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By: Melissa Mitri, MS, RD

ozempic for weight loss

Are you wondering how does Ozempic work for weight loss, the latest weight loss drug? If so, you may wonder if you qualify to get an Ozempic injection for weight loss to speed up the process. But how does Ozempic work for weight loss anyway, and is it safe and sustainable?

While Ozempic can help you lose weight, it is not for everyone. It’s also not available for everyone right now, and for good reason, which we’ll discuss here.

In this post, you’ll learn all about Ozempic, including:

What is Ozempic?

How does it work?

What the research says

How does it help you lose weight?

Side effects

Ozempic alternatives

I’ll also share the experiences of my clients, colleagues, and myself. 

What is Ozempic?

Ozempic, otherwise known as Semaglutide in the medical world, is a prescription medicine FDA-approved as a treatment for type 2 diabetes. It is available as an Ozempic prescription administered once a week to control blood sugar levels.

It’s been around for a while, but only recently is getting more attention in the weight loss world. It is not yet FDA-approved for weight loss but is currently under review for this. 

Clinical trials and more recent studies show Ozempic has a side effect of inducing weight loss. Since then, many people have been asking their doctors (and me) about it. One of my newest mom friends also just brought it up to me, asking me what I thought about it.

It’s important to note even though weight loss can occur when you’re on Ozempic, it is not approved for this purpose.

Even so, many doctors have prescribed Ozempic to their non-diabetic patients to help them lose weight. This made a lot of people very happy, but this led to a severe shortage of Ozempic for people with diabetes who really needed it.

While studies have shown its potential to help you lose weight, Ozempic for weight loss for non-diabetics is not approved for use. 

How Does Ozempic Work?

Ozempic works to lower fasting and postprandial (after meal) blood glucose levels by stimulating insulin secretion from the pancreas. If you have insulin resistance, type 2 diabetes, or cardiovascular disease this may have been suggested to you. 

Those with heart disease are at a higher risk for insulin resistance, as these conditions often go hand in hand.

The goal of Ozempic is to lower your blood sugar levels (if you have type 2 diabetes and they are high) and hemoglobin A1C levels, or A1C. Your A1C gives you a more long-term picture of your blood sugar levels over a 3-month period. 

It helps control blood sugars in 3 key ways:

  • Helps your pancreas produce more insulin when your blood sugar is high, to help bring it back down.
  • Prevents your liver from making and releasing too much sugar.
  • Slows down the rate at which food moves through your digestive tract. 

When Ozempic does these 3 things effectively, it can have the desired side effect of weight loss.

While managing your blood sugar is the ultimate goal with type 2 diabetes, a modest amount of weight loss can be very helpful in regulating your hormones and keeping your blood sugar in check.

How Does Ozempic Work For Weight Loss?

How does Ozempic work for weight loss? According to the research, it does this in a few key ways. It is known as a GLP-1 receptor agonist. It is coined this because it mimics a natural hormone in your body called glucagon-like peptide-1, or GLP-1. 

Here are the top ways Ozempic may promote weight loss and help you to eat better.

Slows digestion

GLP-1 is produced by your digestive system in response to eating and helps slow down the digestion of your food. Doing this slows down blood sugar and nutrient absorption, leading you to feel more full from the delayed digestion and also absorbing fewer calories from your food.

Suppresses appetite

Ozempic can inadvertently lower your appetite by delaying digestion. If you think about when you have a filling meal with a lot of fat in it, you probably won’t feel hungry for a while. Ozempic acts similarly – except you don’t have to eat a ton of calories to curb your appetite.

May lower the desire for high-fat foods

One research study showed those taking Ozempic had less of a desire for higher-calorie, high-fat foods compared to those taking a placebo. High-fat foods are naturally high in calories by default, so having less of these foods automatically cuts your calorie intake.

What The Research Says

It’s essential to look at the research when it comes to medications. You don’t want to just take something at face value, or take advice from someone’s blog who prescribes Ozempic, because the information may be skewed.

Many people taking Ozempic lose weight within the first month. In general, it appears to be a gradual weight loss of 1-2 pounds per week on average.

Here are a few research studies on Ozempic’s role in weight loss:

Study 1 – This was a large, long-term randomized study involving over 1900 people. Over 68 weeks, those taking Ozempic lost 14.6% of their body weight on average compared to 2.4 % in the placebo group. Both groups also were prescribed a lifestyle intervention of diet and exercise.

Study 2 – A small study with 30 people was conducted over 12 weeks. Those taking Ozempic lost 11 pounds in 12 weeks, which is about one pound of weight loss per week. Calorie intake was also around 24% less for all meals in the Ozempic group compared to the placebo.

Those taking Ozempic also reported less appetite and food cravings, better control of eating, and less preference for fatty, higher-calorie foods.

Study 3 – This cohort study involved 175 people. A cohort is a study that assesses results at different points in time and uses a pool of similar individuals.  In this study, the average weight loss was 5.9% at 3 months and 10.9% at 6 months, which is similar to the averages from other trials.

Based on the studies done so far, research suggests you can lose a modest amount of weight while taking Ozempic. But the question is, what happens when you come off of it? Does the weight come back on? 

Ozempic Dose for Weight Loss

The Ozempic dose for weight loss starts off low and is gradually increased as tolerated. A typical Ozempic dose schedule may look similar to this and is administered as a weekly injection:

Weeks 1-4 – 0.25 mg

Week 5 and beyond – Your doctor will increase your dose by 0.5 mg as tolerated every week and up to 2.4 mg weekly based on tolerance.

If you’re experiencing any side effects, the dose may be increased more gradually or remain at the dose where you are achieving results with the least side effects.

How Long Should You Take Ozempic For?

As a Registered Dietitian, I’m always looking at the big picture and if a particular diet, lifestyle, or medication is a long-term solution. 

The longest study on Ozempic was 68 weeks, or a little over a year, with positive weight loss results. However, gastrointestinal side effects were common and occurred in over half of the study participants. 

Since Ozempic is still a fairly newly approved drug, its safety and effectiveness long-term are not 100% known. It’s also possible that if you come off of it, you may gain the weight back. Therefore, it’s questionable how sustainable it is.

Any intervention that helps you lose weight in the first place often needs to be continued. If not, you risk regaining the weight back. So the question is – if Ozempic is approved for weight loss, do you have to be on it forever?

More studies are needed to determine what happens when people come off of Ozempic to answer this question. 

Ozempic Side Effects 

Ozempic has a few common side effects and other warnings that are important to be aware of. The most common mild side effects are:

  • Digestive upset
  • Fatigue
  • Injection-site reactions
  • Dizziness
  • Headache
  • Muscle loss
  • A minor increase in heart rate

There are also more serious side effects that have been reported:

  • Diabetic retinopathy (nerve and blood vessel damage in the eyes)
  • Gallbladder disease
  • Kidney problems
  • Pancreatitis (more common in those who drink alcohol)
  • Increased risk of thyroid cancer
  • Allergic reactions
  • Hypoglycemia (low blood sugar)

Digestive symptoms like nausea, diarrhea, abdominal pain, bloating, and constipation are the most common side effects. They occurred in nearly 75% of people in the large 69-week study. For most people, however, these side effects were short-lived and just in the first few weeks.

Muscle loss is also common with Ozempic and other weight loss medications, which is typical when you lose weight quickly. Unfortunately, the weight you lose is not all fat loss and involves the loss of lean muscle tissue as well. To reduce the amount of muscle lost, eating enough protein and performing strength exercises at least 2-3 times a week is essential.

This will help optimize your health, strength, and metabolism, helping reduce the risk of weight regain if you need to come off the medication.

There is also a black box warning for Ozempic, as it has been seen to increase thyroid cancer risk in rat studies. It’s unclear if this same risk applies to humans, but if you or your family has a history of thyroid issues, speak to your doctor about this risk.

Foods or Medications You Should Avoid With Ozempic

While not incredibly common, it’s important to be aware of the potential food and medication interactions when taking Ozempic.

Certain foods and drinks that are hard to digest may worsen Ozempic side effects, such as:

  • Fatty foods like greasy and fried foods
  • Spicy foods
  • Sugary foods and refined carbs (like pastries or bagels)
  • Alcohol

As you can see, Ozempic and fatty foods don’t mix. These foods and drinks are not the best Ozempic foods to eat, as they can be tough to digest and exacerbate digestive side effects. Most of them are not incredibly weight-loss friendly either, so it is recommended to limit them regardless if weight loss is your goal.

The most important medications to take precautions with on Ozempic are diabetes medications such as:

  • Insulin
  • Sulfonureas (like Glipizide)
  • Meclinitides (like Repaglinide)

Since these medications work to lower blood sugar and so does Ozempic, taking them together with Ozempic may increase your risk of low blood sugar (hypoglycemia).

Eating smaller, more frequent meals can help you meet your daily nutrient needs to support weight loss and reduce the risk of bloat and other digestive side effects.

Always speak to your doctor about your medications, diet, and potential interactions to minimize the risk of side effects.

Who Should Take Ozempic for Weight Loss?

Based on what it is currently approved for, there are a few populations that may consider taking Ozempic. If you are diagnosed with:

  • Type 2 diabetes
  • Insulin resistance or prediabetes
  • Polycystic ovary syndrome (PCOS)
  • Cardiovascular (heart) disease or at risk for it

If you have one of these conditions and want to lose weight, you may want to consult with your doctor about the pros and cons of taking Ozempic.

Who Shouldn’t Take It 

There are a few groups where the risks of taking Ozempic may outweigh the benefits.

Here are a few situations where the manufacturer recommends not using it:

  • You are non-diabetic or have no level of insulin resistance
  • You have a history of diabetic retinopathy
  • You are pregnant or breastfeeding
  • You are drinking alcohol regularly
  • You have a family history of medullary thyroid cancer (MTC)
  • You are diagnosed with MEN 2, a rare endocrine disorder
  • You are allergic to any of its ingredients
  • You have a history of pancreas or kidney problems

If you abuse alcohol or don’t have diabetes, taking Ozempic can cause your blood sugar to go too low, increasing your risk of hypoglycemia. Alcohol tends to lower your blood sugar, and drinking on top of taking Ozempic can bring your blood sugar to dangerously low levels.

My Personal Experience as a Dietitian

I have seen the weight loss and appetite-suppressing effects of Ozempic firsthand. A few of my clients who have taken Ozempic say they feel full and more easily satisfied with smaller portions than they’re typically used to. 

Since Ozempic tries to act like GLP-1, it can help you feel fuller longer, reduce food cravings, and help your body regulate blood sugar and fat storage more optimally. Doing this can also keep you motivated to lose weight.

One of my clients in particular who has PCOS (polycystic ovary syndrome) has lost over 20 pounds from taking it in a few months, and prior to this, it was difficult for her to get over this hump.

PCOS and insulin resistance go hand in hand, and so those with any level of insulin resistance for various reasons who are considered overweight may be a candidate for Ozempic.

I would not recommend it for just anyone wanting to lose weight but would say it may be something to consider if you’re trying to lose weight and have insulin resistance.

What my Dietitian Colleagues Had to Say 

I spoke to a few dietitian colleagues who also have experience with Ozempic. Here is what one of them had to say.

I used to work outpatient at a very busy Endocrinology clinic and counseled several patients on Ozempic. Many patients complained about side effects such as feeling nauseous or having stomach pains while taking this medication.  

Whenever our Endocrinologist and I saw patients together, especially if they were just starting Ozempic, we would make recommendations on how to prevent or reduce the severity of these side effects. 

We would advise them to eat slowly, not to overeat, and to stop eating before they start to feel full. We would even suggest cutting back on very fatty foods such as fast food as this would further slow down their digestion which Ozempic already does. 

Personally, I like Ozempic for patients with diabetes because it tells the pancreas to release insulin only in response to high blood sugar. Some diabetes medications tell the pancreas to release insulin soon after it’s taken no matter what, which can increase hypoglycemia risk.” – Megan Warnke, RDN, CDCES, Diabetes Educator and Owner of Warnke Wellness 

Ozempic Alternatives for Weight Loss

Two other popular prescription drugs claim to promote weight loss as well – Phentermine and Wegovy.

Phentermine 

Phentermine, under the brand name Qsymia, is a stimulant designed for short-term use for weight loss. It has been around much longer than Ozempic and is approved if your BMI is equal to or greater than 30 or 27 or higher with risk factors like high blood pressure or high cholesterol.

It works similarly to Ozempic in that it curbs your appetite, but it does this by stimulating your nervous system to make you feel full. It is a capsule taken an hour or two after breakfast to curb your appetite throughout the day, not an injection like Ozempic and Wegovy. 

It has been tested only in the short term and, therefore, is usually only given for 12 weeks. The average weight loss is about 5% of body weight during this time.

Phentermine’s side effects are less digestive-related but are more concerning as they are heart and respiratory-related, such as chest pain, racing heartbeat, and trouble breathing.

Wegovy

Wegovy is a newer FDA-approved injection medication designed specifically for weight loss. It contains Semaglutide as the main ingredient, the same primary ingredient in Ozempic, but at a higher dose.

Like Phentermine, you must have a BMI of 30 or greater or 27 or greater with another medical condition to qualify for Wegovy. Like Ozempic, you take it as a weekly injection, typically over 16-20 weeks. 

Since it is a higher dose, Wegovy leads to more than twice the amount of weight loss than Ozempic. Like Ozempic, the most common side effects are digestive upset. For a side-to-side comparison of the two, check out my post on Ozempic vs. Wegovy.

Mounjaro

Mounjaro is another medication approved for type 2 diabetes as of May 2022 that has a side effect of weight loss. Mounjaro is a weekly injection that may also cause nausea as a side effect. The FDA does not approve it for weight loss alone. 

It is typically prescribed in the short term, up to 12 weeks, and the long-term side effects are not yet known.

I spoke to one of my other Dietitian colleagues who personally takes Mounjaro:

“I have been taking a weekly Mounjaro injection for 3 weeks. I have lost 6 pounds so far, and noticed a big decrease in my appetite. I used to be able to eat a full bowl at Chipotle, but now I am full on much less. I feel mild nausea usually the day of my injection, that resolves shortly after.” – Ana Reisdorf, Owner, RWS Content + Strategy 

Other than that, she hasn’t experienced any other side effects, but she doesn’t plan on staying on it for more than a couple of months.

Using Ozempic for Weight Loss Wisely

Losing weight is not always easy. If you feel like you’re doing everything right regarding your diet, exercise, and lifestyle and are not seeing the results you want, you may be curious about Ozempic. 

It’s important to remember that the use of Ozempic specifically for weight loss is not yet approved, and there are still a lot of unknowns about its safety profile in those who don’t have diabetes. 

If your blood sugar levels are normal and you take Ozempic, it could put you at risk of hypoglycemia. Even though it is still not approved for weight loss, many doctors are still prescribing it when their patients ask them, so it’s important to know of the risks.

If you need more help in your weight loss journey, speak to your doctor about your options. Always weigh out the risks versus benefits of taking a prescription weight loss medication with your doctor.

When it comes down to it, the sustainable habits you practice will give you the biggest weight loss results in the long term such as managing your stress, getting quality sleep, eating well, and engaging in exercise you love – without the risk of gaining it back.

FAQs

  1. Is Ozempic FDA-approved for weight loss? Ozempic is FDA-approved for type 2 diabetes and cardiovascular disease, but not yet for weight loss. It is currently under review for this purpose.
  2. How does Ozempic work for weight loss? It works by acting similarly to the hormone GLP-1 to slow digestion, curb appetite, and lower the desire for high-fat foods.
  3. How much weight can you lose in a month with Ozempic? On average you can expect to lose around 2.5% of your body weight at 1 month, 5% at 3 months, and 10% at 6 months.
  4. How fast do you lose weight on Ozempic? Weight loss typically occurs at a rate of around 1-2 pounds per week.
  5. Do you need to avoid any foods when taking Ozempic? There aren’t any specific foods you need to avoid with Ozempic. However, you should follow a healthy diet low in fat for the best results.
  6. Do you take Ozempic with food or on an empty stomach? You can take your weekly Ozempic injection with or without food.
  7. What is a typical dose of Ozempic? Doses usually start low, around 0.25 mg, and increase up to 2.4 mg based on tolerance.

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