medications also have weight reduction abilities. Ozempic is one of those drugs that can help reduce weight.

Keep reading to learn more about Ozempic, how it works, who can use it, and how it can help with weight loss.

What Is Ozempic?

Ozempic (active substance: semaglutide) is a diabetes medication manufactured by the pharmaceutical company Novo Nordisk.

The FDA approved the use of Ozempic (semaglutide) in 2017 to regulate blood sugar levels in persons with type 2 diabetes mellitus along with diet and exercise (DM).

Ozempic is available as a liquid in a prefilled pen. It is injected once weekly under the skin of the abdomen, thigh, or upper arm.

Although it was originally developed as a drug for diabetes, several clinical trials showed that Ozempic (semaglutide), in addition to diet and exercise, can help overweight and obese people lose significant weight.

How Does Ozempic Work?

Ozempic belongs to a class of medications used to treat type 2 diabetes called glucagon-like peptide-1 (GLP-1) agonists.

When you consume food, your body naturally produces an intestinal hormone called glucagon-like peptide 1 (GLP-1). When GLP-1 binds to its receptors in the pancreas, it stimulates the secretion of insulin, another hormone that lowers blood sugar levels.

Semaglutide, the active substance in Ozempic, is a GLP-1 agonist – it mimics GLP-1 and can bind to GLP-1 receptors and trigger insulin secretion from the pancreas.

This is how Ozempic injections can help persons with type 2 diabetes lower their HbA1c (hemoglobin A1c), a marker of blood sugar control.

Can You Use Ozempic For Weight Loss?

The short answer is yes.

The glucagon-like peptide (GLP-1) not only regulates blood glucose levels but also regulates your appetite. That is why it is known as a “natural fullness hormone.”

GLP-1 signals your brain that you are full and no longer hungry after a meal.

This is how Ozempic (semaglutide) can help with weight reduction. Since semaglutide mimics GLP-1, it suppresses your appetite, increases your feeling of fullness, and reduces cravings even if you have not eaten much.

That makes it easier to commit to a healthy diet without feeling hungry. You will eat fewer calories and still feel full, which will help you lose weight along with exercising.

Doctors may prescribe weight-loss medications, like Ozempic, to help patients lose weight before surgery.

But is Ozempic (semaglutide) suitable for everyone?

The use of medications to help lose weight is suitable for adults based on their body mass index (BMI) and whether they have weight-related medical conditions.

Your doctor may prescribe Ozempic to help you reduce your weight if you meet the following criteria:

• You are clinically obese and have a BMI of 30 or more
• Your BMI is greater than 27 (significantly overweight), and you have a medical problem related to obesity, such as diabetes, high blood pressure, or high cholesterol.

In general, you should avoid taking Ozempic if you are trying to get pregnant, are pregnant, or are breastfeeding.

Moreover, do not take Ozempic if:

• You or anyone in your family has or ever had (MTC) medullary thyroid cancer
• You have multiple endocrine neoplasia type 2 syndrome (a rare endocrine condition that increases your risk of thyroid cancer)
• You are allergic to any of the ingredients of Ozempic (semaglutide)

Avoid taking weight-loss pills or drugs before consulting your doctor or healthcare provider. Misuse of weight-loss meds can have dangerous consequences.

Despite their potential benefits, medications that help you lose weight may have possible side effects and contraindications.

The Possible Side Effects Of Ozempic

The potential side effects associated with Ozempic can be categorized into common and mild effects, serious side effects, and rare side effects.

Common and Mild Side Effects

Many people taking Ozempic may encounter mild to moderate side effects, including:

Gastro-intestinal Issues

• Nausea: This is a common reaction, particularly when starting the medication, but it often decreases as the body adjusts.
• Vomiting: Some users experience vomiting, which is usually temporary and may subside with continued use.
• Digestive Issues: Problems such as diarrhea or constipation are frequently reported and generally resolve over time.
• Abdominal Discomfort: Pain or discomfort in the abdomen can occur but typically diminishes as treatment progresses.
• Acid Reflux: Occasional acid reflux may occur and can often be managed with dietary adjustments.
• Ozempic Breath: Characterized by a unique, unpleasant odor, often described as a fishy or metallic smell.

Other Issues

• Headaches: Mild headaches are another common side effect, usually manageable with over-the-counter remedies.
• Fatigue: Feelings of tiredness or fatigue may be experienced, especially in the initial stages of treatment.

Serious Side Effects

In addition to mild effects, some serious side effects may arise, including:

• Visual Disturbances: Changes in vision should be reported to a healthcare provider to rule out underlying issues.
• Kidney Function Issues: Monitoring for signs of kidney problems is recommended, as these may develop during treatment.
• Gallbladder Concerns: Symptoms such as pain in the upper right side of the abdomen might indicate gallbladder disease.
• Severe Allergic Reactions: Symptoms such as severe rashes, itching, or difficulty breathing require immediate medical attention.
• Low Blood Sugar: Hypoglycemia can occur, particularly when Ozempic is used in conjunction with other medications that lower blood sugar levels.
• Intestinal Blockage: Intestinal blockage is another potential side effect with serious consequences. This condition can cause severe abdominal pain, vomiting, and an inability to pass stool or gas. You should seek immediate medical attention if you experience these symptoms while using Ozempic.

Rare Side Effects

Some less common but notable side effects include:

• Hair Loss: Although not commonly associated with Ozempic, some users report experiencing hair loss.
• Bone Density Reduction: There may be an impact on bone density with long-term use, warranting periodic monitoring.

Other Possible Effects

Beyond the more common and serious side effects, there are several other effects under investigation:

• Appearance Changes: Users may notice changes in body areas such as the face, buttocks, or breasts due to significant weight loss with terms such as 'Ozempic Face', 'Ozempic Butt', and 'Ozempic Breasts' frequently referenced by consumers on social media and patient forums. These effects can include sagging or changes in skin texture and volume. Such changes are often related to rapid weight loss and reduced skin elasticity, particularly in older adults. Maintaining a high-protein diet may help mitigate these effects, while cosmetic treatments such as fillers or surgery might be considered in some cases.
  • What is ‘Ozempic Face’?
    • The term 'Ozempic Face' refers to the facial sagging or hollowing that can occur as a result of rapid weight loss while using Ozempic. When fat is lost from the face, the skin may lose volume and elasticity, leading to a gaunt or aged appearance.
  • How to avoid 'Ozempic Face'
    • To minimize the appearance of 'Ozempic Face,' consider maintaining a balanced, high-protein diet to support skin health and elasticity. Regular hydration and skincare can also help. For more pronounced changes, cosmetic interventions such as dermal fillers or non-surgical skin tightening procedures may be options to restore facial volume and improve skin texture.
• Pregnancy and Fertility: There have been isolated reports of unexpected pregnancies in women using Ozempic. The exact relationship between the medication and fertility or pregnancy outcomes is not fully understood, necessitating further research to determine any potential connections.
• Surgical Complications: Ozempic use may elevate the risk of complications during surgical procedures, particularly due to its impact on gastric emptying. The medication slows down the digestive process, which can elevate the risk of regurgitation and aspiration during anesthesia. These complications are of particular concern during elective surgeries, as they can interfere with both anesthesia administration and recovery. It is generally recommended that people taking Ozempic discuss their medication regimen with their surgeon prior to any elective surgery.
• ‘Ozempic Personality’ and Behavioral Changes: Some users of Ozempic report experiencing changes in mood and behavior, which can influence their relationship with food and social interactions. These changes may include alterations in appetite, mood swings, or shifts in social engagement. Research into these behavioral effects is ongoing, and it is important for people experiencing significant changes to communicate with their healthcare providers.
• Appendicitis: Although rare, there have been a few cases where appendicitis has been associated with Ozempic use. Appendicitis, an inflammation of the appendix, is an uncommon side effect but should be monitored, especially if symptoms such as abdominal pain, fever, or nausea occur.
• Weight Rebound: After discontinuing Ozempic, some people may experience weight regain. This weight rebound can occur as the body's metabolism adjusts to the cessation of the medication.
• Thyroid Cancer Link: The potential association between Ozempic and thyroid cancer is an area of active research. While preliminary studies suggest a possible link, definitive conclusions have yet to be reached. Ongoing research aims to clarify this potential risk and determine its clinical significance.
• Additional Benefits: Beyond weight loss, Ozempic may offer other health benefits, such as improvements in cardiovascular health, which is particularly significant for people with type 2 diabetes. Emerging research also suggests that medications like Ozempic may have potential benefits for conditions such as Alzheimer's disease, although more studies are needed to confirm these effects.

When to Seek Medical Advice

If you experience severe or unusual symptoms while using Ozempic, it is important to consult a healthcare professional. Promptly addressing symptoms like significant abdominal pain, vision changes, severe allergic reactions, or notable mood changes is crucial. For less severe issues, discussing them with a healthcare provider can help determine appropriate steps or adjustments in treatment.

Is Weight Loss By Ozempic Backed By Science?

The FDA approved Ozempic for the treatment of diabetes based on evidence from seven clinical trials of 4087 patients with type 2 diabetes mellitus (DM).

Since then, clinical trials have shown that Ozempic (semaglutide) helps people lose weight.

A large double-blind trial investigated whether semaglutide can help adults with obesity or those who are significantly overweight lose weight.

The study included 1961 participants with a body-mass index ≥30 or ≥27 in people with ≥1 weight-related coexisting health concern. None of the participants had diabetes.

Half of the participants randomly received once-weekly semaglutide injections (at a dose of 2.4 mg) with lifestyle intervention for 68 weeks. The other half received a placebo instead, also with lifestyle intervention, for 68 weeks. 

On average, people who took semaglutide lost 14.9% of their weight. Weight reduction was 12.4% higher in participants who took semaglutide injections versus those who took the placebo.

• 86.4% of patients lost at least 5% of their body weight
• 69.1% lost at least 10%
• 50.5% (more than half) lost at least 15% after 68 weeks of treatment with semaglutide

On average, patients in the semaglutide group lost 15.3 kg of their weight – 12.7 kg more than the weight loss achieved with the placebo (2.6 kg). 

The most common side effects of semaglutide were mild-to-moderate nausea and diarrhea that typically resolved with time.

Another randomized clinical trial compared the safety and efficacy of semaglutide with liraglutide (another GLP-1 agonist used for diabetes and weight loss) in people who are overweight or obese.

The study included 338 participants with a mean body mass index of 37.5.

Around half received once-weekly semaglutide (2.4 mg) injections for 68 weeks with diet and physical activity. The other half received once-daily liraglutide (3.0 mg) injections instead of semaglutide.

On average, people who took semaglutide lost 15.8% of their weight. Weight reduction was 9.4% higher in participants who took semaglutide injections versus those who took liraglutide. The participants on liraglutide had a 6.4% weight reduction.

Participants had a better chance of losing ≥10%, ≥15%, and ≥20% of their weight with semaglutide than with liraglutide.

• Percentage of patients who lost ≥10% of their weight: 70.9% of patients with semaglutide vs. 25.6% of patients with liraglutide
• Percentage of patients who lost ≥15% of their weight: 55.6% of patients with semaglutide vs. 12.0% of patients with liraglutide
• Percentage of patients who lost ≥20% of their weight: 38.5% of patients with semaglutide vs. 6.0% of patients with liraglutide

These studies show that once-weekly Ozempic (semaglutide) injections are safe and effective for weight reduction in overweight or obese adults who do not have diabetes.

Moreover, Ozempic is more effective in reducing weight than other similar diabetes medications, such as liraglutide.

The Final Word:

Ozempic (semaglutide) is a drug used to treat diabetes, and it can be a safe and effective weight loss medication as well. Studies show that it can help overweight and obese patients lose significant weight, and it is more effective in weight reduction than other similar weight-loss drugs, like liraglutide. 

However, Ozempic is not suitable for everyone, and it might do you more harm than good if you take it without consulting a doctor or healthcare provider first. Before using Ozempic, carefully read the leaflet from the manufacturer inside the pack before taking your first dose.

The thumb rule is to supplement healthy eating and exercise with prescription weight-loss medications, not the other way around.

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Sources:

• Introduction - Clinical Review Report: Semaglutide (Ozempic) - NCBI Bookshelf
• Results - Clinical Review Report: Semaglutide (Ozempic) - NCBI
• Safety of Semaglutide
• Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial | Nature Medicine
• https://www.medicalnewstoday.com/articles/ozempic-face#other-side-effects
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11208009/
• https://pubmed.ncbi.nlm.nih.gov/38525095/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10092593/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10092593/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11202139/

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