What is Ozempic?
- Ozempic is a GLP-1 agonist. GLP-1, or glucagon-like peptide-1, is a hormone that your body naturally produces in your gut. It plays a crucial role in regulating blood sugar levels and controlling appetite. Because of this, a class of medications called GLP-1 agonists are used to treat chronic conditions like Type 2 diabetes and obesity. Ozempic, along with another common medication called Wegovy,are two brands of GLP-1 agonists that enhance the action of GLP-1 made in the body, which is why they are commonly prescribed to manage these conditions.
How do Ozempic and Wegovy lead to weight changes?
- By mimicking natural GLP-1s in the body, these medications stimulate the release of insulin to help lower blood sugar after eating. It also makes you feel fuller for longer by reducing appetite and slowing down gastric emptying.
What are some common myths about GLP-1s?
- These are new drugs on the market
- The first GLP-1 agonist, exenatide (Byette), was approved by the FDA in 2005 for treating type 2 diabetes. Since then, these medications have been approved for obesity management, and have a well-established medical history.
- They are dangerous and cause severe side effects
- While all medications carry potential risks, GLP-1 agonists are generally regarded as safe when appropriately prescribed. The most frequently reported side effects include nausea, vomiting, and diarrhea, which usually occur as the body adapts to the treatment.
- They cause cancer
- Pancreatic and thyroid cancer have been subjects of concern. However, research indicates that these instances are rare and no definitive conclusions for these cancers can be drawn at this point due to low incidence of these conditions. However, it is crucial to use these medications under the supervision of a healthcare provider to ensure safety.
- Taking these medications for weight loss is cheating
- While social media makes these medications look like a quick fix, these are not a “miracle weight loss drug”. Many people take these medications to improve their quality of life and prevent worsening chronic conditions.
- You don’t have to workout or eat healthy when taking medications like Ozempic
- GLP-1s only help to regulate hunger. It’s best in conjunction with a health-forward diet and regular movement!
Things to Consider:
- Compounding Pharmacies: When FDA-approved drugs are in critical shortage, the FDA may allow pharmacies to compound custom versions. However, compounding pharmacies are not regulated by the FDA and these formulas can differ from the pharmaceutical versions. In 2022, a shortage of GLP-1s led the FDA to permit compounding, making lower-cost alternatives to pharmaceutical company versions available.
- Semaglutide and tirzepatide have been removed from the FDA’s shortage list, meaning compounded versions from pharmacies are no longer available.
- Tirzepatide compounding ended on March 19, 2025, and semaglutide followed on April 22, 2025.
- Discontinuing Use:
- No long-term studies are available on weight loss maintenance or side effects after stopping GLP-1 medications.
- Research on adults with overweight or obesity shows significant weight regain within a year of stopping treatment:
- The STEP 4 trial (2021): Participants lost 10.9% of body weight after 20 weeks on semaglutide, then regained 2.7% after 48 weeks on placebo.2
- The STEP 1 trial (2022): Participants lost 17.3% after 68 weeks on semaglutide, then regained 11.6% over 52 weeks on placebo.3
- The Surmount 4 trial (2024): Participants lost 20.9% after 36 weeks on tirzepatide, then regained 14% after 52 weeks on placebo.4
Additional Note:
- GLP-1 drugs effectively manage type 2 diabetes and also promote weight loss. Like metformin, they are intended for long-term use alongside lifestyle changes. While the FDA has approved their use for obesity, long-term studies for this purpose are still pending. Emerging research suggests potential benefits for conditions like Alzheimer’s, heart disease, and addiction. However, given the limited data on long-term effects, any use beyond diabetes should be carefully considered with guidance from a primary care provider.
Sources:
- Drucker DJ. The GLP-1 journey: from discovery science to therapeutic impact. Journal of Clinical Investigation. 2024;134(2); Smits MM, Van Raalte DH. Safety of Semaglutide. Frontiers in Endocrinology. 2021;12. doi:https://doi.org/10.3389/fendo.2021.645563
- Drug shortages. FDA. Accessed April 18, 2025. https://dps.fda.gov/drugshortages.
- 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. JAMA. 2021;325(14):1414. doi:10.1001/jama.2021.3224
- Wilding JP, 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
- Aronne LJ, Sattar N, Horn DB, et al. Continued treatment with Tirzepatide for maintenance of weight reduction in adults with obesity. JAMA. 2024;331(1):38. doi:10.1001/jama.2023.24945
- Peel IJ and M. Weight loss drugs may also treat addiction, alzheimer’s, and heart disease. Ars Technica. December 12, 2024. Accessed April 18, 2025. https://arstechnica.com/health/2024/12/weight-loss-drugs-may-also-treat-addiction-alzheimers-and-heart-disease/.