1. How Do Ozempic and Other Popular Weight Loss Drugs Work?
Beyond its effect on blood sugar, GLP-1 is the primary driver of Ozempic’s weight loss effects. “GLP-1 increases feelings of satiety and decreases appetite while also slowing digestion, which in turn mutes appetite as well,” says Palinski-Wade. She explains that the drug delays food’s exit from the stomach, keeping you feeling full longer.
“Some people feel the appetite-suppressing effects within 24 to 48 hours, but weight loss and blood sugar control will take longer,” Dr. Tchang says. “We see people lose weight and achieve blood sugar control over several months, and these benefits are sustained over a year.”
Similarly, GLP-1 and GIP receptor agonists — a similar class of drugs — mimic the action of a hormone in the lower gut to stimulate insulin release after you eat. Mounjaro and Zepbound (the brand-name versions of the generic tirzepatide) are GIP receptor agonists. Research also shows that GIP signals satiety.
2. Who Has Had the Most Success on Ozempic So Far?
While Ozempic isn’t approved for weight loss specifically, many patients who have used it to treat type 2 diabetes also lose weight as a secondary benefit. Wegovy, the same medication as Ozempic at a higher dose, has been approved by the FDA for excess body weight and has yielded significant results. One placebo-controlled trial found that more than 1,200 people who took 2.4 mg or 7.2 mg of Wegovy for 72 weeks lost an average of 15.6 to 18.7 percent of their body weight.
Regarding Ozempic in particular, so far it’s not clear if people in some demographics might be able to manage blood sugar better or lose more weight on the drug than others. “We don’t have that granularity of evidence yet, but we have general trends from other studies,” says Tchang. “Earlier intervention is better, because people then have fewer years of uncontrolled diabetes, and people who have higher baseline weight tend to lose more weight.”
3. Who Shouldn’t Take Ozempic?
These same restrictions hold true for Wegovy. Mounjaro and Zepbound are also not recommended during pregnancy or for people with family history of these conditions.
4. Should I Stay on Ozempic Forever?
For most people, Ozempic won’t be a short-term fix. “Semaglutide is a medication that people should take for a long time, not temporarily,” Dr. Washington says. “This is because obesity is a chronic disease, and the medication only works when you take it.” When people stop taking Ozempic, she says, they tend to regain the weight they lost.
So how long can you stay on Ozempic? No time limit has been established yet. (The same goes for other newer weight loss drugs.) But as long as you’re tolerating the medication well and your healthcare provider recommends it, you should be able to continue taking it.
5. I Know Ozempic Takes the Weight Off Fast. Are There Any Downsides to That?
When you need to shed pounds, a rapid weight loss drug may be a great fit. Still, losing weight quickly can come with downsides. Muscle mass loss is a particular concern in older adults taking the drug.
“A loss of appetite and a decrease in calorie consumption can promote weight loss. However, it can lead to a lack of balanced nutrition and an increased risk of nutrient deficiencies,” says Palinski-Wade. These potential deficiencies could have lasting consequences. For example, if you’re not getting enough calcium and vitamin D from your diet, you could increase your risk of osteoporosis, she notes. Rapid weight loss can also lead to reduced muscle mass, which can decrease overall metabolism, strength, and balance over time.
Ozempic and the other weight loss drugs might have some drawbacks for your appearance, too. Many people report “Ozempic face,” a hollowed-out facial appearance that comes from rapidly losing fat. (Unfortunately, we can’t control which parts of our bodies lose fat the fastest or most noticeably.) Some Ozempic users even complain of “Ozempic butt.” The same principle applies: As weight comes off rapidly, it can leave your buttocks looking saggy or hollow.
6. I’ve Heard About Some Pretty Yucky Side Effects With This Drug. Should I Be Concerned?
Most prescription drugs come with possible side effects, and Ozempic is no exception. The most common side effects of Ozempic are nausea, vomiting, constipation, diarrhea, and abdominal pain. Less commonly, some people experience fatigue, hair loss, and more severe stomach problems.
Side effects of GLP-1 and GIP receptor agonists are similar, says Palinski-Wade, and are typically gastrointestinal (GI). Some research has shown that people on tirzepatide experience more GI side effects than people on semaglutide, but each person responds uniquely to each drug.
Meanwhile, for most people, the side effects of these newer weight loss drugs are not debilitating and pass quickly. “Generally, these side effects are seen in the first few weeks of therapy as well as when dosing is increased,” Palinski-Wade says. She recommends avoiding large meals or high-fat meals to help reduce GI symptoms.
7. What Are the Long-Term Health Effects of Ozempic?
Because drugs like Ozempic are relatively new, there isn’t a large body of data on their long-term health effects. Still, some research has raised the possibility of a few concerning long-term health outcomes. One study found a link between these drugs and serious GI problems like intestinal blockage, pancreatitis, and gastroparesis. For these reasons, since September 2023, the FDA added a warning about potential side effects on Ozempic’s label.
Another concern is Ozempic’s potential impact on thyroid cancer risk. According to research, the available evidence does not support a causal link between GLP-1 agonists and thyroid cancer.
That said, Tchang encourages caution if you have certain risk factors. “A personal or family history of medullary thyroid cancer is a contraindication to Ozempic because this type of cancer was associated with Ozempic in animal studies,” she says. “However, it’s important to discuss these concerns with your doctor, who best knows your individual circumstance.”
Like Ozempic, the long-term effects of Mounjaro and Zepbound also require more data. Palinski-Wade says that thyroid tumors may eventually be a concern with these meds, too. “The FDA has warned that tirzepatide can cause thyroid tumors in rats, but we do not yet know if this will be the case in humans. More research and longer-term studies are needed,” she says.
8. How Does Ozempic Affect Mental Health?
Washington says that obesity and mental health issues have a bidirectional relationship — meaning it’s often hard to tell which came first. Research has found that obesity is a risk factor for both anxiety and depression.
It’s important to tease apart how Ozempic might affect mental health. “There have been case reports that indicate there is an association between semaglutide and depression,” Washington notes. In one study, two cases of depressive symptoms were recorded. When the two people with depression stopped taking semaglutide, their symptoms went away. Washington says there have been numerous reports of patients experiencing anxiety, depression, or suicidal thoughts while taking semaglutide and tirzepatide.
If you feel that the medication is causing or worsening psychological symptoms, talk to your doctor. “It’s important to closely monitor a person’s mood and make changes if necessary,” Washington says.
9. How Can I Get Ozempic Covered by Insurance?
Insurance coverage for Ozempic (and all drugs, for weight loss or otherwise) varies by provider and plan. In many cases, if you have a valid prescription for the drug, insurance will cover at least a portion of the cost. But some insurance plans only cover Ozempic when it’s prescribed as a treatment for type 2 diabetes, not when it’s prescribed off-label as a weight loss aid. Wegovy and Zepbound, however, are FDA-approved for weight loss, and they aren’t intended to be prescribed to those with diabetes.
10. What Does Ozempic Cost?
11. How Do You Get Ozempic When It’s Not Covered by Insurance?
If your insurance plan doesn’t cover Ozempic, you may have other options for reducing the drug’s cost. Ozempic offers a savings card that allows users with private or commercial insurance to pay as little as $25 per pen for up to a three-month prescription. To access this card, your prescription must be for a one-, two-, or three-month supply, and you’ll need to answer a few qualifying questions online. If you’re interested in another weight loss drug, check the drug’s website for potential savings.
You can also ask your doctor or pharmacist for insider info on any savings or patient assistance programs in your area. Some nationwide drug discount programs like GoodRx could bring costs down.
12. Are There Cheaper Alternatives to Ozempic?
Considering the sometimes high cost of Ozempic, no one can blame you for looking for a less expensive alternative. Unfortunately, Ozempic does not have a generic alternative, Tchang says. While some websites tout knockoff versions of the drug, don’t be fooled: Faux pharmaceuticals are not a safe bet.
Some specialized pharmacies offer compounded semaglutide. These custom-made meds combine the active ingredients of Ozempic with other medications tailored to individual health needs. But Tchang says this option doesn’t have the safety backing of the branded drug. “Compounded semaglutide has not undergone the same clinical trial rigor as brand-name Ozempic, so a patient choosing this route is taking on more risk and must rely on their own research to ensure safety and efficacy.”
If you can’t afford name-brand Ozempic, Tchang says there are other possibilities for weight loss meds. “If Ozempic is inaccessible, patients should speak with a board-certified obesity medicine physician who can discuss other options, such as other GLP-1s or oral anti-obesity medications, which are typically more cost-feasible,” she says.
13. How Do You Use Ozempic?
Ozempic is a weekly injectable drug. As for how to inject Ozempic, it’s relatively simple. The drug comes in a prefilled pen that is injected under the skin. Where to place the injection is largely up to you: You can use it on your abdomen, thigh, or upper arm. Before your first use, store Ozempic in the fridge. After you’ve used it, you can store the pen for 56 days at room temperature between 59 and 86 degrees F or in the refrigerator between 36 and 46 degrees F. Don’t freeze Ozempic — and be sure to keep the cap on the pen when you’re not using it.
14. I’ve Heard That Zepbound and Mounjaro Are Even More Effective Than Ozempic. What Do I Need to Know About These Drugs?
Zepbound and Mounjaro are exactly the same drug, just with different names. Zepbound is the tirzepatide drug that’s specifically approved for obesity, and Monjaro is approved for type 2 diabetes. Like Ozempic, these drugs have been shown to reduce blood sugar in people with type 2 diabetes, as well as promote weight loss. In one study, participants who took tirzepatide lost an average of 15 percent of their body weight on a 5 mg weekly dose, 19.5 percent on a 10 mg dose, and 20.9 percent on a 15 mg dose over 72 weeks. This compares favorably with other research that showed a 2.4 mg weekly Ozempic dose reduced body weight by an average of 14.9 percent over 68 weeks.
Similarly, studies have revealed that Mounjaro reduces A1C in people with diabetes. In research, people on this drug saw A1C reductions ranging from 1.87 to 2.59 percent.
Determining which drug is best for you may be a matter of assessing your health goals. One primary difference between Mounjaro and Ozempic is that Ozempic is FDA-approved to reduce the risk of heart attack and stroke in people with type 2 diabetes, while Mounjaro is not. Talk to your doctor about whether Mounjaro or Ozempic is more appropriate for you.
15. What Happens When You Stop Taking Ozempic?
Ozempic’s effects last only while you’re taking it — so getting off the medication generally results in a rebound of weight gain, Washington says. “The issue is that because obesity is a chronic disease, our bodies resist changes to weight and will start to work to get back to the higher set point. This is where anti-obesity medications help prevent weight gain if you continue to take them,” she says. In one review, people who went off a weight loss drug returned to their baseline weight less than two years later.
Palinski-Wade says this is likely to be the reality for tirzepatide drugs as well as semaglutide. “In general, weight regain after stopping weight loss medications is always a possibility,” she says. “These medications are a tool when it comes to weight management, not a quick fix or a cure.”
Even if you stop taking your weight loss drug, you can always continue to make healthy choices that promote weight loss. “To help decrease the rebound weight gain, people can continue the lifestyle changes that they hopefully learned while taking semaglutide,” Washington says.
Everyday Health’s Weight Loss Reframed Survey queried 3,144 Americans nationwide, ages 18 and older, who had tried losing weight in the previous six months. The study was fielded between July 10 and August 18, 2023, across demographic groups, genders, and health conditions. Survey recruitment took place via an online portal, in app, and via email. The margin of error for the sample size of 3,144 is +/-1.7 percent at a 95 percent confidence level.
The Takeaway
- Ozempic is a GLP-1 agonist drug that increases feelings of fullness and reduces appetite. Other weight loss drugs like Wegovy, Mounjaro, and Zepbound work in a similar way.
- Research shows that these drugs help many people lose weight, but people need to stay on the drugs to keep the weight off. These drugs may cause side effects like nausea, vomiting, and diarrhea.
- Pricing varies depending on your insurance. Because drugs like Ozempic are relatively new, researchers are still studying their long-term health effects.
- These drugs are not recommended for people who are pregnant or have a history of diabetic retinopathy or problems with their pancreas or kidneys.
Read the full article here
