Expert Diet and Weight Loss Solutions

The glucagon-like peptide 1 (GLP-1) drug Ozempic received FDA approval for use in adults with type 2 diabetes in late 2017. But lately, its been in the headlines for other reasons: Purported weight loss benefits and a shortage.

People are talking about them because there is a trend of celebrities and influencers increasingly turning to off-label use of GLP-1 medications like Ozempic for weight loss by people who are not obese or diabetic, says Dr. Rekha Kumar, a New York City-based endocrinologist and head of medical affairs at the weight care program Found.

Kumar says this is particularly problematic.

The trend of medispas, boutique weight loss practices, and illegitimate telehealth businesses liberally prescribing to people who dont meet criteria is not only irresponsible prescribing but could interfere with getting the medication to those who need it the most, Kumar says.

Kumar and other experts separated fact from fiction by answering the following common questions about Ozempic.

Ozempic is a brand name for the drug known as semaglutide, explains Dr. Angela Fitch, FACP, FOMA, the president of the Obesity Medicine Association and chief medical officer of knownwell, a weight-inclusive healthcare company.

Kumar notes that Ozempic is a weekly injectable medication for people with type 2 diabetes. Its initial FDA approval was for doses of 0.5 mg or 1 mg. In 2022, the FDA approved a higher dose of 2 mg.

It lowers blood sugar by helping the pancreas make insulin, Kumar says.

No.

Ozempic is only approved for diabetes, says Dr. Charlie Seltzer, a Philadephia-based physician with board certifications in obesity and internal medicine.

But thats where some of the confusion comes in.

The active ingredient, semaglutide, is approved for weight loss under the trade name Wegovy, Seltzer says.

In October 2022, Elon Musk tweeted that Wegovy helped him lose weight.

Both Ozempic and Wegovy are brand names for semaglutide and injectables. But theyre not exactly the same.

Wegovy is FDA-approved for the treatment of overweight and obesity, Kumar says. Wegovy contains a higher dose of semaglutide, [2.4 mg], than Ozempic and was developed specifically for the treatment of overweight and obesity.

Kumar notes that the research around semaglutide and weight loss used Wegovys dosing, including one from 2021 that indicated that once-weekly doses of 2.4 mg of semaglutide could reduce body weight when combined with lifestyle changes.

[In the] study, those who took the medication and made lifestyle changes lost almost 15% of their body weight, on average, compared to 3% in the placebo group, Kumar says.

So, yes, semaglutide at least at a higher 2.4 mg dose may help with weight loss. Though its unclear if the 0.4 mg difference in dosing for Ozempic versus Wegovy matters, Seltzer notes the two work the same way.

Ozempic causesappetite suppression and increases the time it takes food to exit the stomach, leading to feeling full longer, Seltzer says. It does nothing magical to metabolism.

And Kumar notes that, despite what some celebrities and social media influencers may claim, these drugs are not meant for people looking to lose a couple of pounds.

Normal-weight patients without diabetes might lose weight if they take GLP-1s, but the risks of the medication outweigh the benefit of weight loss just to be thin versus treating a disease, Kumar says. GLP-1s have not been studied in this population, and we will likely see more side effects with this type of inappropriate use.

Experts share that the answer to this question will vary from person to person.

Generally, it takes a few weeks to start seeing the effects of weight loss from Ozempic, says Kumar.

Part of this is that people do not begin taking all 2.4 mg of Wegovy at once. Instead, they start at a dose of 0.25 mg per week and increase every four weeks, maxing out at 2.4 mg.

The dose is gradually raised every four weeks to lessen the likelihood of side effects, says Seltzer. Once the dose that causes appetite suppression sufficient to cause a calorie deficit is achieved, weight loss happens quickly.

Its essential to follow your healthcare providers dosing instructions to decrease side effect risks.

Ozempic is generally considered safe in doses up to 2 mg. for adults with type 2 diabetes, but experts share that some people should not take it.

It should be avoided in many populations, including but not limited to people with a history of pancreatitis, people who have had medullary thyroid cancer or who are at increased risk for medullary thyroid cancer, Seltzer says.

Your doctor can help you determine if you are a good candidate for Ozempic. Additionally, some people may experience side effects. Fitch says common ones include:

A trial of nearly 2,000 people published in 2022 indicated that people who stopped taking 2.4 mg doses of semaglutide had regained two-thirds of the weight they had lost one year after cessation.

Once the drug is stopped or loses its effectiveness, the same issues that got the people into trouble in the first place will still be there, and the weight will come right back on, Seltzer says.

Fitch agrees,

Whatever you do as a person to help with weight loss, you have to keep doing, or the weight will come back, Fitch says. This is the way the human body is engineered. It is built to protect its weight at all costs.

Long-term care is essential.

Since obesity is a chronic disease, you must treat it chronically, ongoing in a coordinated comprehensive way, Fitch says. Patients must work with their doctor for a holistic approach to metabolic health, weight management, and primary care.

Kumar says semaglutide is safe for long-term use, and Fitch says continuing to take it may help a person maintain weight loss.

You have to continue the medication you take if it has helped you to lose weight, just like you continue cholesterol medication once your cholesterol is lower. If you stop it, your cholesterol goes back up, Fitch says.

First, Fitch notes that any treatment for obesity should be non-judgmental and lean into shared decision-making.

Obesity is a lifelong chronic disease for most people and should be treated in a compassionate and comprehensive patient-centered way, such as shared decision making around taking medication or having surgery with the risks and benefits in mind, Fitch says.

Lifestyle tweaks like diet and exercise are often recommended as first-line treatments, but they do not work for everyone.

Obesity is a complex disease with many factors, Fitch says. When lifestyle changes are not enoughwe add in other treatments to help patients live longer, healthier, better quality lives.

Original post:
Ozempic for Weight Loss: Experts Answer 9 Common Questions - Healthline