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Unraveling The Ozempic Craze
Over the past century, humanity has grown increasingly fascinated by the possible benefits of consuming all sorts of pills and potions to lose weight. The newest wave of this craze has come in the form of injectable medications like Ozempic and Wegovy.
The Food and Drug Administration approved Ozempic for Type 2 diabetes in 2017. Susan Yanovski, a physician and nutrition specialist at the National Institute of Diabetes and Digestive and Kidney Diseases, told ScienceNews that although "it's still early days," she has never seen such excitement surrounding a drug line. Considering that these drugs achieve results approaching weight-loss levels previously only possible through bariatric surgery, there's even more reason to be interested. However, many questions remain about how exactly the drugs work, who should be taking them, how long they should be taken for, as well as what side effects users should be wary of.
Ozempic and Wegovy are both brand names for the drug semaglutide. However, Wegovy has a higher maximum dose and has been specifically approved for weight loss, while Ozempic is intended for Type 2 diabetes. Semaglutide imitates GLP-1, the gut hormone that the body releases after the individual eats. GLP-1 stimulates the secretion of insulin, which facilitates the movement of glucose into the body's cells to create energy. Thus, the drug causes the body to mimic a sense of satisfaction and satiation. In a double-blind trial, results were reported that after 16 months, people with diabetes taking a high weekly dose lost about 15% of their body weight.
In addition, semaglutide offers compelling possibilities for assuaging other health problems it was not initially intended to treat. Dr. A. Michael Lincoff, a cardiologist at Cleveland Clinic, conducted a 40-month drug trial with 17,000 participants. Weekly drug injections were shown to lower the risk of heart attacks, strokes and death due to cardiovascular disease by up to 20%. Health incidences caused by cardiovascular disease were noticeably reduced when participants took semaglutide compared to a placebo. This finding could be a groundbreaking advancement in treating the leading cause of death in the world.
A less intuitive benefit of semaglutide may be curbing addictive behaviors such as smoking, vaping and drinking. Dr. Lorenzo Leggio is studying the link between semaglutide and addiction, having published a study showing that semaglutide reduces alcohol drinking in rodents. Leggio posits that semaglutide and chemically similar drugs, also known as analogues, may influence addictive behaviors because they affect not just the gut but the brain as well. He believes semaglutide and other GLP-1 analogues might inhibit the release of dopamine, a neurotransmitter that evokes the feeling of pleasure after smoking and drinking. Regardless, although people claim Ozempic is repressing their nail-biting and online shopping habits, pharmaceutical companies are not actively studying the effects of GLP-1 drugs on addiction. It is clear that more thorough research is required before confirming any causal links.
Pharmaceutical companies are, however, already developing more potent relatives of semaglutide which mimic more than just GLP-1. Tirzepatide, sold under brand names like Mounjaro, mimics both GLP-1 and the gut hormone GIP. The drug was approved in 2022 for treating Type 2 diabetes and for weight loss just last November. If this was not enough, a third drug known as retatrutide, which stimulates GLP-1, GIP and glucagon — another hormone involved in hunger regulation — is in the works and helped people lose up to an astounding 24% of their body weight after 48 weeks of treatment. These drugs are diversifying in their function and in what other health benefits they provide, increasing the number of patients they can treat.
That being said, Ozempic and similar drugs carry a few thorns with their roses. Semaglutide can cause stomach aches, constipation, diarrhea, nausea, vomiting and other unsavory side effects. Rapid, significant weight loss can cause gallbladder disease, which is also an occasional complication of bariatric surgery. Worryingly, semaglutide and GLP-1 analogues have been shown to melt away muscle mass along with body fat, posing a significant concern for older users. What's more, patients using these drugs for weight loss likely will not experience lasting results if they stop taking their medication. Thus, semaglutide and its relatives do not necessarily provide a sustainable method of keeping any lost weight off.
Needless to say, Ozempic usage has exploded in Hollywood and mainstream media for its weight-loss effects. Celebrities such as Oprah Winfrey, Elon Musk and Amy Schumer have admitted to trying these medications to lose stubborn body fat; although Ozempic is officially for Type 2 diabetes, it can be prescribed with the off-label use of aiding in weight loss. Unfortunately, the usage of semaglutide has reached a point where many Americans in actual need of these medications cannot fill their prescriptions. From 2020–22, prescriptions for these drugs increased by 300%, almost reaching nine million prescriptions by the end of 2022. The FDA included both Ozempic and Wegovy on its drug shortages list in 2023. Furthermore, with the drugs' high cost — Wegovy costs nearly $1,350 per month without insurance — and with variable insurance coverage, many people with Type 2 diabetes or a life-threatening level of obesity cannot access the medication they need.
Semaglutide drugs have spawned all sorts of media coverage and Internet jokes like calling stick-skinny Christmas trees "Ozempic trees." However, their prevalence necessitates a longer conversation about other unexpected benefits, class disparity and healthcare access in the United States. We must continue researching how we can use GLP-1 analogues to our advantage and make them accessible to those in need, not just the rich and famous looking to lop off their love handles.
Ozempic For Weight Loss: Cost, Side Effects And Efficacy
While Ozempic is not specifically labeled as a weight loss drug, studies sponsored by Novo Nordisk, the company that makes Ozempic, suggest people who take semaglutide—the active compound in Ozempic—may lose weight . In fact, the FDA approved semaglutide for weight loss in 2021 under the brand name Wegovy. However, Wegovy provides a higher dose of semaglutide than Ozempic—2.4 milligrams of semaglutide in Wegovy compared with 0.5 milligrams, 1 milligram or 2 milligrams of semaglutide in Ozempic.
As a GLP-1 receptor agonist, semaglutide enhances the effects of the naturally occurring hormone GLP-1. Dr. McGowan explains that in addition to its effects on blood glucose and diabetes, GLP-1 also impacts weight via two key mechanisms:
"The net result is decreased hunger, prolonged fullness and ultimately weight loss," adds Dr. McGowan.
In one large clinical trial sponsored by Novo Nordisk, 1,961 adults with excess weight or obesity who did not have diabetes were given 2.4 milligrams of semaglutide or a placebo once a week for 68 weeks, along with lifestyle intervention. Those who took semaglutide lost 14.9% of their body weight compared with 2.4% for those who took the placebo .
It's important to note that the dose of semaglutide used in this study was higher than the dose provided by Ozempic. However, 2.4 milligrams is the dose of semaglutide in the FDA-approved weight loss drug Wegovy.
"Ozempic is FDA approved for the treatment of diabetes only. It is not a weight loss medication," explains Dr. McGowan. "Its sister medication, Wegovy, is specifically approved for the treatment of weight," he adds.
Even though Ozempic and Wegovy are essentially the same medication (just available in different doses), it should be noted that while Ozempic is typically covered by insurance, often, Wegovy is not.
High demand and subsequent inventory and supply chain strains have severely impacted the availability of Wegovy, notes Dr. McGowan. As a result, Wegovy has been repeatedly unavailable since its introduction and many people are turning to off-label use of Ozempic for weight loss. Dr. McGowan notes that this is interfering with the availability of Ozempic for those with diabetes.
While taking semaglutide may help you lose weight while you are on the drug, most people will regain much of that weight if they discontinue using it. "Studies show that stopping Ozempic completely will likely lead to regaining most of the weight lost within several months," notes Rekha Kumar, M.D., head of Medical Affairs at evidence-based weight care program Found, and practicing endocrinologist at an academic medical center in New York City.
"GLP-1 medications [like Ozempic] are designed to be taken long-term," explains Dr. McGowan. "They are chronic medications for the treatment of chronic conditions (both diabetes and obesity)."
Is Ozempic Effective for Weight Loss?While Ozempic is not FDA-approved for weight loss, semaglutide, the active ingredient in both Ozempic and Wegovy (an FDA-approved weight loss medication), slows stomach emptying, which may decrease appetite.
When combined with diet and exercise, semaglutide may promote weight loss and decrease the risk of cancer, diabetes and cardiovascular disease in individuals with obesity or overweight.
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Jillian Michaels Predicts A Massive Fallout From Ozempic Craze
Originally appeared on E! Online
Oh, are we still talking about Ozempic? We are.
And for those who are considering giving the injectable medication—originally marketed for treating Type 2 diabetes—a shot, well, Jillian Michaels has a few words of caution.
"I think the situation is becoming even more concerning as new information gets out about the drugs," the trainer noted in an exclusive interview with E! News. And, as one might expect from the no-bulls--t host of podcast Keeping It Real, she didn't hold back when asked about her apprehension toward the semiglutide injectable used by stars like Sharon Osbourne (who has since said she's struggled to put weight back on) and Chelsea Handler, who said she didn't like how it made her feel.
"With anything medical, whether we're talking about a vaccine or antibiotics, there are always side effects," she explained, listing the potential downsides. "So let's start out with the side effects that are on the f--king website: We've got thyroid tumors, gallbladder problems, pancreatitis, kidney issues, vision loss, stomach problems now including stomach paralysis. There's a class action lawsuit for stomach paralysis." (A spokesperson for Novo Nordisk told Reuters, the company "believes that the allegations in the lawsuit are without merit, and we intend to vigorously defend against these claims." A hearing is set for Jan. 25.)
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More anecdotally, she continued, experts like Dr. Peter Attia have warned of significant muscle loss and the oft-mentioned "Ozempic face," in which the drastic weight loss can lead to sagging and other facial changes.
"People are always like, 'Oh, It's because of rapid weight loss," noted Michaels. "No, it's not."
Across 11 seasons on "The Biggest Loser " and even more as a personal trainer, "I've taken a tremendous amount of weight off of arguably tens of thousands of people," explains the founder of The Fitness App. "I've seen a bazillion before and afters to my website. For everything I've ever done, personally, people always looked better, they never look worse. So anecdotally there's something happening, in my opinion, that's arguably causing the breakdown of collagen."
Throw in vomiting, diarrhea and the number of hairdressers speculating about why they've been seeing increased hair loss in their clients, and it's a strong no from Michaels.
And, to be clear, she's not shaming those who have considered giving the seeming cure-all a shot. "I form zero, and I mean, zero judgment on this," she insisted. "And what's sad is that people are like, well, I don't want to take the easy way out. And trust me, life is hard enough. If this was an easy way out, I would be the first one signing everybody up and selling the drugs through my website."
But the way she sees it, hopping onto the Ozempic bandwagon "is the opposite of an easy way out."
For starters, she explained, she doesn't see a clear path for getting off of the drug. "And if you do all of the meta analyses shows that you gain the weight back—two-thirds within the first year alone and then some," Michaels explained. "It is yo-yo dieting on crack." (Responding to a 2022 study that showed patients regain the weight, Novo Nordisk, the makers of Ozempic and Wegovy, said in a statement, "Not unexpectedly, patients experience weight regain once they stop taking the medication. Obesity is a chronic disease that requires long-term management, much like high blood pressure or high cholesterol.")
With the medication imitating GLP-1—a hormone that naturally occurs in the body, to lower blood sugar levels—it manages appetite by affecting both the stomach and brain.
"If I'm not giving my body food, and I'm consistently eating less than I burned in a day, it's not like f--king Stephen King's Thinner, where you eventually disappear," continued Michaels. "The body is like, 'Oh, wow, we've got to change some things around here biochemically. And we've got to lower our metabolic setpoint.' And it does this by changing out what hormones are released when and so on and so forth. So now you've lowered your metabolism, you've f--ked up your hormone balance, you've lost a ton of muscle. You're working from all the way behind the eight ball if you ever get off of it."
It's also worth noting that Ozempic maker Novo Nordisk previously told E! News that the drug is not FDA-approved for chronic weight management, nor is it marketed as a weight loss aid.
For those that plan to keep using the medication forever and are willing to navigate both the hefty price tag and the supply issues caused by its increased popularity, a plateau looms.
While the experience varies from patient to patient, basically, hypothosized Michaels, the body will adapt to the medication "the way you adapt to coffee. Just the way people adapt to any other drug. Just the way we become insulin resistant or leptin resistant. And you plateau."
Which is why she predicts a backlash will come next.
"Two years from now, you're going to see the fallout from this, just like we did with all the other diet drugs over the years," said Michaels. "And the fallout will be significant. Right now everyone is like, 'I've been on for six months, I look and feel great.' And then what happens when it's no longer impacting your appetite and you plateau in a year and a half? Or what happens when you experience one of these side effects? Or all of a sudden your hair starts falling out six months in or you look like complete s--t?"
Here's what you need to know about semaglutide, the drug commonly marketed as Wegovy and Ozempic.
In other words, she summed up, "I cannot issue a strong enough warning."
For those curious what Michaels is recommending it's a return to the basics: Eat less, move more.
"I'm not saying it's easy," she admitted, "I'm saying it's simple."
She suggests springing for a smartwatch like her go-to iTOUCH Wearables and using it to track how many calories you burn each day.
From there, "You've got to spend two weeks learning how many calories are in the things you eat regularly," she said. And while she understands calorie-counting gets a bad rap, "if I don't tell you how to do it, you won't be able to actually effectuate change. And then you don't believe what I'm saying because you don't realize how much you're eating and you get discouraged and become vulnerable to more fads and trends."
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The goal, she continued, is to create a 500-calorie-a-day deficit, which will translate to losing roughly a pound each week.
And while, yes, she jokes, "I want you to eat, like, Moringa greens, grown by Tibetan monks in the third phase of the crescent moon," she also wants to meet people where they're at.
"If it's too much to ask people to switch that pizza to a chicken salad, here's what we're going to do," Michaels said. "Instead of half the pie, you're going to do one slice of pizza and you're going do a side salad. Or two slices of pizza and a side salad with the dressing on the side. And we're going to opt out of the Coke. Or the two glasses of wine. Done. And all of this will work. I promise."
Sharon Osbourne is getting real about her experience with using Ozempic for weight loss. The 71-year-old revealed to the Daily Mail she is now under 100 lbs after using the medication and admits she can't gain any weight back. "I'm too gaunt, and I can't put any weight on," she said.
In fact, noted Michaels, one of the benefits of the Ozempic obsession has been that "it's evidenced what I've said for three decades. When you eat less food, you will lose weight."
It's just that her way of doing things, she noted, while undoubtedly slower, is also safer. "We're not dealing with significantly less food forever, we're eating a little bit less food," she explained. "And we're still able to get the nutrients from our food, we're not messing with our biochemistry and our hormones. So we don't have any of those negative side effects biochemically."
Of course, the fitness pro isn't the first to sound off on Ozempic's increasing popularity.
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