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Understanding Ozempic

written by ruchi raval Jan 25, 2024

What is this blockbuster drug and why is every talking about it?

Forty two percent of American adults struggle with obesity, and if you’ve read the news lately, or even scrolled on social media, chances are that you’ve come across new weight-loss drugs like Ozempic and Wegovy. Across posts, vlogs, and tweets, it seems as though these drugs are the answer many have been looking for: an effective way to lose weight. If these drugs are as potent as many describe, why shouldn’t they be prescribed to everyone? 

With any new medical or scientific innovation comes an opportunity. On average, the Food and Drug Administration (FDA) approves 43 new drugs a year, each with the intention to improve some human condition. Each new medicine requires a rigorous approval process that requires years of clinical trials. Later, once these drugs are used in practice at a larger scale, patients and providers may begin to notice trends or unforeseen side effects. In the case of Ozempic, this was a drug that was FDA-approved to treat Type 2 Diabetes, but was later found to also help people lose weight.

While your choice to start a new medication is between you and your doctor, this article will share some of the basics behind medicine’s latest hot topic. How do weight loss medications work? What is the cost? What are the risks? Will I gain the weight back? 

What is Ozempic? 

Also known by its generic name Semaglutide, Ozempic is a once-weekly injection that comes in three doses: .5mg, 1mg, or 2mg. So far, it has been approved by the FDA for two purposes (1) improving blood sugar levels in adults with Type 2 Diabetes, and (2) reducing the risk of major cardiovascular events such as heart attack, stroke, or death in adults with Type 2 Diabetes with known heart disease. Ozempic is designed to be taken long-term.

So far, it is not FDA-approved as a weight loss drug, though some doctors do prescribe it to be used specifically for weight loss.

How Does Ozempic Work?

Ozempic reduces appetite and delays stomach emptying, leading to reduced hunger and food intake. Ozempic mimics a hormone called glucagon-like peptide-1 (GLP-1), making it a GLP-1 agonist. GLP-1 agonists function by replicating the actions of the naturally occurring GLP-1 hormone. Naturally occurring GLP-1 has the following functions: 

  • Stimulating the secretion of insulin, a hormone that regulates blood sugar levels.

  • Suppressing the hormone glucagon, thereby reducing hunger.

  • Enhancing feelings of fullness by delaying the emptying of the stomach.

As a GLP-1 agonist, Ozempic mimics the functions of GLP-1 described above to initiate change on the body.  

When Should I Consider Using Weight Loss Medications? 

The FDA recommends weight-loss medications only for those who have already tried lifestyle changes to lose weight and for those who meet at least one of the following conditions: 

  1. Body Mass Index (BMI) that is greater than or equal to 30.

  2. BMI that is greater than or equal to 20 with one or more obesity-related conditions (ex. diabetes, high blood pressure, etc.). 

  3. Have not lost at least 5% of their total body weight in 2-6 months despite lifestyle changes.

Even if you fit these qualifications, it is important to talk to your doctor about the risks of weight-loss treatments as they might not be right for everyone! 

These drugs must be taken in conjunction with lifestyle changes, like a heart-healthy diet and regular aerobic exercise, and not in place of them. 

What is the Difference Between Ozempic and Wegovy? 

Both Wegovy and Ozempic share the active ingredient: semaglutide. However, Ozempic is formulated with lower doses of semaglutide and is designed for individuals with type 2 diabetes. In contrast, Wegovy contains higher doses of semaglutide and is specifically tailored to aid in weight loss.

How Much Does it Cost? 

The cost of weight loss medications is an equity issue in the United States. Unfortunately, most private insurance does not cover weight-loss medications, even for those who qualify. Using Ozempic without insurance coverage can cost in the neighborhood of $15,000 a year.

What are the Potential Side Effects? 

Common adverse effects associated with Ozempic may involve nausea, vomiting, diarrhea, abdominal pain, and constipation. Other, more serious side effects, also exist and should be discussed with your doctor based on your medical/family history. 

Will I Gain the Weight Back? 

The jury is still out on the definitive long-term ramifications of these drugs and whether you will gain all the weight back once/if you get off of it. While some studies say that long-term sustained weight loss is possible over a two-year period, others say it's not. One study indicated that while sustained weight loss was possible after patients were taken off the medicine, their “baseline” state included significant lifestyle and diet modifications. This is why it’s so important to critically analyze articles online. 

Most studies, however, seem to indicate that withdrawal from the drug seems to make patients gain their weight back. This points to obesity as a chronic issue that requires ongoing treatment to maintain improvements.

 

Written by Ruchi Raval.

Edited by Michelle Dalson.

 

References

1. UC Davis Health. Are weight loss medications, like Wegovy, right for you? cultivating-health. Published September 13, 2023. Accessed January 21, 2024. https://health.ucdavis.edu/blog/cultivating-health/are-weight-loss-medications-like-wegovy-right-for-you/2023/09

2. Rubino D, Abrahamsson N, Davies M, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA. 2021;325(14):1414-1425. doi:10.1001/jama.2021.3224

3. Commissioner O of the. FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014. FDA. Published June 21, 2021. Accessed January 21, 2024. https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014

4. Healthline. GLP-1 Agonists for Weight Loss: An Evidence-Based Review. Healthline. Published September 22, 2022. Accessed January 21, 2024. https://www.healthline.com/health/weight-loss/glp1-for-weight-loss

5. Research C for DE and. New Drug Therapy Approvals 2022. FDA. Published online January 10, 2023. Accessed January 21, 2024. https://www.fda.gov/drugs/new-drugs-fda-cders-new-molecular-entities-and-new-therapeutic-biological-products/new-drug-therapy-approvals-2022

6. CDC. Obesity is a Common, Serious, and Costly Disease. Centers for Disease Control and Prevention. Published July 20, 2022. Accessed January 21, 2024. https://www.cdc.gov/obesity/data/adult.html

7. UC Davis Health. Ozempic for weight loss: Does it work, and what do experts recommend? cultivating-health. Published July 19, 2023. Accessed January 21, 2024. https://health.ucdavis.edu/blog/cultivating-health/ozempic-for-weight-loss-does-it-work-and-what-do-experts-recommend/2023/07

8. Han SH, Safeek R, Ockerman K, et al. Public Interest in the Off-Label Use of Glucagon-like Peptide 1 Agonists (Ozempic) for Cosmetic Weight Loss: A Google Trends Analysis. Aesthetic Surgery Journal. 2024;44(1):60-67. doi:10.1093/asj/sjad211

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10. Tu L. Should Insurance Cover Wegovy, Ozempic and Other New Weight-Loss Drugs? Scientific American. Published October 16, 2023. Accessed January 21, 2024. https://www.scientificamerican.com/article/should-insurance-cover-wegovy-ozempic-and-other-new-weight-loss-drugs/

11. Garvey WT, Batterham RL, Bhatta M, et al. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial. Nat Med. 2022;28(10):2083-2091. doi:10.1038/s41591-022-02026-4

12. UCHealth KKM. Wegovy vs. Ozempic: The truth about new “weight-loss” drugs. UCHealth Today. Published April 5, 2023. Accessed January 21, 2024. https://www.uchealth.org/today/wegovy-vs-ozempic-the-truth-about-new-weight-loss-drugs/

13. Wegovy. Wegovy® Pen Instructions | Wegovy® (semaglutide) Injection 2.4 mg. Accessed January 21, 2024.https://www.wegovy.com/taking-wegovy/how-to-use-the-wegovy-pen.html

14. Wilding JPH, Batterham RL, Davies M, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes, Obesity and Metabolism. 2022;24(8):1553-1564. doi:10.1111/dom.14725

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