Ozempic for Weight Loss

Are you considering starting Ozempic to help you lose weight? Scroll down to learn more about Ozempic and see if it is the medication for you.

What is Ozempic?

Ozempic is a prescription medication that is FDA-approved for treating type 2 diabetes in adults. It contains semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist. It is also used off-label to help with weight loss in people who are struggling with obesity.

How Does Ozempic Work?

As mentioned, Ozempic uses Semaglutide as its active ingredient, similar to other brand-name medications like Wegovy and Rybelsus. Semaglutide belongs to a class of drugs called GLP-1 receptor agonists, which mimic the effects of the naturally occurring hormone GLP-1.

GLP-1 stands for "glucagon-like peptide-1," a hormone naturally produced in the human body. It is secreted by the cells in the intestines in response to food intake and helps to regulate blood sugar levels by stimulating insulin secretion from the pancreas. GLP-1 also slows down the digestion process, reduces appetite, and promotes feelings of fullness, which can help with weight management

Along with regulating insulin secretion and appetite, there are also anti-inflammatory effects. There are GLP-1 receptors in a multitude of organs. When activated, they lead to a decrease in the amount of pro-inflammatory receptors and an increase of anti-inflammatory cells in the body. This anti-inflammatory effect may benefit from reducing the risk of atherosclerosis (plaque formation in the arteries) and improving cardiovascular conditions (1).

This may also open avenues for using Ozempic in other inflammatory conditions such as arthritis, polycystic ovarian syndrome, and psoriasis. However, more studies are needed to say for sure.

Who Qualifies for Ozempic?

Ozempic is currently FDA-approved for the treatment of type 2 diabetes. Therefore, if you are diagnosed with type 2 diabetes, you may be eligible to start either Rybelsus or Ozempic. It is also used off-label for obesity. If you have a BMI greater than 30 or a BMI greater than 27 and have an obesity-related condition (diabetes, hypertension, dyslipidemia), you may be eligible to take Ozempic

Due to the weight loss and anti-inflammatory effects, Ozempic may also be used in patients with Polycystic Ovarian Syndrome (PCOS). A narrative review of evidence published in 2021 reviewed over 800 articles and found that there may exist a promising therapeutic role of GLP-1 agonist medications, like Ozempic, in managing PCOS (2). However, more extensive clinical trials are needed to establish a possible role.

The weight loss effects may also benefit other weight-related conditions such as high cholesterol, high blood pressure, and obstructive sleep apnea. You may be eligible for Ozempic if you have one of these conditions and are struggling with obesity. Call your insurance provider if you qualify based on these conditions.

Can Ozempic Be Used for Weight Loss?

Ozempic has been shown to have weight loss benefits when studied in people with type 2 diabetes. These benefits can extend to those who do not have diabetes. It is always important to remember that you should also be dieting and exercising regularly while taking Ozempic. The best results in all trials involving Ozempic were seen when people exercised regularly on a calorie-restricted diet (150 minutes/week of moderate exercise). Moderate exercise is any exercise that gets you actively sweating or increases your heart rate (running, long walks, weight lifting, resistance training, etc.).  

The most popular trial for Ozempic was the SUSTAIN-6 trial published in 2016, which showed that participants receiving weekly Ozempic (semaglutide) lost an average of 3-5 kg (8-11 lbs) after two years (3). It is important to note that the participants were not enrolled in a diet and exercise program. Therefore, dieting and exercising regularly may lead to a more substantial weight loss effect when paired with Ozempic.

Ozempic vs Other GLP-1 Medications

Ozempic vs Mounjaro

Mounjaro (Tirzepatide) is a new dual-action GLP-1 and GIP agonist medication used to treat type 2 diabetes. It has gained a lot of popularity in its off-label use for obesity. It is slightly different from semaglutide since it also works on the GIP (Gastric Inhibitory Peptide) receptors in the body, which increases the effectiveness of GLP-1. Mounjaro is also given as a once-weekly injection.

When Mounjaro was compared to Ozempic in the management of type 2 diabetes, researchers found that tirzepatide had a more significant effect on weight loss at all doses when compared to Ozempic (4). Higher doses of Mounjaro showed more significant changes in body weight and BMI. It should be noted that these participants were not enrolled in a diet and exercise program. Therefore, an even greater weight loss effect may be seen with either of these medications if supplemented with a calorie-restricted diet and regular exercise (~150 minutes/week).

Ozempic vs Trulicity

Dulaglutide is another type of GLP-1 agonist medication sold under the name Trulicity. It is currently FDA-approved for the treatment of type 2 diabetes and to prevent heart problems in people with type 2 diabetes. It can be used off-label in the treatment of obesity. It is also given as a once-weekly injection.

In a study published in 2018 called the SUSTAIN-7 trial, Ozempic was compared to Trulicity in treating type 2 diabetes. They also measured the effects on weight loss. This large clinical trial lasted around 40 weeks and involved over 100 hospitals worldwide. At the end of the study, participants taking Ozempic lost around 4.6 kg (~10 lbs), while participants taking Trulicity lost 2.3 kg (~5 lbs)(5). Larger doses of either medication showed greater changes in body weight. This shows that Ozempic may lead to slightly more weight loss than Trulicity. It should be noted that the participants were not enrolled in a diet and exercise program, so there may be a more substantial change in body weight if this is supplemented as well.

Ozempic vs Victoza

Victoza is another GLP-1 agonist medication with the active ingredient, Liraglutide. Like Ozempic, it treats type 2 diabetes and can be used off-label for weight loss. It is a once-daily pen injection, which is different from Ozempic.

In a meta-analysis published in 2021, researchers compared nine published studies on Ozempic and Victoza when treating type 2 diabetes. One of the things they compared was changes in body weight (6). They found that the studies suggest that Ozempic had a more significant effect on weight loss than low-dose Victoza. However, the weight loss difference was similar at larger doses of Victoza. Ozempic, however, was better at managing diabetes. Ultimately, Ozempic may be better for weight loss than Victoza, but it depends on the dose of Victoza that is given. Ozempic may be better for some patients since it is a once-weekly injection instead of a once-daily injection for Victoza.

Ozempic Side Effects

The most common side effects when taking Ozempic are gastrointestinal, but there are other commonly reported side effects. This includes:

• Abdominal pain
• Nausea
• Vomiting
• Diarrhea
• Constipation
• Headache
• Sore throat, or throat pain

The side effects are usually only mild to moderate in severity and go away over time

Ozempic Dosage and Administration

Ozempic is a once-weekly pen injection that is also started at 0.25 mg. After four weeks, the dose will be increased to 0.5mg. The dose can be increased to 1mg or to a maximum of 2 mg after every four weeks.

Ozempic can be injected into the abdomen, thigh, or upper arm. Make sure to rotate the injection locations with each dose. It can be taken with or without a meal. If you miss a dose, take it at least two days after the original due date. If it's been over two days, skip the dose and wait for the next dose. Do NOT double the dose!

Ozempic Contraindications and Warnings

Pancreatitis

Pancreatitis occurs when the pancreas becomes inflamed. This is an infrequent but potential side effect of Ozempic. If you have a history of pancreatitis, please inform your provider before starting Ozempic.

Hypoglycemia (Low Blood Sugar)

Since Ozempic increases insulin secretion, there is a risk that your blood sugar can be lowered to dangerous levels. This is known as hypoglycemia. If you have a history of hypoglycemia or are currently using insulin, you must inform your provider before starting Ozempic.

Serious Allergic Reaction

You may experience a severe allergic reaction to Ozempic when first taking it. Signs of a severe allergic reaction include swelling of your face, lips, tongue, or throat, problems breathing or swallowing, severe rash or itching, fainting or feeling dizzy, and very rapid heartbeat. Let your provider know immediately if you have experienced this with other GLP-1 medications or are currently experiencing this when taking Ozempic.

Kidney Disease

Though Ozempic is safe for people with kidney disease, the stomach problems associated with Ozempic may lead to fluid loss by vomiting, nausea, or vomiting. If you do have kidney problems, it is essential to stay hydrated while on Ozempic. If the gastrointestinal side effects of Ozempic are preventing you from adequately staying hydrated, then let your provider know immediately.

Severe Stomach Problems

The most common side effect of Ozempic is gastrointestinal upset, which includes stomach ache, nausea, diarrhea, vomiting, and loss of appetite. If these symptoms become so severe that they significantly affect your daily life or ability to eat regularly, then let your provider know.

Changes in Vision

For patients with a history of diabetic retinopathy, there is a chance that your vision can worsen when taking Ozempic. If you do have a history of diabetic retinopathy, then let your provider know before starting Ozempic.

Gallbladder Disease

Ozempic can cause gallbladder issues and other gastrointestinal side effects. Since Ozempic can decrease food movement through the gastrointestinal system, it can also reduce the gallbladder's function. This can lead to gallstone formation, which can block the release of bile, leading to the inflammation of the gallbladder.

If you have a history of gallstones or cholecystitis (inflammation of the gallbladder), then let your provider know before starting Ozempic. If you have had your gallbladder removed in the past, then you can still take Ozempic.

Thyroid Cancer or Family History of MEN-2

Though very rare, there is a risk of developing a specific type of thyroid cancer when taking Ozempic, called Medullary Thyroid Cancer. If you have a history of medullary thyroid cancer or a family history of Multiple Endocrine Neoplasia Cancer Syndrome Type 2 (MEN-2), let your provider know before starting Ozempic. MEN-2 is a genetic cancer syndrome that puts a patient at risk for developing Medullary Thyroid Cancer, so patients with this syndrome should avoid taking Ozempic.

Pregnancy

The use of Ozempic in pregnant patients is not well studied. Studies in pregnant rats do show an increased risk for miscarriage and structural abnormalities when rats were given semaglutide (the active ingredient in Ozempic). The current recommendations are not to take Ozempic during pregnancy.

Ozempic Coverage and Cost

The cost of Ozempic can be costly. Ozempic can range from $900-950 for a month’s supply.

Therefore, you should discuss which medication your plan covers with your insurance provider or if you qualify for any benefit plans.

Depending on your insurance plan, you may be eligible for an Ozempic Savings Card, where you can pay as little as $25 for a 1,2, or 3-month prescription. Around 92% of commercial insurance plans cover Ozempic, so your plan can help with the costs. You may also be eligible for the Patient Assistance Program offered by NovoCare, where you may receive Ozempic for free!

Where Can I Get Ozempic?

If you want to learn more about GLP-1 medications or see if you might be eligible for medication-assisted weight loss, check out Mochi Health, where board-certified obesity medicine physicians can offer expertise in this realm!

Mochi Health is a virtual obesity medicine practice that connects you with medical providers, like licensed physicians and nurse practitioners, to help you optimize your weight loss journey. We provide monthly video chats with actual medical providers to provide guidance about weight management and to get you started on prescription weight loss medications to supplement your weight loss plan.

Frequently Asked Questions

Check out our Mochi Health Blogs to learn about different topics on weight loss medications.

‍Who should avoid taking Ozempic?

‍What is the best diet while taking Ozempic?

‍Can Ozempic lower my blood sugar?

‍Does Ozempic cause thyroid cancer?

‍Can Ozempic prevent me from having babies?

Get started at Mochi Health today!

References

1. Jensen JK, Binderup T, Grandjean CE, Bentsen S, Ripa RS, Kjaer A. Semaglutide reduces vascular inflammation investigated by PET in a rabbit model of advanced atherosclerosis. Atherosclerosis. 2022 Jul;352:88-95. doi: 10.1016/j.atherosclerosis.2022.03.032. Epub 2022 Apr 4. PMID: 35400496; PMCID: PMC9241989.
2. Abdalla MA, Deshmukh H, Atkin S, Sathyapalan T. The potential role of incretin-based therapies for polycystic ovary syndrome: a narrative review of the current evidence. Ther Adv Endocrinol Metab. 2021 Jan 27;12:2042018821989238. doi: 10.1177/2042018821989238. PMID: 33552465; PMCID: PMC7844452.
3. Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jódar E, Leiter LA, Lingvay I, Rosenstock J, Seufert J, Warren ML, Woo V, Hansen O, Holst AG, Pettersson J, Vilsbøll T; SUSTAIN-6 Investigators. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2016 Nov 10;375(19):1834-1844. doi: 10.1056/NEJMoa1607141. Epub 2016 Sep 15. PMID: 27633186.
4. Frías JP, Davies MJ, Rosenstock J, Pérez Manghi FC, Fernández Landó L, Bergman BK, Liu B, Cui X, Brown K; SURPASS-2 Investigators. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. N Engl J Med. 2021 Aug 5;385(6):503-515. doi: 10.1056/NEJMoa2107519. Epub 2021 Jun 25. PMID: 34170647.
5. Pratley RE, Aroda VR, Lingvay I, Lüdemann J, Andreassen C, Navarria A, Viljoen A; SUSTAIN 7 investigators. Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): a randomized, open-label, phase 3b trial. Lancet Diabetes Endocrinol. 2018 Apr;6(4):275-286. doi: 10.1016/S2213-8587(18)30024-X. Epub 2018 Feb 1. PMID: 29397376.
6. Alsugair HA, Alshugair IF, Alharbi TJ, Bin Rsheed AM, Tourkmani AM, Al-Madani W. Weekly Semaglutide vs. Liraglutide Efficacy Profile: A Network Meta-Analysis. Healthcare (Basel). 2021 Aug 30;9(9):1125. doi: 10.3390/healthcare9091125. PMID: 34574899; PMCID: PMC8466858.

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