Ozempic for Type 2 Diabetes and Weight Loss – Efficacy and Side Effects

Last Updated: May 21, 2024

David Levin Reviewed by David Levin
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Obesity contributes significantly to 30–53% of new diabetes cases in the U.S., with type 2 diabetes mellitus patients being more prone to obesity (Body mass index BMI ≥ 30 kg/m2 or ≥27 kg/m2). The well-known “blockbuster success,” Novo Nordisk’s diabetes drug Ozempic, generally addresses both conditions effectively.

However, its popularity has extended past diabetic/obese patients to individuals only seeking “easy” weight loss, causing shortages and raising safety concerns, even on social media platforms like TikTok. The hashtag #Ozempic had been viewed over 600 million before the app restricted weight-loss product marketing to foster positive body image and mental health.

Keep reading to understand the frenzy behind this drug, its risks, benefits, and the questions in between.

What Is Ozempic?

Trade Name: Ozempic®

Generic Name: N/A

Ozempic is a brand-name weekly injection medication developed by Novo Nordisk, the largest pharmaceutical company in Denmark.

It is one of three FDA-approved prescription medications containing semaglutide designed to lower blood sugar levels in adults diagnosed with type 2 diabetes mellitus (T2DM) and known cardiovascular disease. No generic version of this medication is currently available.

According to Novo Nordisk and following FDA-approved uses, this drug offers the benefits of:

  • Reducing the risk of major cardiovascular events such as heart attack, strokes
  • Avoiding death due to high blood sugar levels in adults diagnosed with T2DM

Off-label Uses

While not FDA-approved for these indications, it may also be used off-label for other purposes, including:

How Does Ozempic Work?

Type 2 diabetes mellitus (T2DM) is a chronic condition characterized by high blood sugar (glucose) levels due to insulin resistance or insufficient insulin production by the pancreas.

It’s often associated with obesity, a sedentary lifestyle, genetics, and aging. It may initially be managed through lifestyle modifications, such as diet and exercise. Yet, as some individuals may eventually require prescription medication, semaglutide is one of the clinically trialed and FDA-approved options.

The semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist that reduces blood sugar and energy intake. Its mechanism of action consists of:

  • Mimicking the glucagon-like peptide-1 (GLP-1), a hormone released in the gut after meals
  • Prompting the pancreas to release/produce insulin, which helps regulate blood sugar levels
  • Also, decreasing the production of glucagon, a hormone that raises blood sugar levels
  • Delaying stomach emptying, resulting in a slower glucose release into the bloodstream post-meals
  • Affecting brain regions responsible for appetite, reducing hunger and increasing satiety

How Ozempic Works for Weight Loss?

The most sought-after off-label use of this medication is for weight loss, especially for obesity. There is an apparent correlation between the rising obesity rates (as of March 2024, 41.9% of American adults are obese) and the 300% increase in prescriptions for “obesity drugs” in the U.S. over the past three years.

This correlation makes sense, considering that the consensus‐based clinical guidelines for the treatment of obesity include the use of pharmacotherapy along with diet and exercise since successfully managing long‐term obesity with lifestyle changes alone has been proven difficult.

Ozempic may cause weight loss because:

  • Contains semaglutide as active ingredient
  • Semaglutide regulates appetite and hunger, inducing satiety and fullness due to slower digestion
  • Satiety and fullness lead to reduced calorie consumption and weight loss over time

It’s important to note that weight loss can be considered a side effect of Ozempic. This drug is not approved for that purpose and shouldn’t be considered a “miracle diet drug.” Mid to long-term risks may involve intestinal obstructions, pancreatic cancer, and cardiovascular issues.

Wegovy is currently the only semaglutide medication FDA-approved for chronic weight management in adults who have at least one weight-related comorbidity, such as high blood pressure, type 2 diabetes or high cholesterol. Evidence shows people taking semaglutide lost an average of 14.9% of their body weight over 68 weeks, but results may vary.

Ozempic vs. Wegovy

Wegovy gained public recognition when Elon Musk tweeted that he fasted and used Wegovy to lose weight. Yet, Ozempic’s popularity peaked when a shortage of Wegovy began in 2022.

Both are manufactured by the same company and contain semaglutide. Ozempic is available in injections of 0.5mg, 1mg and 2mg for weekly subcutaneous injection for type 2 diabetes management, while Wegovy comes in a 2.4 mg injectable prescription with 5 different dose strengths and is specifically approved as a weight loss drug.

Ozempic is typically covered by insurance for treating type 2 diabetes mellitus. Copayments or coinsurance may still apply. Coverage for Wegovy is often not included.

Ozempic Risks and Side Effects

As indicated by the manufacturer, this medication may cause mild and serious side effects, including:

Mild Side Effects

  • Nausea
  • Diarrhea
  • Vomiting
  • Constipation
  • Headache
  • Dizziness
  • Fatigue
  • Abdominal pain

Serious Side Effects

  • Hypoglycemia (low blood sugar)
  • Pancreatitis (inflammation of the pancreas)
  • Acute kidney injury
  • Gallbladder problems
  • Changes in vision
  • Thyroid tumors
  • Allergic reactions, including a severe rash, body parts swelling or itching

This medication has an FDA-boxed warning, which is the strongest warning by the FDA, for thyroid C-cell tumors, medullary thyroid carcinoma, and multiple endocrine neoplasia syndrome type 2 (MEN 2). This means the drug carries a significant risk of serious or even life-threatening adverse effects.

Ozempic Dosage and Schedule

This medication is available in prefilled, disposable pens containing a liquid solution.

The table below shows the various strengths of pens and the drug manufacturer’s proposed dosing schedule. Always follow your healthcare provider’s instructions for administration.

Time (Months) Strength (mg/mL) Dose per Injection*
First Month Pen of 0.25 or 0.5mg only 0.25mg
Month 2 Pen of 0.25 or 0.5mg only 0.5mg
Month 3** Pen of 1mg only 1mg
Month 4** Pen of 2mg only 2mg

*Once weekly

**If additional blood sugar management is necessary. The maximum dose is 2 mg once a week.

Ozempic Challenges and Limitations

While this medication has shown remarkable efficacy in managing type 2 diabetes, its widespread adoption for weight loss has brought forth practical concerns such as:

Challenges of Diabetes Medication

  • Ozempic’s weight loss popularity among celebrities causes misuse and high demand, leading to a shortage.
  • Shortages cause difficulties for diabetic patients in treating their condition.
  • With the patent valid until 2031, there may be further delays in production and distribution worldwide.

Limitations of Diabetes Medication

  • Ozempic costs $969/month ($11,628/year) and Wegovy costs $1,349/month ($16,188/year)
  • These lifelong medications can be a financial burden without insurance coverage
  • Discontinuing may result in weight regain
  • Concurrent use with other medications may lead to unfavorable interactions
  • Pregnancy and breastfeeding are contraindicated due to unknown risks to the fetus or infant
  • Alcohol consumption can worsen side effects or interfere with medication effectiveness
  • This medication is contraindicated for pancreatitis, thyroid cancer risk (MTC/MEN 2) or kidney disease

Ozempic Precautions and Tips

  1. Keep refrigerated at 36°F to 46°F (2°C to 8°C) until use. Do not freeze
  2. Each pen is for single patient use only. Do not share pens or needles
  3. Check the expiration date before each use. Do not use if expired (56 days after opening)
  4. Rotate injection sites to avoid skin thickening, infections or lumps (abdomen, thigh or upper arm)
  5. Consult a healthcare provider before taking it with other medications
  6. If a dose is missed, administer it within five days, then resume regular schedule
  7. Do not exceed the prescribed dosage to avoid potential adverse effects.
  8. Maintain a balanced diet and incorporate weight and strength training to prevent sarcopenia
  9. Safely discard needles in a puncture-proof container to prevent accidents

Ozempic for Weight Loss − Final Considerations

As a community, we should avoid turning Ozempic into a drug of abuse. Individuals with normal weight or blood sugar levels shouldn’t take this medication. Data on its long-term effects and possible health risks in these groups is limited.

Remember, weight loss is most effective when combined with lifestyle changes for long-term success, and medications are only used for chronic obesity. If food addiction or binge eating disorders are a concern, seek help from a healthcare provider or the National Eating Disorders Association (NEDA).

People Also Ask

Is Ozempic for weight loss?

No. Although it may lead to weight loss as a side effect in individuals with type 2 diabetes, Ozempic is not manufactured nor FDA-approved for weight loss.

What does Ozempic do to your body?

Ozempic, containing semaglutide, mimics the GLP-1 hormone, regulating blood sugar by stimulating insulin release, reducing appetite, slowing gastric emptying, and promoting feelings of fullness, helping in type 2 diabetes management.

How much weight can you lose in a month with Ozempic?

Weight loss varies among people with or without type 2 diabetes. In non-diabetic people with obesity, the study shows an average loss of 14.9% of their body weight over 68 weeks of taking Wegovy.

Page Sources

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  2. What is Ozempic®? | Ozempic® (semaglutide) injection. (n.d.). https://www.ozempic.com/why-ozempic/what-is-ozempic.html
  3. Research, C. F. D. E. A. (2024, January 10). Medications containing semaglutide marketed for type 2 diabetes or weight loss. U.S. Food And Drug Administration. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/medications-containing-semaglutide-marketed-type-2-diabetes-or-weight-loss
  4. Semaglutide reduces severity of common liver disease in people with. (2024, March 5). National Institutes of Health (NIH). https://www.nih.gov/news-events/news-releases/semaglutide-reduces-severity-common-liver-disease-people-hiv
  5. Siamashvili, M., & Davis, S. N. (2021). Update on the effects of GLP-1 receptor agonists for the treatment of polycystic ovary syndrome. Expert Review of Clinical Pharmacology, 14(9), 1081–1089. https://doi.org/10.1080/17512433.2021.1933433
  6. Goyal, R., Singhal, M., & Jialal, I. (2023, June 23). Type 2 diabetes. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK513253/
  7. Miles, K. E., & Kerr, J. L. (2018). Semaglutide for the Treatment of Type 2 Diabetes Mellitus. The Journal of Pharmacy Technology : JPT : Official Publication of the Association of Pharmacy Technicians, 34(6), 281-289. https://doi.org/10.1177/8755122518790925
  8. Fleck, A. (2024, March 4). Obesity is rising in the U.S. Statista Daily Data. https://www.statista.com/chart/11497/obesity-in-the-us/
  9. 2023 Trends Shaping the Health Economy Report. (2023, September 27). Trilliant Health. https://www.trillianthealth.com/reports/2023-health-economy-trends
  10. Ruseva, A., Michalak, W., Zhao, Z., Fabricatore, A., Hartaigh, B. Ó., & Umashanker, D. (2024). Semaglutide 2.4 mg clinical outcomes in patients with obesity or overweight in a real‐world setting: A 6‐month retrospective study in the United States (SCOPE). Obesity Science & Practice, 10(1). https://doi.org/10.1002/osp4.737
  11. Office of the Commissioner. (2021, June 4). FDA approves new drug treatment for chronic weight management, first since 2014. U.S. Food And Drug Administration. https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014
  12. Wilding, J., Batterham, R. L., Calanna, S., Davies, M. J., Van Gaal, L. F., Lingvay, I., McGowan, B., Rosenstock, J., Tran, M. T. D., Wadden, T. A., Wharton, S., Yokote, K., Zeuthen, N., & Kushner, R. F. (2021). Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine, 384(11), 989–1002. https://doi.org/10.1056/nejmoa2032183
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Retrieved on May 12, 2024.

Published on: May 12th, 2024

Updated on: May 21st, 2024


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