Unpacking the Ozempic Craze: What a Dietitian Wants You to Know

Here are the pros, cons, and considerations

As seen in Metro Style, December 2, 2023

Weight loss is really hard, and everyone always wants a quick fix. Have we finally found it in Ozempic? This new class of drugs, along with Saxenda, Wegovy, and similar medications, have captured our attention as an effortless solution to weight loss, as celebrities, news, and TikTok fuel this trend. Is it as easy as it seems? Will it make you lose weight for good? Will you be healthier? Here are some things to consider as these drugs make waves in the weight-loss space.

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What Is Ozempic?

Ozempic is an injectable medication approved for treating type 2 diabetes, but it has garnered attention for its off-label use for weight loss. Saxenda is a similar medication also for treating type 2 diabetes, while Wegovy is specifically formulated for weight loss and weight management. 

How Does It Work?

To lower blood sugar, Ozempic imitates the body's natural hormone GLP-1. People with type 2 diabetes usually have insulin resistance, and this hormone helps your pancreas release insulin to lower your blood sugar. The weight loss on Ozempic also likely comes from GLP-1’s effects on appetite: it slows down the movement of food from the stomach into the intestines, so you feel fuller for longer. This hormone also signals the brain to reduce hunger and increase fullness.

Contrary to traditional belief, weight loss is not as simple as calories in versus calories out. There are many hormones involved, also genetics related to appetite and fullness levels, dopamine responses to food, and even stress relief through food. If you’ve ever been in a calorie deficit, you know that the body responds by making you hungrier in an effort to get you to eat what your body needs. By suppressing hunger, Ozempic counters the body's usual response to a calorie deficit. 

Is It Effective?

It depends on what you mean. Studies do show that people who use these drugs, along with lifestyle changes, experience an average weight loss of 15% over one year. Those with type 2 diabetes also show improvements in blood sugar levels and HbA1C levels, which measures long term blood sugar control.

However, studies also show that you need to take these drugs long term to maintain results. After discontinuing Ozempic, people tend to regain approximately two thirds of the weight lost within a year as appetite returns. Many studies also show a significant amount of metabolically active lean muscle lost along with fat. This has an effect on total metabolism, as well as the possibility of your body getting used to using fewer calories, which likely explains some of the weight regain.

So yes, you can lose weight and see improvements in blood sugar, but once your appetite returns, the weight might as well.

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Does It Make You Healthier?

Surely, large amounts of weight loss can make a difference in someone’s well being. One could have improved mobility, less strain on joints, improved sleep if there are issues like sleep apnea, and also improvements to heart health. There are also improvements to health as blood sugar improves, such as reduced damage to cells and organs from high blood sugar, and improvements in hormone issues, energy levels, and even mood. 

I do find it is important to recognize that health is multifaceted and goes beyond weight alone. Health includes factors like nutrition, physical activity, stress management, sleep, mental health, and social connections too. Even a sense of purpose is a part of health.

And because we know that the weight loss effects of Ozempic can be reversed, I do recommend using it as a tool to better health rather than a band aid or a replacement for a healthy lifestyle. Studies do show that a healthy lifestyle does improve the results of Ozempic. Exercise, for example, is not just for burning calories, and has a whole range of benefits. As does healthy eating.

Moreover, especially once someone is eating less and losing weight, proper nutrition and lifestyle becomes even MORE important to counter negative effects like muscle loss and a slowed metabolism. In particular, a protein-rich diet, and resistance exercise can help prevent the loss of lean muscle mass. Getting enough vitamins and minerals also is important if one is not eating enough food for an extended period of time.

Are There Side Effects?

As with any medication, there are risks and side effects to consider. These range from common issues like slow digestion, nausea, vomiting, diarrhea and constipation to more severe and scary concerns like thyroid tumors, pancreatitis, kidney problems, vision changes, hypoglycemia, and reports of stomach paralysis. As this is a newer drug, long-term effects are still uncertain and under study.

Going Beyond Weight

As a dietitian, you might think my main focus is weight loss. But to me, nutrition is not solely about weight; it's about fueling your body with the nutrients it needs and feeling good. Don’t get me wrong, I do think it is a positive development to have such powerful tools to improve health, especially in the face of rising obesity and especially type 2 diabetes rates, and so far, I do think there are ways to use these correctly.

However with the constant obsession with thinness, and with now more artificial ways to achieve it, I also worry about the risks of developing disordered eating patterns, body dysmorphia, and the intense societal pressure on body image. Surely, there are many people out there using Ozempic is solely for aesthetic reasons and seeking weight loss at any cost.

In considering the use of Ozempic, or really any other weight loss methods, it's always important to weigh the pros and cons carefully. There is no replacement for a holistic approach to health that includes good nutrition, exercise, and mental well-being. As with any medication, I recommend consulting with your healthcare provider to come up with an individualized plan that fits your individual case and needs.