Western society is notably obsessed with finding a “miracle” weight loss solution. From restrictive fad diets to intentionally consuming tapeworm parasites, there’s no shortage of outrageous and dangerous things people do in hopes of losing weight quickly.¹
But, despite social and cultural pressures to be the thinnest version of yourself, obesity rates across America are the highest they’ve ever been.²
Based on 2017–2020 data, the Centers for Disease Control and Prevention (CDC) report that 41.9% of American adults have obesity.² Being an adult with obesity means that your Body Mass Index (BMI) — also known as height to weight ratio — falls outside a healthy range.
However, knowing your BMI doesn’t automatically tell you how healthy or unhealthy you are. Nevertheless, it can be a useful tool for estimating body fat.
In addition, referring to BMI gives researchers and public health experts a common standard for assessing weight.³ (If you have questions about your BMI, chat with your doctor). Also, when considering the prevalence of being overweight in America, it’s important to remember that some people experience more barriers to nutritious eating and regular exercise than others. For example, challenges to healthy weight management might include (but aren’t necessarily limited to) an absence of affordable fresh produce or lacking a nearby park to exercise in.⁴ As the number of people struggling with weight-related health issues climbs, interest and investment in weight-loss programs, medications, and therapies also grows.⁵ One of the newest weight-loss fads involves the diabetes medication Ozempic (generic drug name semaglutide).
The drug has become social media famous through viral videos. To date, short-form videos tagged #Ozempic and #OzempicJourney have amassed over 141.2M views on TikTok.⁶
However, this injectable medication is FDA-approved only to treat type 2 diabetes. Still, people have been using Ozempic with weight loss as their main goal, and the trend is concerning for many reasons.
The pharmaceutical brand’s website explicitly states: “Ozempic is not a weight-loss drug.”⁷
So why all the publicity lately, and what should you know about this prescription-only medication?
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Type 2 diabetes is a condition involving high blood sugar (glucose) levels due to low insulin sensitivity, also known as insulin resistance. The onset of this form of diabetes usually occurs in adulthood. Staying active and maintaining a healthy body weight can be helpful for type 2 diabetes prevention.
Typically, treatment for type 2 diabetes involves lifestyle changes, eating a healthy diet, and taking medication.
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 is usually in childhood.
Type 1 diabetes treatment focuses on insulin therapy. Accompanying insulin therapy with appropriate dietary measures and regular exercise is helpful. However, inactivity or poor eating habits can’t cause type 1 diabetes. Unmanaged, both forms of diabetes can cause significant damage to the kidneys, liver, eyes, and nervous system.⁸
Ozempic (semaglutide) is a medication created specifically to improve the management of type 2 diabetes, and it was first approved by the U.S. Food and Drug Administration (FDA) in 2017.⁹
Along with eating well and exercising, Ozempic can improve blood sugar and lower the risk of stroke, heart attack, or death in adults living with type 2 diabetes.¹⁰
If a doctor recommends Ozempic specifically for weight loss, that is “off-label” use — prescribing it for a condition other than what the FDA has approved it to treat.
Ozempic interacts with the body like glucagon-like peptide-1 (GLP-1), a hormone your body makes in response to eating.¹¹ GLP-1 is known to have a variety of effects on appetite and weight.⁹ According to its pharmaceutical makers, Novo Nordisk, Ozempic improves blood sugar control in three important ways:
Encouraging the pancreas to release more insulin when blood glucose levels are high.
Preventing the liver from making and releasing too much glucose into the bloodstream.
Slowing down the speed at which food leaves the stomach after a meal.
Ozempic is usually taken once a week through a single-use injection pen administered in a thin layer of fat on the arms, thighs, or abdomen.
In the interest of learning more about the impact of Ozempic on weight loss, its makers (Novo Nordisk) sponsored and conducted the Semaglutide Treatment Effect in People with Obesity (STEP) program, which began in 2018.¹²
Participants were overweight or obese but did not have diabetes.
The 68-week, randomized, double-blind, placebo-controlled trial found that those who took Ozempic in combination with lifestyle modifications (like eating well and exercising) showed a weight loss of 14.9% from baseline.
These numbers are notable because they’re similar to outcomes in patients undergoing more invasive weight loss measures — like gastric sleeve surgery.¹³
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
For Ozempic to become approved as a weight-loss drug, extensive research, and further testing must be done. Aside from Ozempic’s current lack of FDA approval as a weight-loss drug, there are other reasons why its apparent benefits aren’t necessarily worth the risk — unless you have type 2 diabetes and your doctor believes the pros outweigh the cons.
For example, Ozempic is not recommended for anyone with a family history of thyroid cancer — even as a potential treatment for type 2 diabetes.¹⁰ ¹⁵
A variety of side effects that range in severity are associated with using Ozempic.
Common mild side effects include:
Nausea
Vomiting
Diarrhea
Stomach pain
Constipation
Increased gassiness
Dizziness
Fatigue
Changes in your sense of taste
More severe side effects may include:
Hypoglycemia — Also known as low blood sugar, hypoglycemia is a common side effect of medications designed to treat diabetes. While mild hypoglycemia can be corrected by eating a source of fast-release carbohydrates, severe hypoglycemia can be a life-threatening condition that requires immediate emergency medical attention.
Pancreatitis — Defined as inflammation of the pancreas, pancreatitis can be incredibly painful. Additionally, because insulin is created and released from the pancreas, inflammation of this area can cause serious health problems for those living with type 2 diabetes.
Diabetic retinopathy — Ozempic therapy can cause significant damage to the capillaries of the retina in the eye. When this occurs, permanent visual disturbances can appear, which can cause significant disability.
Anaphylaxis — While it is not a common reaction, some people may develop a life-threatening allergic reaction to Ozempic. If this occurs, the person will require immediate emergency medical attention and life-saving medication as soon as possible.
With the growing awareness of Ozempic’s weight-loss capacity, many health care providers began writing their patients off-label prescriptions.¹⁶ But, since Ozempic wasn’t made for this purpose, the manufacturer was unprepared for the massive uptick in demand. As a result, shortages emerged around the world.
Australians experienced a particularly severe Ozempic shortage recently.
The situation became so critical that the Therapeutic Goods Administration and Australian Medical Association had to make a formal announcement to healthcare professionals. 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
Ashleigh Rae, who has type 2 diabetes, recently spoke to news.com/au about how the Ozempic shortage has impacted her life: “I found it really hard to go out in public because you just didn’t know what was going to happen or when. Without it, your blood sugar goes a bit crazy, which means the rest of your diabetes can be really hard to manage,” described Rae. She also expressed concerns about the effects of unmanaged blood sugar on her immune system because rates of COVID-19 are high in her community.¹⁶
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. Here are a few healthy weight loss tips from the American Heart Association:¹⁸
Keep track of your food intake — Often referred to as caloric input and output, the amount of food you eat and the amount of exercise you participate in on a daily basis affects your weight. In most cases, you should strive to be in a calorie deficit (burning more calories than you eat in order to lose weight.
Learn your BMI and monitor for changes — Your body mass index is based on your weight-to-height ratio. It can be a useful metric to monitor if you are on a weight loss journey.
Keep portions in mind — Different foods have different caloric densities. Whenever possible, filling your plate with calorie-light foods like fruits and veggies can help to provide a full feeling without leading to over indulgences.
Get active — Exercise is a great way to burn some extra calories and move your body. Whether you want to join an exercise class, walk around the block, or spend some time gardening in the backyard.
As much as you may want to dream about eating whatever you want and not gaining weight, a healthy diet, lifestyle, and exercise habits are all essential aspects of weight maintenance and weight loss. Though early research shows evidence to support a potential therapeutic role for Ozempic outside the scope of managing type 2 diabetes, more long-term research is needed. 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.
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Sources
History's weirdest fad diets | BBC News
Adult obesity facts | Centers for Disease Control and Prevention (CDC)
Defining adult overweight & obesity | Centers for Disease Control and Prevention (CDC)
CDC’s division of nutrition, physical activity, and obesity | Centers for Disease Control and Prevention (CDC)
Association of body mass index with health care expenditures in the United States by age and sex (2021)
Ozempic | TikTok
Diabetes and your eyes, heart, nerves, feet, and kidneys | National Kidney Foundation
Ozempic (semaglutide) injection, for subcutaneous use (2017)
Once-weekly semaglutide in adults with overweight or obesity (2021)
Safety of semaglutide (2021)
‘Havoc’: Woman deprived of lifesaving drug because people want to lose weight | News.com.au
Joint statement: Prioritisation of semaglutide (Ozempic) supply for people with type 2 diabetes during shortage | Therapeutic Goods Administration (TGA)
Life's essential 8™ - How to manage weight fact sheet | Heart Attack and Stroke Symptoms
We make it easy for you to participate in a clinical trial for Weight management, and get access to the latest treatments not yet widely available - and be a part of finding a cure.