Ozempic – Is the Miracle Weight Loss Drug Worth It?

By Neeladri Misra MD, FACP, Internist, Roseville, CA

Semaglutide, popularly known as the drug “Ozempic,” is a Type 2 diabetes drug that gained FDA approval in 2017. The drug works on the body in many ways by slowing down stomach emptying, increasing the body’s glucose tolerance, and helping insulin production, which eventually lowers blood sugars. Earlier drugs in its class were well known to have similar effects with the primary aim of glucose reduction and secondary benefits of weight loss; however, the extent of weight loss was seen more in trials with semaglutide. This particular class of drugs was used in obese Type 2 diabetics where weight loss and glucose control both need to happen for desirable diabetic control.

In 2021, the FDA approved the weight loss drug Semaglutide (Ozempic), now remarketed as Wegovy (semaglutide), at a different dosage for weight loss based on clinical trials published showing up to 15% body weight loss occurred in patients taking this drug given as an injection once a week. The drug was approved for patients with a BMI of 30 or more. Since the approval, the drug caused waves in the market as it was the first weight loss drug approved since 2014. Its popularity increased further after marketing and endorsements by celebrities helped the drug achieve and reach a target population far beyond its intended use.

The drug is a great viable option for people who are struggling with obesity and fail to achieve weight loss. The ease of administration (injection once a week) helps curb appetite along with its effects on insulin, glucose, and body fat, making it an extremely popular drug for weight loss. The effects of weight loss are felt as early as 4 weeks into its use, with most people experiencing about a 10 to 15% weight loss by the time they have used it for at least 3 to 6 months. Patients also reported a marked improvement in their overall health due to weight loss, with improvements in their diabetes, blood pressure, and other health conditions. The drug is now also available in an oral form (Rybelsus) taken every day, which may be more suitable for people not willing to take an injection.

However, the big question is: are these miracle drugs good for you and worth taking for weight loss? More recently, the drug has come under scrutiny by the FDA because of side effects and adverse reactions. Because the drug acts by slowing down the stomach, many patients feel sick, noticing an increase in nausea and vomiting to the point where they have to be hospitalized. This can also lead to dehydration and kidney failure at times. Patients also had an increase in mental health issues, including depression, after taking the drug, which was extremely unusual, leading to scrutiny of this medication. There were also several reports of patients regaining weight back after stopping using the medication. The drug is also expensive, and often not covered by insurance. There are discounted coupons available, and off-label uses, but yet, it remains an option out of reach for many.

So, is this drug right for you? There is no good answer, but there are pros and cons. If you have health conditions such as Type 2 diabetes your body mass index is 40, and you are struggling with weight loss, there is a good benefit of taking this drug, as this drug will quickly help you curb your appetite, improve your glucose tolerance, help with your body metabolism, and aid you in losing weight. The effects of the drug will be quickly visible with weight loss, and in a few weeks’ time, you will start noticing the difference. The drug is easy to administer and is usually taken once a week.

For people, however, whose BMI is less than 40 and who do not suffer many health issues, a lifestyle change, including diet and exercise, is certainly the first option to consider. Not only will it give you similar weight loss, but it will also be longer-lasting and more effective. You will also adopt a healthier lifestyle that will benefit you throughout your life. One can still consider using Ozempic, Wegovy, or Rybelsus in this group if you have attempted diet and exercise and are still struggling to lose weight. The key to weight loss is to alter your body’s metabolism in the right way. The caveat, however, is always that if you choose to use this drug, the side effects may be disabling and need to be very carefully considered.

Overall, the drug has good benefits for people, and it has been the first drug that has now shown very good results. It has also shown additional benefits in the cardiovascular world with improvements in heart failure, and coronary artery disease, and in the future, this drug will likely help many patients with metabolic issues.