Is Ozempic Safe for Weight Loss?

More than two in five Americans struggle with obesity, a common but serious disease that has created an epidemic in the United States. From heart disease to early mortality, obesity presents several risks to healthy aging. 

Because of this, drug manufacturers and patients alike are constantly in search of ways to treat obesity. The latest potential solution, an off-label use of a type 2 diabetes drug called Ozempic, has made national headlines. 

In this blog we talk to Brian Herritt, M.D., a bariatric surgeon at INTEGRIS Health Weight Loss Center about Ozempic and whether it is a safe option for weight management.

What is Ozempic and how did it become so popular?

Ozempic (semaglutide) is a weekly injectable medication to treat diabetes by lowering blood sugar levels. In humans, a hormone produced in the intestines called glucagon-like peptide-1 (GLP-1) increases the levels of incretins, another hormone that helps produce more insulin.

Insulin is a hormone produced by the pancreas that regulates and stores blood sugar (glucose). People with type 2 diabetes don’t produce insulin and have trouble regulating it. They also secrete lower amounts of GLP-1.

Ozempic is a class of medication called glucagon-like peptide-1 agonists, meaning it triggers incretin receptors to release insulin. These drugs have been used for more than a decade to treat type 2 diabetes, with semaglutide earning FDA approval in 2017. Ozempic has been clinically shown to help lower A1C for people with type 2 diabetes and it is generally considered safe to use under proper supervision. 

As more people used Ozempic to treat diabetes, they noticed one major side effect – weight loss. That’s because glucagon-like peptide-1 agonists can also suppress your appetite. 

In 2021, Ozempic began to circulate among patients, especially celebrities, as an off-label use (prescribing medication for an unapproved use) for weight loss. Many people were drawn to the idea of Ozempic as a weight loss solution, and the headlines caused many overweight and obese patients to request prescriptions from their doctors. The drug is now so popular that supply chain issues have occurred, and virtual clinics have popped up online for doctors to prescribe the drug.

How does semaglutide work?

Semaglutide is a synthetic version of glucagon-like peptide-1, which plays two main roles – insulin production and hunger suppression.

Boosts insulin production

Semaglutide works by helping to produce more insulin to regulate glucose levels. The synthetic GLP-1 sends a signal to incretins, a type of peptide hormone that stimulates pancreatic cells to make more insulin.

Suppresses glucagon

Glucagon is a hormone that increases blood sugar levels and prevents them from dropping too low by prompting the liver to release stored glucose. 

• In other words, it has the opposite effect of insulin. 
• Some people with type 2 diabetes have higher than normal levels of glucagon. 
• Semaglutide helps balance the levels of insulin and glucagon.

Promotes satiety

Whenever you eat, GLP-1 activates hormones that tell your brain you’re hungry or full. 

• Ghrelin and a host of other hormones help control appetite and fullness by sending chemical messages to the brain. 
• Meanwhile, ghrelin, which is made in your stomach, lets your brain know when your stomach is empty so it knows when to eat.

One of the main effects of taking synthetic GLP-1 is that it reduces ghrelin, making you feel less hungry between meals. 

• By doing so, it increases satiety so you feel fuller and consume less calories. 
• For example, for a person who regularly consumes 3,000 calories per day, semaglutide may cut that in half to 1,500 calories.

Slows gastric emptying

As you begin to digest food, the stomach goes through phases of gastric emptying that helps move contents from the stomach to the duodenum (first part of the small intestine).

Typically, this process takes one to two hours. 

• When taking synthetic GLP-1, the time it takes for food to leave the stomach greatly decreases and food remains for longer than normal. 
• So as long as you still have food in your stomach, you stay fuller for longer because you don’t need to eat as frequently.

Is Ozempic safe for weight loss for people without diabetes?

In today’s day and age, people are always looking for ways to improve their health or shed a few more pounds. That’s why Ozempic became so popular.

Although some doctors use Ozempic for off-label use, the main takeaway is that Ozempic is appropriate and approved for diabetes, but Ozempic specifically has not gained approval for weight loss. However, there are other GLP-1 agonists that have been approved.

It’s important to remember these drugs, despite the headlines, are not magic pills or a cure for weight loss. Ozempic isn’t a vanity drug, either. Medications are meant to improve your health, not to make you look better. There is no substitute for awareness and responsibility when it comes to your own health. 

“While Ozempic (semaglutide) is a popular medication for those seeking assistance in losing weight, it’s not currently approved by the FDA as a weight loss medication. For people who don’t have diabetes and are in search of weight loss solutions, talk to your doctor about which lifestyle changes, medications, or surgery may be right for you,” says Herritt.

People also shouldn’t take it unless they need to, as the FDA has warned against low supply due to increased demand among those trying to lose weight. Issues with demand cause problems for people with diabetes who need semaglutide to manage diabetes.

The side effects of using Ozempic for weight loss

Gastroparesis: This condition occurs when the muscles and nerves of the GI tract don’t work properly and cause delayed emptying. People with gastroparesis can have low appetite and may struggle meeting basic nutritional needs.

GI problems: Since Ozempic delays gastric emptying, it can cause a host of gastrointestinal problems because food sits in the stomach longer. Examples include acid reflux, nausea, diarrhea, vomiting or constipation.

Body composition changes and malnourishment: It is important to remember that the human body requires a level of nutrients on a daily basis. It is possible while taking this medication to consume a diet that is higher in calories but low in nutrients if the proper foods are not prioritized. Body composition changes can also occur with rapid weight loss. Losing large quantities of fat, especially fast, can leave behind loose skin fibers that make skin sag and stretch.

Fatigue: Consuming less calories and a general disinterest in eating can lead to a lack of energy and therefore overall general fatigue.

Loss of interest in food: For people who enjoy eating and trying new foods, Ozempic can make mealtime and social outings to restaurants less desirable than before. This is because you lose your appetite on Ozempic, and the cravings you once had for food can diminish.

Intestinal obstruction: This is another very rare side effect, but slowing down the transit time of digestion can lead to constipation that turns into intestinal obstruction. Blockages occur when food and stool can’t move freely through the intestines.

What happens when you stop taking Ozempic?

The human body is smart and can adapt to weight loss. 

• Whenever you try to lose weight, the brain senses danger if you consume fewer calories than normal. 
• The body tries to adjust to these habits by slowing down metabolism and conserving more energy to carry out bodily functions. 
• At the same time, hormones tell the brain to increase feelings of hunger and cravings.

This explains why it’s hard to lose weight and why your weight loss journey can be a rollercoaster. Research published in the Diabetes, Obesity and Metabolism journal found people regained two-thirds of the weight lost a year after they stopped taking semaglutide. This underscores the need for lifestyle changes as part of a long-term weight loss strategy, rather than solely relying on medication to treat obesity. 

Bottom line on Ozempic

The best way to approach weight loss is to have a medical team put together a comprehensive plan that includes medication or surgery, lifestyle modifications such as diet and exercise and behavioral modifications.

Not every approach to weight loss works for every person, so it is important to have a detailed conversation with your health care provider about which options are best for you, including medications, lifestyle modifications and/or surgery. 

The use of Ozempic and medications like it can be effective for weight loss, although not approved by the FDA, but they also can carry side effects for those who use it.

Talk with your doctor if you find it hard to achieve and maintain a healthy weight. They can assess your health and recommend lifestyle changes, medication and other treatments as appropriate. Contact your provider for more information on these medications and weight loss options. Visit our website to learn more about the INTEGRIS Health Weight Loss Center.