Is Ozempic Safe For Weight Loss? What You Need To Know
This blog explores how Ozempic works and outlines possible side effects and potential risks to help you make informed choices.
What is Ozempic, and Why Did It Become So Popular?
Semaglutide, most widely known as Ozempic and Wegovy, is a GLP-1 agonist, meaning it mimics the peptide hormone GLP-1. The GLP-1 peptide is a naturally occurring hormone produced by the gut that sends signals to the brain, affecting metabolism and appetite. Originally developed to treat diabetes, Ozempic keeps blood sugar low by stimulating insulin secretion and slowing glucagon release. This effect on blood sugar facilitates lipolysis or fat-burning.
As more people used Ozempic to treat diabetes, many noticed significant weight loss. Around 2021, Ozempic began circulating among patients as an off-label weight-loss medication. As Ozempic was increasingly seen as a weight loss solution, prescriptions of this medication became commonplace and garnered a lot of media attention. Eventually, semaglutide became a weight loss drug known as Wegovy.
How Does Semaglutide Work?
Boosts Insulin Production
Semaglutide helps produce more insulin to regulate glucose levels.
The synthetic GLP-1 sends a signal to incretins, a peptide hormone that stimulates pancreatic cells to make more insulin.
Suppresses Glucagon
Glucagon is a hormone that increases blood sugar levels and prevents them from dropping too low by prompting the liver to release stored glucose.
In other words, it has the opposite effect of insulin.
Some people with type 2 diabetes have higher than normal levels of glucagon.
Semaglutide helps balance the levels of insulin and glucagon.
This improved ratio of insulin and glucagon facilitates the use of stored fat more efficiently.
Promotes Satiety Hormones
Peptide YY: GLP-1 enhances PYY secretion, which promotes satiety and reduces food intake
Leptin: Overweight or obese patients often develop insensitivity to leptin. Leptin regulates hunger and energy expenditure. Ozempic and other GLP-1s support leptin’s efficacy by improving insulin sensitivity and reducing inflammation. This makes leptin more effective at signaling for satiety.
Reduces Hunger Hormone
Ghrelin: This is the primary hunger hormone. It is produced by the stomach, with smaller amounts secreted by the pancreas and small intestine. It is crucial in stimulating appetite and regulating metabolism and energy balance. Ghrelin primarily signals to the brain (the hypothalamus specifically). It encourages reward-driven eating by interacting with the dopaminergic system in the brain, contributing to cravings and sometimes overeating. One of the main effects of taking Ozempic is that it reduces ghrelin, making you feel less hungry between meals and turning the volume down on cravings.
Slows Gastric Emptying
As you begin to digest food, the stomach goes through phases of gastric emptying that help move contents from the stomach to the duodenum (the first part of the small intestine). Typically, this process takes one to two hours.
Taking Ozempic slows the transit time of food leaving the stomach, making you feel fuller longer.
Is Semaglutide Safe?
What Are The Side Effects of Taking Ozempic?
Our patients tend to tolerate semaglutide well, primarily because we coach them with a “low and slow” dosing strategy. That said, below are the most common side effects, which are typically mild and improve over time:
Nausea (most common) - often experienced when starting or increasing the dose
Diarrhea or constipation - GI changes are common, but generally temporary
Stomach cramping or bloating - can be mild to moderate
Vomiting - less common, usually a dosing problem
Excessive loss of appetite - typically can be resolved with lower dose
Acid reflux - food choices and timing can help mitigate
Fatigue - some experience 1-2 days of fatigue following the injection day.
Dietary adjustments can help patients manage side effects, and you can learn more about them in our Side Effects of Semaglutide For Weight Loss blog.
What Are The Risks of Taking Ozempic?
Gastroparesis (Severe Delayed Stomach Emptying): Some users experience prolonged nausea, bloating, and vomiting due to slowed digestion.
Pancreatitis: Rare but serious inflammation of the pancreas (severe abdominal pain, nausea, vomiting).
Gallbladder issues: Increased risk of gallstones and cholecystitis (gallbladder inflammation).
Hypoglycemia (Low Blood Sugar): More common if used with insulin or sulfonylureas.
Kidney problems: Can worsen dehydration-related kidney issues.
Thyroid tumor risk (in rodents): There’s a warning about possible thyroid C-cell tumors, but human risk is unclear.
Does Ozempic Cause Muscle Loss?
“A 2021 study on semaglutide found that 39% of total weight lost was from lean mass (muscle & bone).”
Ozempic (semaglutide) can contribute to muscle mass loss, but it’s not the drug itself that causes it. Rapid weight loss, calorie restriction, and nutrition choices can lead to the loss of muscle mass.
Muscle mass loss can be a difficult thing to avoid when cutting calories. With longevity in mind, you are better off being a little overweight with a healthy level of muscle mass than being “thin” with poor muscle mass.
Losing muscle mass sabotages metabolism and longevity.
Muscle mass loss seen in the semaglutide studies was similar to other rapid weight loss interventions, including bariatric surgeries.
Reduced physical activity may be a cause of muscle mass loss, as fatigue can be a side effect of this medication.
How To Minimize Muscle Mass Loss When On Ozempic
In our clinic, we pair every Ozempic prescription with the following instructives:
Increase Protein Intake: Aim for 1g of protein per pound of body weight daily to preserve muscle.
Strength Training: Resistance training 2 - 4 times weekly helps maintain lean mass.
Stay Active: Incorporate walking, cardio, and bodyweight exercises to support overall muscle retention.
Monitor Weight Loss Pace: Losing weight too fast (>1–2 lbs per week) can increase muscle loss risk.
Stay Hydrated & Get Enough Electrolytes: Helps prevent fatigue and supports muscle function.
What Happens When You Stop Taking Ozempic?
What Studies Show About Weight Regain After Ozempic
Research published in the Diabetes, Obesity, and Metabolism journal found people regained two-thirds of the weight lost a year after they stopped taking semaglutide.
Why Does Weight Come Back After Stopping Ozempic?
Appetite Returns: Semaglutide suppresses hunger, but after stopping, ghrelin (hunger hormone) increases, making it harder to maintain a calorie deficit.
Slowed Metabolism: Rapid weight loss can reduce metabolic rate, leading to faster weight regain once normal eating resumes.
Loss of Lean Mass: If muscle mass is lost during weight loss, metabolism drops, making it easier to gain fat back.
Lifestyle Factors: If users rely solely on the medication without changing diet and exercise habits, weight regain is more likely.
How To Maintain Weight Loss After Stopping Ozempic
Our clinic pairs every Ozempic (semaglutide) prescription with the following prescriptive:
The imperative of maintaining muscle mass
Dedicating to regular strength training and exercise
Focusing on a high-protein diet
Mindful eating and portion control
Gradual weaning off the medication
Is There a Difference Between The Safety Profile of Ozempic and Mounjaro?
While Ozempic (semaglutide) and Mounjaro (tirzepatide) have similar safety profiles, Mounjaro may have slightly different effects and risks due to its dual action on GLP-1 and GIP receptors.
Differences Between Ozempic vs. Mounjaro Safety Profile:
Are There Additional Health Benefits to Taking Ozempic To Factor Into The Risk-Benefit Analysis?
While Ozempic does carry risks, there may be some health benefits of taking this medication that you might consider weighing in your decision-making process.
Interesting industry data shows that patients taking Ozempic appreciate several health benefits:
Lowers CRP: Studies show that Ozempic can reduce CRP, a marker of inflammation and cardiovascular risk.
Lowers inflammatory cytokines: Ozempic may reduce inflammatory cytokines like TNF-α, IL-6, and IL-1β.
Reduces Inflammation: Research in mice suggests that Ozempic may reduce inflammation by targeting the brain.
Reduces heart disease risk
Improves metabolic health: reduces progression of type 2 diabetes
Brain and cognitive benefits: studies show some neuroprotective benefits of this medication
May improve mood and reduce depression
Reduces fatty liver disease
Reduces addictive behaviors: many patients drink less alcohol when taking Ozempic.
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