Integrating lifestyle changes amplifies results, and ongoing monitoring supports long-term health. Costs can be managed via savings programs and insurance, while side effects require careful handling. Eligibility hinges on BMI and health status, with online platforms offering convenient access. Studies show benefits persist with ongoing treatment. Dehydration should be prevented and treated to reduce risk of acute kidney injury. Patients should be monitored for depression, suicidal thoughts and behavior, and mood changes, and those who experience suicidal thoughts or behavior should discontinue semaglutide. Semaglutide should not be prescribed in patients with a history of suicidal attempts or active suicidal ideation. No increase in QT intervals or adverse cardiac events have been noted.30,76 Heart rate should be monitored in participants taking semaglutide. Several other adverse events have been reported with semaglutide.75 For example, as with other GLP1-RAs, increases in heart rate averaging 2.539 to 5.4 beats per minute51 have been observed in clinical trials. While these folks may talk a lot about their success with Ozempic for weight loss, it’s important to remember that no one strategy is a magic bullet for shedding pounds. It can be frustrating and discouraging when someone repeatedly fails at weight loss or loses only to regain. If you’ve attempted weight loss in the past only to find pounds creeping back onto your frame, you know that it’s rarely easy. Since DAEs occurred more frequently in semaglutide, it may be due to its longer half-life (165 h), potentially inducing a more abrupt return of hunger when pausing the treatment and leading to permanent discontinuations (Lau et al., 2015; Rubino et al., 2022). Compared with placebo, semaglutide increased the incidences of AEs, SAEs, and DAEs, especially DAEs, and gastrointestinal side effects accounted for the majority, particularly nausea and diarrhea, which is probably owing to the long-term gastric emptying (Aroda et al., 2019; Wharton et al., 2022). In this regard, it is successfully recognized that semaglutide may be particularly suitable for obese patients with cardiovascular disease. Ji et al. (2021) revealed that semaglutide was related to a significant 26% reduction in the risk of major adverse cardiovascular events compared with placebo, with a 39% reduction in stroke. Subgroup analysis revealed semaglutide 1.0, 2.4, and 2.8 mg led to distinct reduction in body weight, BMI, and WC, but exhibited more events in semaglutide 2.8 mg, whereas less in 2.4 mg. Ozempic is the brand name for semaglutide, a medication belonging to a class called GLP-1 receptor agonists. While this medication is getting a lot of attention, it comes with benefits and potential risks. While it’s completely understandable to be looking for new weight-loss options, it’s crucial to leave Ozempic supplies to those living with type 2 diabetes. Instead of searching for a quick way to lose weight that could have unwanted side effects, there are more sustainable ways to shed a few extra pounds. However, this approach carries the risk of severe side effects. For some people, some seem to improve as their journey progresses.” Lifestyle factors, such as eating processed foods or limiting exercise, can trigger or worsen these side effects. “These gastrointestinal effects often increase with higher doses, but that’s not always the case. Ozempic is generally well-tolerated, but as doses increase, so can the likelihood of experiencing side effects. Blood work every few months checks metabolic health. Each has unique pros and cons based on health profile. Non-drug methods like bariatric surgery suit some cases. Food and Drug Administration (FDA) approved Ozempic (semaglutide) in 2017 for use by adults with type 2 diabetes, it ushered in a new era of blood sugar and weight loss drugs. The cost-effectiveness of semaglutide is unclear, though one recent study demonstrated that semaglutide, relative to no treatment, diet and exercise alone, and other anti-obesity medications, was cost-effective at the willingness-to-pay threshold of $150,000 per quality-adjusted life year over a 30-year horizon.89 As part of the shared decision-making process, insurance coverage and out-of-pocket expenses should be discussed openly with patients. For example, in STEP 2, patients taking sulfonylureas were instructed to reduce the dose by approximately 50% at treatment start, at the researcher’s discretion.39 Patients taking medications that carry the risk of hypoglycemia should be encouraged to monitor their blood glucose regularly and be provided education about preventing, recognizing, and managing hypoglycemia. Thus, doses of other diabetes medications may need to be lowered if initiating semaglutide, and patients should be informed about hypoglycemia risk. As shown in STEP 2, semaglutide at a higher dose of 2.4 mg produces larger weight losses than the 1.0 mg dose approved for type 2 diabetes.39 Special considerations are needed when prescribing semaglutide in patients with type 2 diabetes. (The US FDA recently approved a 2.0 mg dose of semaglutide for type 2 diabetes.) Changes in HbA1c, systolic and diastolic blood pressure, and other cardiometabolic risk factors were significantly greater in participants who received semaglutide 2.4 mg than placebo. Thus, the 2.4 mg dose significantly increased weight loss, compared to 1.0 mg, the latter which was originally approved for the treatment of type 2 diabetes. STEP 2 was a 68-week trial of 1210 adults with type 2 diabetes (ie, glycated hemoglobin of 7–10%) and overweight/obesity who were assigned in equal numbers to once-weekly semaglutide 2.4 mg, semaglutide 1.0 mg, or matching placebo.39 Study eligibility included taking up to three oral glucose-lowering medications (ie, metformin, sulfonylureas, SGLT2 inhibitors, or thiazolidinediones) but not insulin. In East Asian countries, the BMI threshold for obesity is ≥28.0 kg/m2 and for overweight is ≥24.0 kg/m2.18 In India, the BMI threshold for obesity is ≥25.0 kg/m2 and for overweight is ≥23.0 kg/m2.19 The decision to begin anti-obesity medications should be personalized, considering the benefits and risks of all treatment options. The findings of this cohort study suggest that semaglutide is clinically effective for weight loss at 3 and 6 months for people with overweight or obesity. Lack of coverage and high demand for these medications have led to a national shortage of Wegovy and Zepbound. I would encourage patients to communicate their concerns with their health care provider. That’s because the brain pathways that regulate the weight are no longer treated by the medication. Not many people may know obesity was recognized as a disease by the American Medical Association in 2013. Individually, the risk for discontinuation due to adverse events is 6% for semaglutide group and 2.9% for placebo group. The major source of heterogeneity was with the dose of semaglutide. (B) Sensitivity analysis showing the effect of semaglutide on mean weight difference versus placebo. (A) Forest plot showing the effect of semaglutide on mean weight difference versus placebo. Use this medication with caution, and always under careful supervision of your doctor. Ultimately, the decision to use Ozempic or Wegovy should be made with your healthcare provider. For some, however, the side effects may outweigh the benefits. Studies are showing some promising results, but the potential side effects may be concerning for some. As shown in STEP 2, semaglutide at a higher dose of 2.4 mg produces larger weight losses than the 1.0 mg dose approved for type 2 diabetes.39 Special considerations are needed when prescribing semaglutide in patients with type 2 diabetes.Similar to our reported results, gastrointestinal symptoms, particularly nausea, are the most commonly reported adverse effects with semaglutide.18 We also report a significant number of patients with fatigue, which was not reported in previous studies.18Send an email toSemaglutide in pill form is in the works and may be appealing to more people when it's approved.The agency reviews drugs for specific conditions with strict data requirements.Meanwhile, a 2025 study found GLP-1 drugs, including semaglutide, “probably have little or no effect” on a person’s risk of developing obesity-related cancers.After four weeks, doses may rise to 0.5 mg, then higher if tolerated.The active ingredient in Ozempic is semaglutide, a GLP-1 receptor agonist. Within the broader GLP-1RA medication class, differences exist in drug structure, efficacy, and adverse events. At week 68, a larger proportion of participants in the semaglutide 2.4 mg and semaglutide 1.7 mg group than the placebo group had achieved a ≥5% (83 vs 72 vs 21%), ≥10% (61 vs 42 vs 5%), and ≥15% or higher reductions (41 vs 24 vs 3%) in baseline bodyweight. The average decrease in body weight at week 68 was 13.2% in the semaglutide 2.4 mg group and 9.6% in the semaglutide 1.7 mg group versus 2.1% in the placebo group. These categorical losses are similar to those observed in STEP 1, as are the greater improvements at week 104 in cardiometabolic risk factors in semaglutide- vs placebo-treated participants. The GLP-1 hormone plays a key role in controlling blood sugar levels and appetite. Novo Nordisk lauded the drug’s safety and efficacy in clinical trials. It uses semaglutide as an active ingredient to help the pancreas make more insulin. Ozempic is the brand name of a medicine that boosts insulin and lowers blood sugar levels. The Medical Minute is a weekly health news feature produced by Penn State Health. For the longest time, all we could offer our patients was lifestyle modifications ― cut down your calories, be physically active ― which are important. This is a very hopeful time in the field of obesity medicine. The situation became so critical that the Therapeutic Goods Administration and Australian Medical Association had to make a formal announcement to healthcare professionals. Unmanaged, both forms of diabetes can cause significant damage to the kidneys, liver, eyes, and nervous system.⁸ However, inactivity or poor eating habits can’t cause type 1 diabetes. Type 1 diabetes is an autoimmune condition that stops your body from making insulin, and a way to prevent it hasn’t been discovered yet. The onset of this form of diabetes usually occurs in adulthood. Suddenly doctors were prescribing it to their overweight patients as a way to mitigate the variety of health conditions related to obesity. And while some people have been taking GLP-1 receptor agonists for their weight loss benefits for years, it wasn’t until 2021 that the FDA officially approved Wegovy for weight management. Ozempic is indicated for type 2 diabetes; UK supply guidance has stated that using it for weight management is off-label and can put availability for indicated patients at risk. Ozempic is the brand name for semaglutide, a synthetic compound designed to act like a hormone in the body. People report significant reductions in body weight, often when combined with lifestyle changes. Originally developed for other health concerns, its role in shedding pounds has sparked widespread interest. It’s a prescription medication that many turn to for its promising results. These often improve with time and dose adjustments. Ozempic focuses on diabetes with lower max dosing. However, it’s not officially tested or approved for this alone. It also reduces cardiovascular risks like heart attacks in those with heart disease. Lose Weight and Melt Stress With the 28 Day Indoor Walking Challenge: Walking for Weight Loss Plan “I am not usually expecting significant weight loss after the first month at the 0.25mg dose,” Dr. Garcia-Webb says. “In general, the weight loss is dose-dependent, so a patient will have a greater weight loss if they go to the highest dose.” Another trial, published in the medical journal Lancet, only included overweight or obese people with type 2 diabetes. In a trial published in the New England Journal of Medicine, people without type 2 diabetes were given 2.4 mg of semaglutide or a placebo, along with nutritional counseling. These medications mimic a hormone called GLP-1, which helps to regulate appetite and blood sugar. However, Wegovy contains higher doses of it and is designed for weight loss. It's important that people continue to make lifestyle changes to help their weight loss, such as eating right and exercising. The active ingredient in Ozempic, semaglutide, does work for weight loss, according to research. When using Ozempic to treat diabetes, weight loss is a common side effect. Other side effects not listed may also occur in some patients. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. These side effects may go away during treatment as your body adjusts to the medicine. Understanding how does Ozempic work for weight loss reveals a clever mimicry of natural body processes. Benefits extend to diabetes control and related health protections. Consult your doctor on full medical history and current medications for interactions. Medullary Thyroid Carcinoma (MTC) and Multiple Endocrine Neoplasia Syndrome Type 2 (MEN A known hypersensitivity to semaglutide or any of its excipients is a contraindication for use of the medication. The rarity and long-term timeline of these events require larger-scale, longer-duration, randomized clinical trials designed to assess the effects of semaglutide on the thyroid system. However, some patients may be “non-responsive” to semaglutide, which using CMS guidelines is considered a Below we discuss selection considerations for use of subcutaneous semaglutide for chronic weight management. Ozempic, which has become synonymous with weight loss medication, is FDA-approved only for treatment of Type 2 Diabetes Mellitus (T2DM). Hardly a day goes by without another headline touting the benefits of new Food and Drug Administration (FDA)-approved injectable weight loss medications. Second, we outlined the correlation between baseline variables and main effects, proposing the influence of dose on weight loss effects and adverse events, further providing direction for clinical individualized medication. Semaglutide, a new once-weekly GLP-1RA, has performed a significant weight loss effect in obese or overweight patients with or without diabetes (Blundell et al., 2017; Ahrén et al., 2018; Kushner et al., 2020; Davies et al., 2021; Kadowaki et al., 2022), and exhibited favorable advantages in reducing obesity complications (Ryan et al., 2020; Kushner et al., 2021). Don't Focus On Kids' Weight Gain. Focus On Healthy Habits Instead Studies with greater sample sizes and longer periods of follow-up are further needed to support the effectiveness of semaglutide. Moreover, some of the abstracted weights were self-reported, which might be not as accurate as clinic measurements (noncalibrated vs calibrated scales). This study has some strengths, including an adequate sample size at 3 and 6 months of follow-up. "I can go about three weeks without the medication before I start to notice my appetite increasing. It’s just been discipline. Knowing how much I should be eating." In 2024, Corona began scaling back on the medication because she felt she wasn't eating enough calories to be able to work out, she explained on TikTok. Corona described the weight-loss process as gradual and still requiring food discipline and regular exercise to work. She plans to keep taking the drug hoping to lose a few more pounds, but if that doesn't happen over time, she says she'll probably discontinue it. With these medications having surged in popularity due to their effectiveness, it is essential for users to weigh the benefits against the potential risks that may affect their vision permanently. The concerns surrounding semaglutide have emerged as its popularity has soared in recent years, particularly among individuals seeking effective weight loss solutions. The results indicate that among this group, 8.9% of semaglutide users developed NAION, contrasting with a mere 1.8% among those using alternative medications. This research could have significant implications for millions of individuals currently using these drugs or considering them as treatment options. The effectiveness and side effects of Ozempic can vary from person to person. Ozempic may cause side effects such as nausea, vomiting, diarrhoea, and constipation. What are the potential side effects of Ozempic? More gradual titration of semaglutide or down-titrating insulin could help mitigate rapid decreases in glucose concentrations and reduce the risk of diabetic retinopathy worsening, though further research is needed. Caution should be taken when using semaglutide in patients with diabetic retinopathy, and retinal screenings should be performed regularly to detect progression of retinopathy. For semaglutide-treated participants without known pre-existing diabetic retinopathy at baseline, the risk of diabetic retinopathy was low and not statistically different than placebo.80 Early worsening of pre-existing diabetic retinopathy was most evident in the initial 16 weeks, during which there was a rapid improvement in glycemic control. Must people remain on weight loss medication for life? As with all medications, potential side effects exist with weight-loss medications. We need more studies to better understand the mechanism and how to best use these drugs for our patients. The new class of weight loss drugs that includes Wegovy and Zepbound work like the gastrointestinal hormones that naturally exist in our body. In many cases, if you have a valid prescription for the drug, insurance will cover at least a portion of the cost. If you feel that the medication is causing or worsening psychological symptoms, talk to your doctor. Like Ozempic, Mounjaro and Zepbound are so new that data on long-term effects isn’t yet available. “Generally, these side effects are seen in the first few weeks of therapy as well as when dosing is increased,” Palinski-Wade says. “At some point, a patient’s body is going to reach a new ‘normal’ and weight loss will plateau.”. “That dose is really just to help a patient’s body get used to the medication.” Weight loss is typically gradual with GLP-1 medications, especially because it can take a few months to get up to the full dosage. This action helps lower glucose without risking severe lows. Ozempic boosts insulin release from the pancreas when blood sugar rises after eating. It supports heart health in some cases too. Ozempic isn’t a standalone fix but part of a broader health plan. This medication falls into the GLP-1 receptor agonist class, mimicking body hormones. Regardless of which brand of semaglutide the celebs are taking, it is important to address the risks and safety concerns that people have around the so-called 'miracle' weight loss drug. A medication called semaglutide, which is sold under different brand names, including Ozempic, approved in 2017 for treating type 2 diabetes, and Wegovy, approved just last year for weight loss. The diabetes medication semaglutide has recently become a trendy weight loss treatment. Health professionals worry this trend might overshadow the drugs’ primary purpose as critical medications for diabetes and obesity. Ozempic has been approved only for type 2 diabetics, and Wegovy has been approved only for patients with a BMI above 30, or 27 if they have a weight-related comorbidity like high blood pressure. That's why some medical providers use the two doses somewhat interchangeably, as obesity and type 2 diabetes are inextricably linked–obesity is the leading risk factor for developing type 2 diabetes. Chao says many insurance companies cover Ozempic for diabetes but don't cover Wegovy for obesity—a prime example of weight bias in health care. Potential Side Effects Adults with uncontrolled type 2 diabetes stand to gain most from Ozempic. Common reactions include nausea, especially when starting or increasing doses. Mental boosts come from achieving health goals steadily. Overall, this medication empowers many toward healthier weights when used wisely. Combined with healthy choices, it aids sustainable loss while managing diabetes risks. Low blood sugar risks rise with other diabetes meds. Off-label use means no set “weight loss dose,” but higher amounts like 2 mg often yield stronger results. One study found people who received weekly semaglutide injections lost an average of about 15 pounds after three months and about 27 pounds after six months, which translates into about a 5-pound weight loss per month. In November 2024, the Biden administration proposed a new rule that would require Medicare and Medicaid to cover weight-loss drugs for people with obesity. People with obesity seeking to lose weight can also turn to Wegovy, which contains semaglutide — the same active ingredient as in Ozempic — and is approved for weight loss. And evidence shows the new class of drugs are far more effective than prior obesity medications. Semaglutide, injected subcutaneously once weekly at doses of 1.0 and 2.0 mg for type 2 diabetes, was well studied in the SUSTAIN clinical trial program. To minimize gastrointestinal side effects, it is titrated up starting at 0.25 mg once a week with dose increases every 4 weeks until the full dose of 2.4 mg is reached. These include its efficacy and safety, as well as its contraindications, potential adverse effects, management of comorbidities and drug interactions, insurance coverage and cost, and patient preferences. In addition, considering the 16-week semaglutide titration schedule and having only 44.0% of the patients in our cohort reach maximal semaglutide doses (ie, 1.7 or 2.4 mg) compared with more than 94% of patients in RCTs,18 weight loss is expected to increase as more patients achieve the maximal doses of this medication. In the STEP 2 trial comparing 1 mg and 2.4 mg of semaglutide for patients with type 2 diabetes, similar weight loss trends compared with those in our study were seen. In one study including 1306 patients taking semaglutide, 2.4 mg, weight loss of approximately 6% was achieved by week 12 and 12% was achieved by week 28.18 Our results reflect similar weight loss outcomes within the same period, particularly for patients taking doses of 1.7 mg and 2.4 mg. Because semaglutide may delay gastric emptying, the absorption of oral medications may be delayed. Patients who were not able to tolerate liraglutide due to gastrointestinal side effects may tolerate longer-acting semaglutide, though studies are needed to examine the effects of switching between agents. Mediation analysis demonstrated that weight loss effects were unrelated to gastrointestinal side effects.74 Permanent discontinuation of medication due to GI side effects was reported by 4.3% of participants on semaglutide. Acute pancreatitis and pancreatic cancer have been a concern of incretin-medications as a class.67 No clear signal linking incretin-based therapies and acute pancreatitis or pancreatic cancer has been identified, though the FDA and EMA have indicated that pancreatitis should be considered a risk with incretin medications until further data are available. In addition, if you use semaglutide or tirzepatide, that doesn’t mean you can forget about following a healthy lifestyle. Dr. Gudzune has patients taking semaglutide and tirzepatide who have reported feeling full on smaller portions, and many describe a reduction in “food noise” (ever-present thoughts about eating and food). If you notice any other effects, check with your healthcare professional. Appropriate studies have not been performed on the relationship of age to the effects of Ozempic® in the pediatric population. Semaglutide injection is also used together with diet and exercise to help lose weight and keep the weight off in patients with at least one weight-related medical condition. Each study has their own diet plan and exercise program for the participants in addition to treatment, which could also have affected the magnitude of the effect estimate. For those with resistant hypertension, studies suggest semaglutide can help reduce reliance on multiple blood pressure medications. Serious risks include pancreatitis, gallbladder issues, or low blood sugar when combined with other diabetes drugs. Once prescribed almost exclusively in endocrinology clinics, semaglutide-based drugs are now widely sought for weight loss, promoted across social media and increasingly accessed through online consultations. It is possible that, in the future, the FDA will approve very small GLP-1 doses to treat conditions for which these drugs are not currently approved, such as type 1 diabetes. Thanks to social media buzz and celebrity claims, Ozempic, the semaglutide-based medication originally designed for type-2 diabetes, has become shorthand for rapid weight loss. Studies back its protective role in high-risk groups. Ozempic primarily helps adults with type 2 diabetes achieve better A1C levels. Off-label prescribing is common in medicine when benefits outweigh risks. This means using it beyond approved indications based on clinical judgment. Doctors sometimes prescribe it off-label for weight concerns. With the growing awareness of Ozempic’s weight-loss capacity, many health care providers began writing their patients off-label prescriptions.¹⁶But, since Ozempic wasn’t made for this purpose, the manufacturer was unprepared for the massive uptick in demand. For Ozempic to become approved as a weight-loss drug, extensive research, and further testing must be done. In separate research known as the SUSTAIN clinical trials (which were also funded and conducted by Ozempic’s manufacturer), participants who took Ozempic experienced weight loss due to improved blood sugar control, reduced appetite, and a decrease in food cravings.¹⁴ These numbers are notable because they’re similar to outcomes in patients undergoing more invasive weight loss measures — like gastric sleeve surgery.¹³ Types of studies and patient characteristics These combined effects help control blood sugar and lead to weight loss, the doctor simplified.Based on 2017–2020 data, the Centers for Disease Control and Prevention (CDC) report that 41.9% of American adults have obesity.²Being an adult with obesity means that your Body Mass Index (BMI) — also known as height to weight ratio — falls outside a healthy range.Distribute protein across meals and include fiber (veggies, beans, whole grains) to tame hunger between doses.• Hydration + electrolytes.Ozempic is generally well-tolerated, but as doses increase, so can the likelihood of experiencing side effects.The efficacy and safety of semaglutide 2.4 mg, once weekly subcutaneous, for chronic weight management was demonstrated in the Semaglutide Treatment Effect in People with Obesity (STEP) program.38 The STEP program is a series of multicenter, phase 3 randomized clinical trials focused on evaluating the safety and efficacy of semaglutide 2.4 mg as a weight loss medication in patients with obesity (or a BMI of ≥27.0 kg/m2 with at least one cardiovascular disease risk factor).While reducing daily calorie intake and increasing daily calorie output are important for weight reduction, they do not go far enough in managing obesity.These tools empower healthier lives when used wisely.Another trial, published in the medical journal Lancet, only included overweight or obese people with type 2 diabetes.So why all the publicity lately, and what should you know about this prescription-only medication? Patients should “make sure that they're focusing on a healthy dietary pattern, reducing calories, as well as increasing physical activity,” she says. Still, she recommends trying those approaches before turning to medication. Seventy-five percent of the U.S. population is overweight or obese. The FDA approved semaglutide for weight management in 2020 under the name Wegovy; however, the brand Ozempic is not FDA-approved for weight loss (only diabetes management). They can only prescribe and dispense Ozempic for its intended use (treatment of type 2 diabetes) and must stop prescribing it for weight loss until health agencies officially clear it.¹⁷ With the introduction of the first FDA approved weight loss medication in 2012, we began to address the underlying physiology of obesity. It plays a key role in regulating blood sugar levels. Over time, the dose may increase based on response and needs. Users typically start with lower doses to build tolerance. It’s manufactured by Novo Nordisk, a company focused on diabetes care. The medication falls under the category of GLP-1 receptor agonists. It signals to the brain that you’ve had a meal, so patients have reduced appetite, and when they do eat, they feel full sooner. Semaglutide is a synthetic version of a hormone known as GLP-1, which the body releases into the intestine when people eat food, as TODAY.com previously reported. Wegovy doses go up higher, up to 2.4 milligrams weekly, versus 2 milligrams maximum for Ozempic. Possibly—many people see improvements and require less medication.If a patient on a high dose of semaglutide cannot fill their prescription for a large injection pen due to a shortage, they may fear that they will have to go back to square one, the smallest starter dose, and lose months of progress.The cost-effectiveness of semaglutide is unclear, though one recent study demonstrated that semaglutide, relative to no treatment, diet and exercise alone, and other anti-obesity medications, was cost-effective at the willingness-to-pay threshold of $150,000 per quality-adjusted life year over a 30-year horizon.89 As part of the shared decision-making process, insurance coverage and out-of-pocket expenses should be discussed openly with patients.A landmark placebo‑controlled trial reported mean losses approaching the mid‑teens (% body weight) at 68 weeks on 2.4 mg weekly, illustrating the upper end of what the class can achieve when maximally dosed and supported (note that this differs from Ozempic’s lower diabetes doses).But the fact that people may need to stay on Wegovy indefinitely in order to maintain the weight loss has raised concerns about long-term use.“They could definitely have a lot of poor side effects, because they didn't titrate up to that level yet,” Godwin says.Most users experience mild gastrointestinal side effects when starting Ozempic, such as nausea, vomiting, diarrhea, or constipation.More recently, Mounjaro and Zepbound — both poised to possibly have even bigger health impacts — were also approved by the FDA.Ozempic suits adults with BMI over 27 and weight-related conditions, or over 30 without. If Ozempic isn’t suitable, consider Wegovy, the same drug approved specifically for weight loss. Microdosing isn’t nearly as easy with tirzepatide (Mounjaro and Zepbound), another blockbuster diabetes and obesity drug in the same family as semaglutide, because it comes in a pen that does not allow for click counting. Individuals considering or currently taking semaglutide medications should prioritize conversations with their healthcare providers and remain proactive in monitoring their health. If side effects persist, dose adjustments or alternatives might be considered. Like any medication, Ozempic can cause side effects. Improved cardiovascular health markers, like lower blood pressure, are common. In studies, participants lost an average of 15-20% of body weight over a year. In summary, among individuals with obesity without T2DM, subcutaneous semaglutide is effective for weight loss with an 11.85% reduction from baseline compared to placebo. Since obesity has been increasing in prevalence worldwide and can cause serious complications like cardiovascular disease and diabetes,2,3 safe and acceptable treatments for this condition are crucial to prevent further health complications. However, it is important to consider that the Rubino study randomized participants to continue with semaglutide treatment or placebo after the target dose was reached. The very low-calorie intake as well as increased minutes of physical activity in Wadden et al.’s study may have resulted in more weight loss especially in the placebo group, causing a smaller mean weight difference compared to the other studies. Owing to high insurance denials and the national shortage of semaglutide, we subsequently excluded those patients from the analysis. We excluded patients with a history of bariatric procedures (ie, surgical or endoscopic), taking other FDA-approved AOMs, or with an active malignant neoplasm or pregnancy. We performed a retrospective review of the electronic medical records (EMRs) of patients in the Mayo Clinic Health System using semaglutide between January 1, 2021, and March 15, 2022. Hydration helps manage side effects and supports metabolism. Starting weight influences how quickly pounds come off; heavier folks may see faster initial drops. Regular check-ins ensure the dose aligns with progress. Hamilton's doctor prescribed Wegovy because she had an elevated BMI, high blood pressure and elevated blood sugar.Patients with type 2 diabetes often have impairments in insulin, a hormone that helps break down food and convert it into fuel the body can use, Chao says.Hardly a day goes by without another headline touting the benefits of new Food and Drug Administration (FDA)-approved injectable weight loss medications."If this risk was carried over millions of users, those affected could end up being a sizable group of patients," VanderBeek noted.Factors like starting weight, dose, and habits influence results greatly.But the authors of both papers said they can't determine if the antidiabetic drugs cause eye complications until large clinical trials are done.Regardless of which brand of semaglutide the celebs are taking, it is important to address the risks and safety concerns that people have around the so-called 'miracle' weight loss drug.For some, however, the side effects may outweigh the benefits. By activating the GLP-1 receptor, GLP-1RA enhances insulin secretion and inhibits glucagon secretion to lower blood glucose, ingeniously suppressing appetite, increasing satiety, and delaying gastric emptying, thus achieving weight reduction (Torekov et al., 2011; Monami et al., 2012; Lee 2021). Since then, GLP-1RA has created a new field for obesity treatment (Zhang et al., 2015; Christensen et al., 2019; Ryan et al., 2021). Semaglutide exhibited a positive effect on blood pressure, C-reactive protein, and lipid profiles, expressed more adverse effects than placebo, mainly gastrointestinal reactions. The risk of hypoglycemia is low overall but increases when semaglutide is combined with diabetes medications known to cause hypoglycemia such as sulfonylureas, meglitinides and/or insulin therapy. In a weight loss maintenance trial with liraglutide 3.0 mg/day, the effect of the medication on increasing heart rate was attenuated when liraglutide was combined with a moderate-to-vigorous-intensity exercise program.77 Encouraging moderate-to-vigorous-intensity exercise combined with semaglutide may help to mitigate increases in heart rate and improve cardiorespiratory fitness, but studies are needed to examine the efficacy of this strategy. The 13.2% initial weight loss of patients treated with semaglutide 2.4 mg in this trial was slightly lower than the 14.9% weight loss in STEP 1, though STEP 1 did not include participants with type 2 diabetes who tend to have smaller weight losses. Sustained clinically meaningful weight loss is a major goal in preventing the progression of diabetes and other obesity-related complications (Sharma and Garber, 2009). Once you start taking weight loss medications, you’ll likely need to stay on them to maintain results. “For people who have not had success with lifestyle alone or have been previously unsuccessful with other medications, these medications offer a new option that may support their health goals,” Gudzune says. Here’s what experts say about research on the effectiveness of semaglutide (Ozempic, Wegovy) and a similar GIP/GLP-1 medication, tirzepatide (Mounjaro, Zepbound) and when to consider them for weight loss. “If patients are unable to obtain their medication for a period of time due to a supply shortage, it’s always better to stay on whatever dose they can, instead of stopping the medication completely,” Dr. Saunders says. Experts say that there are several legitimate reasons why people using semaglutide might want to microdose. Some people who take Ozempic (semaglutide) are using a method called “counting clicks” or microdosing to get a little more or less medication in each shot than the standard amount measured out by the injection pen. Rapid weight loss can often lead to muscle loss if not accompanied by balanced nutrition and strength training, resulting in diminished strength and other health issues. Without sustainable dietary habits and healthy routines established alongside medication, weight can return and sometimes overshoot previous levels. Pregnancy is a contraindication for use of semaglutide, and semaglutide should be discontinued at least 2 months before a planned pregnancy due to the long half-life. Caution also should be used in patients with a history of hypersensitivity to other GLP-1RAs. Patients should be informed that it is unknown whether semaglutide causes thyroid C-cell tumors, including medullary thyroid carcinoma in humans. Many of the contraindications and adverse events of semaglutide are shared among other GLP-1RAs, including liraglutide; however, there are differences in occurrence and severity as further detailed below. The medication’s efficacy in improving self-reported appetite and in reducing objectively-measured energy intake may reduce the need for traditional behavioral counseling to support changes in these behaviors. Used as a shortcut—a pharmaceutical override of hunger—it risks compounding the very deficiencies that drive chronic disease. Medicine is replete with examples of treatments that worked—until they didn’t. When weight is lost without interrogating these factors, the underlying pattern remains. The medication should be discontinued promptly if pancreatitis is suspected, and the patient should be referred for further evaluation and treatment. Patients prescribed semaglutide should be advised about potential side effects that may occur and provided guidance on how to mitigate these side effects. Patients should seek medical treatment and discontinue the medication if they develop a serious hypersensitivity. However, the clinical significance of anti-semaglutide antibodies appears to be low in most people. GLP-1RAs, including semaglutide, are protein-based molecules and are thus potentially immunogenic.23,66 Antibodies can increase risk of local or systemic hypersensitivity. "What the pharmaceutical companies have done is taken this hormone that is naturally occurring and restructured it into a drug," he explains. Wegovy's active ingredient — semaglutide — is a GLP-1, or glucagon-like peptide-1, which mimics the GLP-1 satiety hormone in our bodies. "I'm very frustrated about the weight coming back on in so little time," Hamilton says. And, after a few months of not taking the drug, she has gained back 20 pounds. She now works in a hospital ER registering patients, which requires her to sit most of the day. However, what’s often overlooked, and Nagpal stressed this, is that without balanced nutrition and strength training, weight loss also strips muscle. Appetite suppression helps weight loss, but when hunger plummets too far, the body pays a price. Experts warn that ozempic is a medical aid, and not a lifelong fix or a shortcut to health. As the landscape of obesity management continues to evolve, the emergence of new findings like those presented in the JAMA Ophthalmology study underscores the importance of ongoing research in the field. Staff should also educate patients on the signs and symptoms of NAION to foster a better understanding of the potential risks involved. A concise summary of one‑month Ozempic results also notes ~2 kg by month two and explains how dose escalation shapes early outcomes.• 3 months.The 13.2% initial weight loss of patients treated with semaglutide 2.4 mg in this trial was slightly lower than the 14.9% weight loss in STEP 1, though STEP 1 did not include participants with type 2 diabetes who tend to have smaller weight losses.Second, previous studies based on semaglutide in obese patients with or without diabetes had been published, potentially affecting the innovation of our research; thus, some other aspects were discussed, such as the narrowing of patients, the specific dose of semaglutide, and the potentially beneficial effects on cardiovascular disease.It may also cause some people to have suicidal thoughts and tendencies or to become more depressed.A comprehensive systematic search of PubMed/MEDLINE, Cochrane and Google scholar was performed from inception to June 2021 to identify publications in the English or foreign language with adequate English translations on semaglutide versus placebo and other GLP-1 RAs for weight loss in obesity without T2DM.These typically lessen with time and dose adjustments. The rebound weight gain is not a surprise given how the medication works. "Weight-loss drugs like Wegovy may be covered, depending on the member's benefit plan," a spokesperson for the company said. And when people stop taking it, there's often rebound weight gain that's hard to control. But at a cost of about $1,400 a month — out of pocket when insurance doesn't cover it — many people can't afford to stay on the medication for the long term. There's been such an increase in demand that an FDA database lists the medication's active ingredient, semaglutide, as "currently in shortage." Its manufacturer, Novo Nordisk, says keeping supplies stable is a priority. Ozempic has gained attention for its potential positive effects on heart health beyond just glucose control. High blood pressure, or hypertension, often occurs alongside type 2 diabetes, creating extra strain on the heart and blood vessels. Ozempic, known generically as semaglutide, is a once-weekly injection primarily used to manage type 2 diabetes. Off-label use for weight loss depends on individual evaluation. Buying from unverified sources risks health. Users report 5-15% body weight drops in trials focused on diabetes. Similar drugs like Wegovy fill that gap with targeted approvals. Ozempic met standards for diabetes but not standalone weight management. The agency reviews drugs for specific conditions with strict data requirements. Ozempic is a brand-name prescription drug made by Novo Nordisk for adults with type 2 diabetes. As STAT reported last week, the Moffitt Cancer Center in Florida is lobbying for legislation that would allow Medicare to pay for obesity drugs, citing the link between obesity and cancer risk. Medicare does not cover Wegovy or other weight loss drugs, and many insurers follow Medicare's lead. But, the drugs aren't intended for cosmetic weight loss. Ozempic can be a powerful part of diabetes and weight loss treatment — but it requires careful medical oversight, patient education, and insurance navigation. Ozempic, known generically as semaglutide, is a once-weekly injection primarily used to manage type 2 diabetes.Weekly 1.7-mg or 2.4-mg semaglutide subcutaneous injections for 3 to 6 months.But how much weight can you really lose on Ozempic or Wegovy?Both Ozempic and Wegovy can cause side effects like nausea, dehydration, fatigue, malaise, and changes in bowel movements.O’Neil, Wilding and Rubino et al.’s studies each mentioned that death was reported during the trial period, but was not considered to be related to semaglutide or placebo treatment.As STAT reported last week, the Moffitt Cancer Center in Florida is lobbying for legislation that would allow Medicare to pay for obesity drugs, citing the link between obesity and cancer risk.Food and Drug Administration (FDA) for use in adults with type 2 diabetes. Subsequently, eight studies involving 4,567 participants (Wilding et al., 2021; Wadden et al., 2021; Rubino et al., 2021; Rubino et al., 2022; O'Neil et al., 2018; Friedrichsen et al., 2021; Hjerpsted et al., 2018; Jensterle et al., 2021) were included in the meta-analysis. The remaining 28 studies were reviewed in full text, excluding trial registration records, duplicates of reporting, and non-English literature. A total of 474 studies were preliminarily retrieved from the databases, among which 55 were from ClinicalTrials. The fixed effect model was used when there was no statistical heterogeneity in the included studies (Ⅰ2 ˂ 50% and p ˃ 0.10); otherwise, the random effect model was represented (Ⅰ2 ≥ 50% or p ˂ 0.10) (Chen and Benedetti, 2017). When merging statistics, continuous data were performed as the mean difference (MD) to express effect size, while dichotomous data were adopted as the risk ratio (RR), and 95% confidence intervals were used for interval estimation correspondingly. While some choose to offset these side effects with fillers, multiple celebrities have fallen victim to dramatically different faces after openly trying GLP-1s. "When we get older, definitely the facial volume changes and shifts around. When you lose weight so acutely and quickly ... we're seeing these types of changes in their face where it's actually making them look older," he added. We work with experts and keep a close eye on the latest in health and wellness. Tenzin is a health and lifestyle journalist with six years of experience covering fitness, nutrition, mental health, and evolving wellness trends. Her remarks arrive at a moment when semaglutide drugs are under intense clinical and public scrutiny. Staying informed about potential risks not only empowers patients but can also lead to safer treatment decisions. Furthermore, healthcare professionals are encouraged to monitor their patients closely, especially those with other risk factors that might compound the likelihood of developing NAION. It’s crucial to assess individual health profiles, weigh the potential benefits of the medications, and remain vigilant for any signs of vision changes. The rarity and long-term timeline of these events require larger-scale, longer-duration, randomized clinical trials designed to assess the effects of semaglutide on the thyroid system.These medications act on several areas of brain involved in weight regulation.These medications mimic a hormone called GLP-1, which helps to regulate appetite and blood sugar.The major source of heterogeneity was with the dose of semaglutide.Ozempic is a medication approved to help manage type 2 diabetes.Genetic differences influence how strongly the drug works.Finney encourages his patients to eat small meals slowly and avoid heavy or greasy foods to minimize nausea, and to pick fiber-rich foods and drink plenty of water to reduce constipation.Studies have demonstrated the impact of GLP-1 drugs on reducing appetite. Furthermore, the studies included the weight for participants who were lost to follow-up and this could have affected the mean percent weight difference. However, since the trials were all done within a specified follow-up period, it is difficult to predict whether there will be weight gain following discontinuation of treatment, and whether continuous treatment will be necessary. The subjects of the trials all had at least one unsuccessful non-surgical attempt to lose weight, and based on this meta-analysis, a 5 to 10% weight reduction could be achieved with semaglutide. They also have 27% more physician visits, outpatient costs and 80% higher expenses on prescription medications.14 Stay hydrated and avoid alcohol to lessen risks. Long-term use requires monitoring for thyroid tumors based on animal studies. More serious issues, though rare, involve gallbladder problems or low blood sugar. The maximum for off-label weight use often reaches 2 mg. After four weeks, doses may rise to 0.5 mg, then higher if tolerated. Many users share stories of steady progress that improves daily life and health markers. Published in Annals of Internal Medicine, the study was led by Dr. Mark Eisenberg’s lab at The Lady Davis Institute for Medical Research at the Jewish General Hospital. Hashmi founded the nonprofit organization SelfPrinciple.org to provide accessible and accurate health, nutrition, and wellness information to the public. I get this question a lot from patients and providers. This is what we aim for with Penn State Health’s lifestyle program for obesity, Digital Weight Management. In Wegovy trials, participants most commonly reported gastrointestinal side effects along with headache and fatigue. Underlying conditions such as thyroid issues or medications can slow progress. While effective for diabetes, weight reduction often occurs as a secondary outcome. Factors like starting weight, dose, and habits influence results greatly. Novo Nordisk stands behind the safety and efficacy of all its GLP-1 medicines when they’re used as indicated and taken under the care of a licensed health care professional, it says in a statement to TODAY.com. “There’s a concern that maybe they’ll have some effect that we just don’t know in the long term,” Hari told TODAY.com, echoing a worry other patients may have. In the fall of 2025, Novo Nordisk, the pharmaceutical company that makes them announced a steep discount for select doses. For a more extensive understanding of the impacts and safety profiles of diabetes and weight loss medications, readers can visit the Centers for Disease Control and Prevention (CDC) for reliable statistics and insights. However, as these drugs become more commonplace, healthcare professionals and patients alike must stay informed about their potential risks. Recent research has raised serious concerns regarding the safety of two widely prescribed medications, Ozempic and Wegovy, which are primarily utilized for managing diabetes and weight loss respectively. Wegovy is a once-weekly injection approved by the FDA in 2021 for chronic weight management. Ozempic has a smaller dose of semaglutide than Wegovy. Ozempic, known generically as semaglutide, was approved in 2017 by the U.S. There is a FDA-approved semaglutide weight loss medication called Wegovy®. In the STEP‑1 extension, people who discontinued 2.4 mg semaglutide after 68 weeks regained about two‑thirds of their prior weight loss over the next year, underscoring obesity’s chronic nature and the need for an ongoing plan. In diabetes‑focused trials, higher weekly doses of semaglutide tend to produce greater weight reductions, with the 2.0 mg strength outperforming 1.0 mg and 0.5 mg once people reach and tolerate maintenance. Studies show average weekly losses of 1-2 pounds at maintenance doses. If needed, dose goes to 1 mg weekly after that period. Treatment starts at 0.25 mg weekly for four weeks to ease into side effects. Clinical data highlights its role in reducing risks like heart events alongside slimming down. Five studies (Wilding et al., 2021; Wadden et al., 2021; Rubino et al., 2021; Rubino et al., 2022; O'Neil et al., 2018), including 4,424 individuals, displayed the proportion of participants who achieved weight loss of more than 5, 10, 15, and 20%. Subgroup analyses of RBW and ABW changes between semaglutide and placebo based on specific doses were carried out, as shown in Supplementary Tables S4, S5, indicating that the higher the dose, the better the body weight reduction effect. Meta-analysis results revealed the weight loss in semaglutide ranged from 5.16 to 16.40% (5.20–17.36 kg), while the placebo ranged from 0.38 to 5.70% (0.40–6.20 kg) (Figure 4, Supplementary Figure S6, Supplementary Table S3). Meanwhile, a 2025 study found GLP-1 drugs, including semaglutide, “probably have little or no effect” on a person’s risk of developing obesity-related cancers. Additional studies also are needed that test head-to-head comparisons of weight loss medications. New medications such as tirzepatide, a “twincretin” that combines GLP-1 and glucose-dependent insulinotropic polypeptide receptor agonism, have shown weight losses of 20.9% of initial weight loss91 and even greater weight losses than semaglutide.92 Tirzepatide is being tested in the phase 3 SURMOUNT clinical trial program. Our cohort experienced a wide range of weight loss responses to semaglutide at 3 and 6 months (eFigure 2 in the Supplement). Of 102 patients who were followed up for 6 months, 89 (87.3%) achieved weight loss of 5% or more, 56 (54.9%) achieved weight loss of 10% or more, 24 (23.5%) achieved weight loss of 15% or more, and 8 (7.8%) achieved weight loss of 20% or more (Figure 2). In our cohort of 175 patients, 94 (53.7%) had weight loss of at least 5% and 26 (14.9%) had weight loss of 10% or more at 3 months. At 3 months, 175 patients achieved a mean (SD) weight loss of 6.7 (4.4) kg, equivalent to a mean (SD) weight loss of 5.9% (3.7%) (P P Figure 2). Our secondary end points included the percentage of patients who achieved a categorical weight loss of 5% or more, 10% or more, 15% or more, and 20% or more. Among individuals with obesity without T2DM, how effective and safe is semaglutide for weight loss? A comprehensive search of PubMed/MEDLINE, Cochrane and Google scholar was performed to identify trials on the efficacy and safety of subcutaneous semaglutide on patients with obesity without diabetes. Before he'll write a prescription for a weight-loss drug, Khan talks with patients to find out how seriously they've taken their previous weight-loss attempts, and he discusses the financial burden and potential side effects—including the possibility of needing to stay on the drug for life. Even when patients experience rapid weight loss, it happens without addressing the actual root causes of obesity. It's been dubbed as "nature's Ozempic" by some, due to its potential effects on blood sugar and weight loss. “To help decrease the rebound weight gain, people can continue the lifestyle changes that they hopefully learned while taking semaglutide,” Washington says. "These medications are a tool when it comes to weight management, not a quick fix or a cure.” Palinski-Wade says this is likely to be the reality for tirzepatide drugs as well as semaglutide. There were 408 prescriptions of subcutaneous injections of semaglutide between January 1, 2021, and March 15, 2022, at the Mayo Clinic Health System. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline. Weekly 1.7-mg or 2.4-mg semaglutide subcutaneous injections for 3 to 6 months. “If a patient does need to stop semaglutide, it is really important to make sure that her lifestyle changes are optimized,” Dr. Garcia Webb says. If you do need to stop taking Ozempic or Wegovy, be vigilant about diet and exercise to avoid regaining the weight you lost in the long term. It can interact with drugs affecting blood sugar or digestion. Ozempic excels at stabilizing blood glucose, which indirectly supports weight loss. In people with type 2 diabetes or obesity, GLP-1 levels might not function optimally. This shift highlights a growing trend in using medications to support long-term health goals. Extrapolating across the results of STEP 1 and STEP 3, the addition of IBT appeared to increase the rate of weight loss with semaglutide during the first 12–16 weeks, but this combination was no more effective at week 68 than semaglutide combined with the less intensive (and less costly) diet and activity counseling provided in STEP 1. Participants who received IBT combined with semaglutide 2.4 mg lost 16.0% of body weight at week 68 and achieved significantly greater improvements in multiple measures of cardiometabolic risk than the placebo-treated group. The average placebo-subtracted weight loss for semaglutide was 12.7 kg.21 Semaglutide has generated much scientific, clinical, and public excitement and interest given these large weight losses. Semaglutide at a dose of 2.4 mg administered as a once-weekly, subcutaneous injection, was approved for chronic weight management by the FDA in 2021, by the UK Medicine and Health Products Regulations Agency in 2021, and by the European Medicines Agency’s Committee for Medicinal Products for Human Use in 2022. Will I need to change my blood pressure medications while on Ozempic? This happens mainly through weight loss, but some effects may be direct. Ozempic is generally safe and often beneficial for people with high blood pressure, particularly those with type 2 diabetes. Your doctor may adjust hypertension medications if blood pressure improves. These combined effects support long-term heart health for those managing diabetes and hypertension. Without these supports, the results may look quick, but they are unlikely to last, or feel truly healthy. When treatment stops, appetite often floods back. Semaglutide’s action, delaying gastric emptying and curbing hunger, frequently causes nausea, bloating and low energy early in treatment. In vulnerable people, prolonged nutrient inadequacy can influence energy levels, mood and overall metabolic balance. Dr Nagpal says that while it may have certain benefits, one cannot ignore the side-effects. What should I do if my blood pressure changes while taking Ozempic? No evidence from trials or prescribing information shows Ozempic causing high blood pressure. Never adjust doses yourself; your doctor will monitor and make changes based on regular checks. Ozempic often leads to modest reductions in blood pressure, around 2-5 mmHg systolic. While reducing daily calorie intake and increasing daily calorie output are important for weight reduction, they do not go far enough in managing obesity. More than half of the participants in Wegovy research trials achieved 15% weight loss and one third achieved 20% or greater. In addition to weight loss, what other benefits does Wegovy provide? Here, Soleymani discusses these medications and provides context and clarity around how they work and how they’re used and prescribed. Call your doctor for medical advice about side effects. Some side effects may occur that usually do not need medical attention. Although not all of these side effects may occur, if they do occur they may need medical attention. Along with its needed effects, a medicine may cause some unwanted effects. If you or your caregiver notice any of these side effects, tell your doctor right away. Despite these confounding factors, we still believe that semaglutide is a major factor in weight reduction because the subjects all attempted to lose weight prior to starting treatment but were unsuccessful. Hence, semaglutide alone probably will not be able to achieve an 11.85% weight loss. This could have affected the results because participants could have lost weight with initial treatment with semaglutide.