Ozempic for Weight Loss: How Does It Work and Who Can Use It?

Weight management is a complex challenge faced by many people across the U.S. Despite many efforts, traditional weight loss methods often fall short, leaving people searching for alternative solutions. But within the last few years, glucagon-like peptide-1 (GLP-1) agonists have emerged as a top contender for helping people lose weight.

Ozempic (semaglutide) is a GLP-1 agonist approved to treat Type 2 diabetes. It’s not approved for weight loss, but people can lose weight while using it. Because of this, researchers studied Ozempic to see if it could help people without diabetes, too. In June 2021, the FDA approved Wegovy — a higher-dose version of Ozempic used specifically for weight loss.

Prior to Wegovy’s approval, Ozempic could be prescribed off-label for weight loss. Today, healthcare professionals still continue this practice — even with Wegovy on the market. If you’ve been prescribed Ozempic for weight loss, you may be wondering what to expect. We discuss what you should know below.

What is Ozempic and what is it used for?

Ozempic is an injectable medication to help with blood glucose (sugar) management in adults with Type 2 diabetes. It’s also approved to lower the risk of serious cardiovascular events (stroke, heart attack, or cardiovascular death) in people with both Type 2 diabetes and heart disease.

Ozempic belongs to a class of medications called GLP-1 agonists. GLP-1 agonists work by mimicking a gut hormone called GLP-1 to lower blood glucose levels after you’ve eaten a meal. They also lower glucose production in the liver and help you feel full for a longer period of time.

Ozempic is available as a prefilled injection pen that’s used once weekly. It’s considered to be a long-acting option in its class. That’s because Ozempic works longer in your body compared to other medications that need to be injected once or twice a day.

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Semaglutide, the main ingredient in Ozempic, is also available as an oral tablet for Type 2 diabetes under the brand name Rybelsus. And a higher-dose version called Wegovy is available for weight loss in certain people with and without diabetes.

Is Ozempic a type of insulin?

No, Ozempic is not a type of insulin or a substitute for insulin. But it does stimulate your pancreas to release insulin when glucose is present, such as after a meal. Ozempic relies upon your body’s own insulin to have this effect. So, it’s not normally used when your pancreas can’t make insulin, such as in Type 1 diabetes.

How does Ozempic cause weight loss?

GLP-1 agonists like Ozempic help to lower your blood glucose levels, but people taking them also tend to lose weight. GLP-1 is the key hormone involved in this process.

After you eat, cells in your intestines release GLP-1. This triggers insulin release and reduces glucose production. It also slows down how quickly food leaves your stomach, making you feel full. GLP-1 is also thought to directly affect the area of the brain that regulates appetite, as well as certain hunger hormones.

By mimicking the effects of GLP-1, Ozempic can lessen your appetite and make you feel full so you consume fewer calories. This can result in weight loss.

Is Ozempic a stimulant?

No, Ozempic is not a stimulant. Other weight loss medications, like phentermine (Adipex-P, Lomaira), have stimulating effects that help lower your appetite. As described above, Ozempic works differently to cause weight loss.

Can Ozempic be prescribed for weight loss?

Generally, yes. If you have Type 2 diabetes, one of the reasons you may be prescribed Ozempic is because it can help you lose weight. But if you don’t have diabetes, it’s also possible that your prescriber may prescribe Ozempic for weight loss. This is considered an off-label use.

Does this mean that anyone can use Ozempic for weight loss? Not necessarily. Your prescriber will weigh the benefits of Ozempic against the potential risks to determine if it’s right for you. For example, they may recommend a medication like Ozempic if you have prediabetes to help lower your risk of developing Type 2 diabetes.

Wegovy, on the other hand, is approved for weight loss in certain people with and without diabetes. It’s approved for use in adults and children ages 12 and older who are considered obese. Adults who are considered overweight and have at least one weight-related health condition are also eligible for Wegovy.

How long does it take to lose weight on Ozempic?

It can take a few months to reach your target dose of Ozempic. That’s because how much you inject is slowly increased over time to manage side effects. During this time, you may notice some weight loss. And how much weight you lose can depend on your Ozempic dose.

The starting Ozempic dose for Type 2 diabetes is 0.25 mg once weekly for 4 weeks. This dose doesn’t typically have an effect on your blood glucose or body weight. It’s meant to help your body get used to the medication. But after that, your dose is increased to 0.5 mg once a week.

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During clinical trials, people receiving the 0.5 mg dose lost around 8 lbs over 30 weeks. For some people, this dose isn’t enough to adequately manage their blood glucose levels. If needed, the dose may be increased in 4-week intervals up to a maximum of 2 mg once weekly.

In general, more weight loss may be seen with higher Ozempic doses. During a 40-week study, people receiving the 1 mg Ozempic dose lost an average of 13 lbs. And people receiving the 2 mg Ozempic dose lost an average of 15 lbs.

Ozempic vs. Wegovy for weight loss

Compared to Ozempic, Wegovy has a higher target dose — 2.4 mg once weekly. During the first 20 weeks (5 months) of treatment, people receiving Wegovy during clinical trials lost 10% of their starting body weight. An additional 8% body weight loss was seen over the 48 weeks (about 11 months) that followed.

Keep in mind that medications like Ozempic and Wegovy should be paired with lifestyle changes, such as a nutritious diet and regular exercise, to get the most benefit.

How long should you take Ozempic?

Ozempic is only approved for Type 2 diabetes. Since diabetes is a chronic health condition, you’ll typically need to take Ozempic long term to manage your blood glucose levels. You also likely need to continue taking Ozempic to maintain its heart-related benefits.

For chronic weight management, Wegovy is also meant to be taken long term. And you’ll typically sustain the weight you’ve lost as long as you continue treatment.

But if you stop Wegovy, you may regain most (or all) of the weight you’ve lost. If you’re prescribed Ozempic off-label for weight loss, there’s a good chance of rebound weight gain after stopping it, too. However, recent evidence suggests that the combination of lifestyle changes and slowly tapering off the medication (instead of stopping cold turkey) may help manage potential rebound weight gain.

Is Ozempic safe for weight loss?

Ozempic isn’t technically a weight-loss medication. But it’s considered safe and effective for Type 2 diabetes, and you may lose weight as a result of treatment. As mentioned above, if you’re prescribed Ozempic and you don’t have diabetes, this is considered off-label use. Semaglutide is approved for weight loss under the name Wegovy.

Ozempic and Wegovy have been linked to many of the same risks, including pancreatitis (inflammation of the pancreas), gallbladder disease, and kidney damage. It’s recommended to avoid Ozempic if you have a history of pancreatitis.

Animal studies have shown an increased risk of thyroid C-cell tumors with these medications. But this risk hasn’t been confirmed in people. Because of this, you shouldn’t take Ozempic or Wegovy if you have a personal or family history of medullary thyroid cancer. You also shouldn’t take them if you have a genetic condition called multiple endocrine neoplasia type 2 syndrome.

What are the side effects of Ozempic?

Especially when you’re first getting started on Ozempic, you may experience digestion-related side effects. These side effects are also common after your dosage is increased. For most people, they get better over time.

Common Ozempic side effects include:

• Nausea

• Vomiting

• Diarrhea

• Stomach pain

• Constipation

These same side effects were seen with Wegovy during clinical trials for weight loss. But since Wegovy doses are higher than Ozempic, side effects may be more likely with Wegovy.

Are there any foods or medications you should avoid while on Ozempic?

Ozempic doesn’t have many known drug interactions. But that doesn’t mean that interactions aren’t possible. For example, Ozempic may interfere with how you absorb medications that you take by mouth. Studies haven’t shown this to be an issue, but it’s a good idea to be aware of it. For example, some people taking birth control pills have become pregnant while using Ozempic.

In general, taking Ozempic with other diabetes medications can increase the risk of hypoglycemia (dangerously low blood glucose). Examples of these include:

• Insulin

• Sulfonylureas (e.g., glipizide)

• Meglitinides (e.g., repaglinide)

Certain foods and drinks may worsen Ozempic side effects — especially those that can upset your stomach. And others may sabotage Ozempic’s blood glucose-lowering effects and counteract potential weight loss. It’s best to minimize these during treatment:

• Spicy foods

• Greasy, fried foods

• Sugary foods and refined carbohydrates (such as white bread)

• Alcohol

Your healthcare team can review your current medication list to flag potential Ozempic interactions up front. They can also give you tips for any dietary changes to help manage side effects and get the most from treatment.

Is Ozempic covered by insurance for weight loss?

It depends. Most insurance plans cover Ozempic for Type 2 diabetes. But Ozempic may not be covered if you’re using it for weight loss and don’t have diabetes. Check with your insurance provider for more information on coverage requirements.

If you don’t have diabetes, but you have a high body mass index (BMI) and heart disease, you may be able to get Wegovy covered by your insurance instead.

Are there any Ozempic alternatives approved for weight loss?

There are three FDA-approved weight-loss medications that work in a similar way as Ozempic. These include two GLP-1 agonists, Wegovy and Saxenda (liraglutide). The third is Zepbound (tirzepatide), which works in a similar but slightly different way. Of these three medications, Zepbound may result in the most amount of weight loss.

There are several other medications that work like Ozempic that are being studied for weight loss. Examples include retatrutide, CagriSema, and ecnoglutide.

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Written by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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