Can Ozempic Help Me Lose Weight?

Obesity is a chronic health condition that affects an increasing number of people worldwide. In the United States, more than 70% of adults are overweight (often defined as having a BMI of 25-29 kg/m2), and more than 40% have obesity (BMI greater than or equal to 30 kg/m2). Complications of obesity include diabetes, heart disease, sleep apnea, anxiety, depression, and a reduced life expectancy. Because modest weight reduction can reduce many of these complications, scientists have developed prescription medications to help obese and overweight individuals achieve better weight control and have healthier, longer lives.

What are weight loss medications?

Since the 1990s, multiple prescription medications have been evaluated and approved by the United States Food and Drug Administration (FDA) for weight management in overweight or obese individuals. Some of these drugs were better known for their undesirable side effects than for their weight loss benefits. Orlistat (Xenical), which the FDA approved in 1999, was associated with oily rectal leakage, gassiness, or abnormal bowel movements. Lorcaserin (Belviq), approved in 2012, was withdrawn from the market in 2020 due to concerns that it caused cancer. There are also several so-called "weight loss supplements." Unlike prescription and over-the-counter medicines, the FDA does not regulate dietary supplements. Here is a list of medications that have been approved by the FDA for weightloss.

What are some new weight loss medications?

In 2014, the FDA approved liraglutide (Saxenda) for chronic weight management in obese or overweight adults with weight-related medical conditions. The FDA expanded the approval age range to those aged 12 and older in 2020. In 2021, the FDA approved semaglutide (Wegovy) for chronic weight management in obese or overweight adults with high blood pressure, type 2 diabetes mellitus, or high cholesterol. 

How does Ozempic work?

Liraglutide (Saxenda, Victoza) and semaglutide (Wegovy, Ozempic, Rybelsus) belong to the "GLP-1 receptor agonist" class of drugs. GLP-1 is a hormone produced by the body in response to food intake. GLP-1 agonist drugs help the body make higher levels of GLP-1, which can affect hunger, food intake, and weight. GLP-1 acts on the pancreas to increase insulin release after carbohydrate consumption, and it also causes a sensation of decreased appetite and increased fullness. Because of this, GLP-1 receptor agonists have been explored as weight loss drugs. Since GLP-1 also affects insulin release and blood sugar control, some GLP-1 agonist drugs are also used to treat diabetes mellitus. GLP-1 agonist drugs are available in both oral and injectable forms. Rybelsus is an oral formulation of semaglutide, while Wegovy and Ozempic are injectable. Saxenda and Victoza are injectable versions of liraglutide. 

Ozempic vs. Wegovy

Ozempic, Wegovy, and Rybelsus all contain the same active ingredient, semaglutide. However, the drugs are dosed differently and are prescribed for treatment of different conditions. Ozempic and Rybelsus are only approved to improve blood sugar control in adults with diabetes, while Wegovy is FDA-approved for weight management.

Table: common GLP-1 agonist prescription medications

Is Ozempic insulin?

Ozempic is not insulin; it acts on the body differently than insulin does. Because of their effects on food intake, members of the GLP-1 class of drugs, including semaglutide and liraglutide, have many potential effects on the human body that affect hunger and weight. These drugs slow the rate at which food is transferred from the stomach to the intestines (called "gastric emptying"), which enhances the feeling of a full stomach. The drugs also pass through the bloodstream into the brain, where they act on the nervous system to decrease both food intake and appetite.

Can you use Ozempic for weight loss?

The FDA approved Ozempic for improving blood sugar control and reducing risk of heart disease in diabetic patients. While Ozempic is not currently FDA-approved for weight loss, many studies have investigated the effects of GLP-1 agonist drugs on weight loss. In a 2009 study that evaluated the weight-loss effects of liraglutide versus Orlistat or placebo, individuals who used liraglutide lost, on average, 11-16 pounds (4.8-7.2 kilograms) over 20 weeks. In a 68-week trial published in the New England Journal of Medicine in March 2021, obese or overweight adults who took semaglutide had a 15% decrease in body weight and also experienced improvements in physical function and risk factors for heart disease. The results of one study suggest that injectable semaglutide is more effective in promoting weight loss than oral liraglutide.

What happens when you stop taking Ozempic?

Weight loss caused by GLP-1 agonist drugs is not always permanent. In clinical trials, people who stopped taking semaglutide regained the majority of their prior weight loss within a year. In addition, those who stopped taking semaglutide also experienced increases in blood pressure, cholesterol, and blood sugar levels, suggesting that continued use of the medication is needed to maintain both weight loss and the reduction in risk factors for heart disease.

Is semaglutide (Ozempic) safe?

GLP-1 agonist drugs, including semaglutide (Wegovy, Ozempic, Rybelsus) and liraglutide (Saxenda), are generally well-tolerated and are not associated with significant unwanted side effects. Common adverse effects of these medications include nausea, vomiting, abdominal pain, and diarrhea.

Does insurance cover Ozempic?

While semaglutide (Wegovy, Ozempic, Rybelsus), and liraglutide (Saxenda) are FDA-approved, individual insurance coverage policies for these medications vary. A good way to find out if your insurance covers a prescription medication is to call the number on the back of your insurance card.

Can foods act as natural Ozempic?

Some studies have shown that certain foods containing fiber, protein, omega-3 fatty acids, and non-digestible carbohydrates increase GLP-1 levels in the human body. Although regular consumption of these foods may lead to increased fullness that can translate into weight loss over time, there is no evidence that eating these foods is equivalent to taking Ozempic or other similar pharmaceuticals. One reason for this is the relatively short lifespan of GLP-1 in the body. Once it is released into the human body, GLP-1 is broken down very quickly, within minutes, into inactive metabolites. Pharmaceutical formulations of GLP-1 receptor analogs, including Ozempic, are specially designed to reduce the enzymatic breakdown of the drugs. This means that the active forms of the drugs can persist for much longer periods of time within the human body, and result in more sustained clinical effects, including weight loss and appetite suppression. This also explains why Ozempic can be given once a week.

Does "Ozempic cookie dough" work?

Although regular consumption of healthy foods, including those rich in fiber and certain carbohydrates, may have beneficial health effects, there is no evidence that they provide the same sustained clinical effects as Ozempic, Wegovy, or other prescription GLP-1 receptor agonists. The "Ozempic cookie dough" recipe, as promoted on TikTok, may be delicious and fun to make. Some TikTok recipes for "Ozempic cookie dough" include protein powder, oatmeal flour as a carbohydrate, and coconut flour as a fiber source. When these ingredients are blended and eaten, they may stimulate a limited amount of natural GLP-1 release from the body. However, consumption of this concoction is unlikely to result in a sustained release of GLP-1 from the gut and brain that will result in significant weight loss. Furthermore, adding extra ingredients such as chocolate chips and sprinkles may promote weight gain, make the recipe much less healthy overall, and contribute to unwanted increases in blood glucose levels that can be harmful to those with diabetes.

What do I do if I have a bad reaction to or take too much semaglutide (Wegovy, Ozempic, Rybelsus) or liraglutide (Saxenda)?

If you took too much or have unwanted or unexpected side effects after using GLP-1 agonist drugs such as liraglutide (Saxenda) and semaglutide (Wegovy, Ozempic, Rybelsus), reach out to Poison Control immediately to find out what to do. Get a fast personalized recommendation online or call 1-800-222-1222. Both options are free, confidential, and available 24 hours a day.

Kelly Johnson-Arbor, MD
Medical Toxicologist

For media inquiries, please contact Krista Osterthaler at osterthaler@poison.org.