This time last year, few people knew about Ozempic, a prescription drug for type 2 diabetics. But due to one specific side effect of the drug, significant weight loss as a result of its appetite-suppressing and digestion-slowing features, it quickly garnered attention from Hollywood A-listers, social media, and doctors alike.
Now, Ozempic ads are plastered around a subway station in Times Square, TikTokers try to guess which celebs are injecting themselves, and the medication even made it into a joke at the Oscars this year.
Doctors say that Ozempic's viral status has filtered into their practices too. “A lot of patients are inquiring about it,” says Gitanjali Srivastava, MD. “I have patients who are asking about it too,” adds Mir Ali, MD.
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Meet the experts:
Gitanjali Srivastava, MD, is the medical director of Vanderbilt Obesity Medicine.
Kunal Shah, MD, is an assistant professor in the division of endocrinology at the Rutgers Robert Wood Johnson Medical Center.
Mir Ali, MD, is a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California.
Unfortunately, its popularity also resulted in a shortage in late 2022, which the supply chain is still recovering from, says Kunal Shah, MD.
Ozempic is currently only FDA-approved to treat patients with type 2 diabetes, but can be prescribed off-label for weight loss, meaning a doctor prescribes a drug to treat a different condition than the one it's approved for.
Although Ozempic is enveloped in a cloud of contentious ethical and pop culture discussions, doctors say that this shouldn't distract from the fact it is a *real* medication that can help people who need it. There are legitimate and practical reasons why someone may benefit from using Ozempic for weight loss—and thrive because of it. But there are also solid indicators that you don't need to be using the drug.
If you're curious to know more, here’s experts' best advice on when it actually makes sense to go on Ozempic.
First: What is Ozempic and how does it work?
Let’s start at the beginning. Ozempic (generic name: semaglutide) is a prescription injectable medication for adults with type 2 diabetes. It can also aid in weight loss along with a healthy diet and regular exercise. The medication helps the pancreas release the correct amount of insulin when someone's blood sugar is too high, and mimics a gastrointestinal hormone that aids in digestion and signals satiety. Ozempic can also lower a type 2 diabetic's risk of stroke, heart attack, or death.
Specifically, Ozempic belongs to a class of medications known as GLP-1 agonists, a list that includes Trulicity, Byetta, and Saxena. “It slows down travel of food from your stomach to your gut, making you feel fuller after a meal," says Dr. Shah. "It stimulates insulin release in response to a meal to help people with diabetes, and even may have an effect on making you less hungry in general.”
While specifically designed to manage blood sugar levels, patients noticed they lost weight, as well, Dr. Srivastava says. (The official Ozempic website even says that people with type 2 diabetes who took the drug lost up to 14 pounds in two different studies.) Soon, non-type 2 diabetics started being prescribed Ozempic off-label for obesity, and that group saw a "significant benefit" from weight loss, too, Dr. Srivastava says.
What requirements should you meet before taking Ozempic?
The FDA states that Ozempic should be prescribed under certain circumstances. Technically, in order to use it, you should meet the following criteria:
- Have type 2 diabetes
- Have already tried to manage your diabetes with diet and exercise and failed
Despite not being FDA-approved for weight loss, though, people are still getting it prescribed off-label by their doctors to shed pounds. Ozempic also has been shown to cause thyroid C-cell tumors in rat studies. However, the FDA stresses that it’s “unknown” whether Ozempic has the same effect in humans. To be safe, people with a family or personal history of thyroid cancer probably shouldn't take Ozempic.
What other options should I consider if I'm not diabetic?
There is another version of the semaglutide injectable medication, Wegovy, that comes as a higher 2.4 milligram dose (Ozempic is usually 2.0 milligrams), and is FDA-approved for weight loss.
The combination of early Wegovy shortages and tricky insurance coverage requirements for weight-loss medications meant some people have been opting for off-label Ozempic prescriptions instead. Ozempic is “the same [as Wegovy] … for all intents and purposes,” says Dr. Shah.
“Insurance may likely cover this medication [Wegovy] if you have a BMI over 30 or are overweight with certain risk factors such as high blood pressure, cardiovascular disease, arthritis, diabetes, or sleep apnea,” Dr. Shah continues.
Can Ozempic be used for short-term weight loss?
No. Technically, Ozempic requires long-term, consistent use, Dr. Ali notes. That means you should absolutely *not* consider it if you're just trying to lose a few pounds or fit into a dress before an event; it’s for people with obesity and/or diabetes, and is considered a medication you'd take for the forseeable future.
Consider this too: You have to inject the medicine into your own body. If that freaks you out, or you have a fear of needles, this is not for you.
Lastly, many experts and patients encourage people to consider Ozempic use from an ethical standpoint. Because, yes, you'd technically be using a medication intended to treat people with type 2 diabetes. There are some diabetics who are struggling to access or still can’t access Ozempic right now.
Ultimately, if you are considering Ozempic for weight loss, it warrants a candid conversation with your doctor.
If you're concerned about your ability to lose weight and are at a weight that puts you at an increased risk for certain health complications, it’s worth talking to your doctor about options, including whether a semaglutide injection may work for you.
“If you are generally interested in help in losing weight, it can be helpful,” Dr. Srivastava says. “Maybe you have joint aches or pains from excess weight, or maybe you want to prevent those complications because you have a family member with obesity.”
While this can be a sensitive topic, Dr. Srivasta explains that “if you go to your doctor and say, ‘I’m concerned about my weight,' your primary care physician should be equally engaged in a conversation about next steps."
Dr. Ali tells patients that it's a tool that can help them settle into a healthier lifestyle, emphasizing a point several doctors have made about the importance of pairing the injection with a healthy diet and exercise. “If patients use it, it works. But if they’re not changing their habits and still eating the wrong things and not exercising regularly, they will have significant weight regain when they stop using it," Dr. Ali says.
Consider the side effects before starting the medication.
Since this is a medication you'd be taking for an extended period of time, it's important to consider the possible side effects (short-term and long-term) you could have while taking it.
“The major risks of Ozempic include a risk of pancreatitis, which is an inflammation of pancreas and causes extreme abdominal pain, nausea, and vomiting and it was also found to have a minor association with a very rare type of thyroid cancer called medullary thyroid cancer,” Dr. Shah says. “So anybody with a history of pancreatitis or somebody with or has a family history of medullary thyroid cancer or MEN syndrome—a syndrome that puts you at risk for thyroid cancer—would not be a good candidate.”
Here's the deal: The weight-loss drug space is a little contentious at the moment, but doctors are adamant that these medications can help people with obesity lose weight, and improve health outcomes and longevity. Ozempic will likely be FDA-approved for weight loss in the near future, and similar medications, like Mounjaro (a tirzepatide injection for type 2 diabetics with similar weight loss side effects), will likely follow suit.
