What to know about Ozempic and weight loss

Jeremy Byrd, MD

Internal Medicine, Pediatrics

You’ve probably heard about popular new drugs like Ozempic or Wegovy that people are using to lose weight. Ozempic, used to aid in managing blood glucose levels, has become so popular for weight loss, in fact, that people are struggling to even find it. Is it worth the hype? Jeremy Byrd, MD, explained what you need to know about Ozempic and other weight loss medicines.

How do weight loss medicines work?

“Weight loss medicines typically use ingredients that help suppress your appetite, and so you end up eating less and lose weight as a result,” Dr. Byrd said. “Years ago, there was a medicine called fen-phen, and it had some really bad side effects. But what we discovered is that one of the medicines used in fen-phen, called phentermine, was actually very safe for use. It’s not for everybody, particularly if you have a history of cardiovascular issues, but I’ve seen a lot of effective weight loss with this medicine. It’s been proven safe and it’s affordable.”

The recent focus, however, is on GLP-1 agonists, which include injectable medicines like Ozempic and Victoza that were developed to help people with diabetes. Ozempic (also known by the generic name semaglutide) works by mimicking a hormone known as glucagon-like peptide-1, triggering insulin production and lowering blood sugar. It also suppresses appetite and slows digestion. Wegovy, which is the same medication but in a slightly lower dose, was approved by the U.S. Food and Drug Administration (FDA) as an anti-obesity drug in 2021.

“We’ve seen dramatic weight loss with these medicines – up to 14% of a person’s weight – with few side effects,” Dr. Byrd said. “This is exciting, because folks who have not been able to lose weight on their own now have some other options available to them.”

Who is a good candidate for weight loss medicine?

Those who might benefit from weight loss medicine are people with a body mass index (BMI) over 30 or those with a BMI over 25 who have another chronic condition such as heart disease.

Dr. Byrd said weight loss medicines can be extremely helpful for those struggling with obesity.

“Doctors recognized obesity as a chronic medical condition about 10 years ago, and that gives us a clue as we approach treatment. It is something that we want to treat lifelong and chronically. Weight loss medications are very effective at doing that.”

But it’s important to remember that not every medicine is right for every person.

“It depends upon your risk factors, such as if you have a history of diabetes or heart disease or something else,” he said. “But there are great medicines out there and they all have different benefits.”

Do you have to take weight loss medicine forever, then?

“The GLP-1 medicines, like Ozempic or Victoza, have to be taken lifelong,” Dr. Byrd said. “I don’t recommend stopping them without talking to your doctor. If you go on a medicine for diabetes, you wouldn’t want to stop it, unless you were put on something else. Likewise, with obesity, it’s something you’d want to stay on long term. But we monitor things like blood pressure, weight and side effects to make sure your treatment is as safe as possible. The most common side effect is nausea.”

Taking GLP-1 medicines for short-term weight loss is not recommended.

What should you do if you’re struggling to lose weight?

Talk to your doctor to see if weight loss medication is right for you and how it can fit into your overall weight loss plan. Because medicines like Ozempic and Wegovy are expensive and have been difficult to find, Dr. Byrd said it’s worth considering other weight loss medicines.

“A very common medicine for folks with diabetes is metformin and you can lose a lot of weight on that medicine. It’s not for everybody, but some non-diabetics can take that medicine and lose weight.”

Dr. Byrd also suggested the following:

• Shift toward a healthier diet. The Mediterranean diet, which is higher in vegetables and fruits and lower in starches and the fats, is frequently recommended. Obesity experts also recommend using eatingwell.com to develop a food plan and get recipes ideas. If you need some help getting started, your primary care physician can refer you to a nutritionist or dietitian.

• Increase exercise. Try joining an aerobics or swim class or exercise with a friend so you have accountability and community. Starting with small goals can help ease you into a routine.

“Exercise and the diet are sometimes the hardest things to change, so I encourage patients to ask their doctors what option would be right for them and not feel that this is a moral failure,” Dr. Byrd said. “Weight is something many of us are struggling with and there’s not an easy answer.”