A new movement has been gaining a lot of buzz the last couple of years – people using diabetes drugs like Ozempic for weight loss. But do medical professionals actually prescribe Ozempic for weight loss?
What is Ozempic?
Ozempic is also known by its generic name semaglutide. It received approval in 2017 from the U.S. Food and Drug Administration (FDA) for managing type 2 diabetes in adults. It’s a once-weekly shot that aids in lowering blood glucose levels by enhancing insulin production in the pancreas. While it’s not officially approved for weight loss, some doctors do prescribe it off-label for this purpose.
How does Ozempic work?
Ozempic is part of a category of drugs known as GLP-1 receptor agonists, named after a hormone that they are designed to replicate. In recent years, other similar medications have entered the market: Wegovy (approved for weight management and reducing cardiovascular risks in some adults), Mounjaro (type 2 Diabetes treatment) and Zepbound, which has been approved specifically for weight loss. All these treatments are administered through weekly injections.
Both Wegovy and Ozempic contain semaglutide, which mimics the hormone GLP-1 to boost insulin production in the pancreas and slow gastric emptying. Mounjaro and Zepbound function similarly but use tirzepatide (instead of semaglutide) to mimic both GLP-1 and an additional hormone, GIP.
Also semaglutide and tirzepatide also act on the brain: They suppress hunger signals and reduce what many users refer to as “food noise.”
These medications aren’t effective for everyone. In clinical trials, a small percentage of participants didn’t achieve significant weight loss.
However, for numerous patients, these drugs can be remarkably effective. An analysis of the largest and longest study on semaglutide revealed that participants who took the medication for four years managed to lose an average of about 10 percent of their body weight and maintain that weight loss. A major trial on tirzepatide found that individuals who took the highest dose lost an average of approximately 18 percent of their body weight after 72 weeks.
“They’re truly a game-changer,” said Dr. Melanie Jay, director of the N.Y.U. Langone Comprehensive Program on Obesity.
How much do these medications cost?
The current list price for Ozempic is roughly $968 for a one-month supply. Wegovy is priced at around $1,349, Mounjaro is approximately $1,069, and Zepbound costs about $1,059. Often patients don’t pay the full list price as many insurance providers cover these drugs, though the extent of coverage varies, and some insurers have introduced new restrictions. Also some individuals may qualify for savings cards offered by the drug manufacturers.
Due to the high cost of these medications, some people have turned to compounded versions of semaglutide and tirzepatide, as there isn’t a generic alternative for either semaglutide or tirzepatide.
Does Ozempic work for weight loss?
Research confirms that the active ingredient in Ozempic, semaglutide, is effective for weight loss. However, it’s important to maintain lifestyle changes, such as regular exercise and a healthy diet, to support your weight loss journey.
While Ozempic is not officially approved for weight loss, semaglutide is sanctioned under the name Wegovy for this purpose. The difference is that Ozempic contains a lower dose of semaglutide compared to Wegovy.
You have to understand that if you start using these drugs for weight loss, your body may adapt to them. Studies show that if you discontinue Ozempic (or Wegovy), there’s a high likelihood that you’ll regain the weight you lost.
GLP-1 agonists, such as Ozempic, help regulate blood sugar levels, but they also tend to aid in weight loss. GLP-1 is a pivotal hormone in this process.
After you eat, the cells in your intestines release GLP-1, which triggers insulin secretion and inhibits glucose production. It also slows the emptying of your stomach, making you feel full longer. GLP-1 is also believed to directly influence the part of the brain that controls appetite, as well as certain hunger-related hormones.
By mimicking GLP-1, Ozempic can help reduce your appetite and make you feel fuller, so you’ll eat fewer calories.
Who can take diabetes drugs like Ozempic for weight loss?
GLP-1 medications are generally safe for most people, as long as they are prescribed by a doctor. But insurance usually only covers the cost for specific conditions. For example, people with type 2 diabetes often have the cost covered by insurance. If you are overweight, with a BMI over 26, and have a serious health issue like heart disease, insurance may also cover the medication.
If you’re seeking the drug solely for weight loss, insurance coverage usually requires a BMI above 30, after you’ve tried a structured diet and exercise regimen. Some insurance policies also require that you have other health issues related to being overweight.
What are the side effects?
Doctors usually start their patients with a low dose to minimize side effects and then gradually increasing the dosage. Mild nausea is common when beginning treatment. Other typical side effects include diarrhea, gallbladder issues, constipation and stomach pain.
Some rare but more severe side effects include stomach paralysis and pancreatitis. There is also a label warning about an increased risk of thyroid cancer, although this connection is still uncertain.
Although GLP-1 drugs are promoted as a solution to the stubborn weight gain often associated with menopause, experts warn that losing body fat can also lead to a loss of muscle and bone. Postmenopausal women should get a baseline bone density assessment before starting these medications.
Are GLP-1 drugs “forever drugs”?
Once you stop taking diabetes drugs like Ozempic, cravings tend to return and the weight may gradually come back. However, you might not need to take the same medication indefinitely, as new and more effective treatments are being developed.
Bariatric Surgery vs. Medical Weight Loss
When someone weighs 350 pounds, they’re not likely to reach a healthy weight solely through medication. They might shed 50 pounds, but that would still leave them at 300. You’ll hear about people who’ve dropped from 300 pounds to 180 using Ozempic, but they may experience severe constipation.
The outcomes vary widely from people not losing enough weight, to dealing with too many side effects, to being completely happy with the results. But remember, it’s a lifelong medication. If your insurance covers it because you have diabetes or severe obesity, that’s great. However, you’ll still need to inject the medication weekly for life, at least for now.
How do these medications compare to or replicate bariatric surgery? These drugs stemmed from research on how gastric bypass functions and it was found that gastric bypass causes the release of several hormones from the gut shortly after eating—hormones that typically would be released much later after a meal.
In procedures like gastric bypass or sleeve, you get a surge of GLP-1 a hormone produced in the gut that stimulates insulin release and curbs hunger when you start eating. It’s released in a balanced way, so you don’t experience nausea because it’s not constantly present, unlike with these medications that keep GLP-1 circulating in your body all the time.
This is a significant part of how these surgeries work. Along with GLP-1, other hormones are also released, creating a more natural response compared to having a drug constantly in your system, even when it’s not needed.
Some people who’ve had gastric bypass and regained the weight later turn to these medications and find they help. They might need more GLP-1 than what the surgery provided, which results in renewed weight loss. But once they stop the medication, the weight comes back because the underlying issue remains. If the medication isn’t there, the condition persists.
What it’s like to stay on Ozempic for years?
As the demand for Ozempic rises, you might know someone who’s just started or has been on it for a while. Data from Novo Nordisk, the drug’s manufacturer, shows that around 60,000 new weekly prescriptions were being written in the U.S. However, only a smaller group of patients has been on Ozempic for years as the drug is relatively new in the market.
NBC News interviewed seven people who have been on Ozempic for between one and two and a half years and they all agreed that the drug isn’t a shortcut to health. While Ozempic has helped them lose weight, lower blood sugar, or both, these changes require ongoing effort to maintain.
Edward Matias, 45, from Connecticut, has been on Ozempic for nearly two years and he emphasized that “this isn’t a miracle drug or a magic solution. It requires effort and commitment.” Matias, who has diabetes, has lost 80 lbs (230 lbs now down from 310 lbs) but still needs to manage his diet carefully.
Many of those interviewed noted that Ozempic helped kick-start healthier habits, like enabling them to exercise more than they could before. Jackson-Williams lost 180 pounds and now has the energy to be more active.
Ozempic, along with its sister drug Wegovy, is considered a long-term treatment. But since these drugs have been on the market for only a few years, doctors and patients are still learning about their long-term use. Dr. Eduardo Grunvald, an obesity medicine specialist, pointed out that while the benefits likely outweigh the risks, there are still unanswered questions, such as the potential for decreased bone density or an increased risk of thyroid cancer.
For some, Ozempic has made healthy eating easier by reducing cravings for high-fat or sugary foods. Kimberly Tabor, who also has Type 2 diabetes, said she didn’t see significant weight loss until after she started the medication.
However, there are challenges. Some users experienced weight gain when they stopped exercising or indulged more while on the medication. One person who initially lost 25 pounds gained back 17 after his routine was disrupted.
Long-term use of diabetes drug Ozempic for weight loss and other similar medications isn’t without its hurdles. High costs, potential side effects, and limited supply are common concerns that people encounter.