Could Ozempic Actually Be Making People Fatter? We’re Taking A Closer Look At This Controversial Weight Loss Drug

By now, most of us are familiar with Novo Nordisk’s new semaglutide injection Ozempic, but what many may not realize is that this drug actually has the potential to make patients unhealthier than they were before.

By Anna Powers5 min read
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Shutterstock/Natalia Barliaeva

Ozempic (semaglutide) is a prescription injection manufactured by pharmaceutical giant Novo Nordisk. In late 2017, Ozempic became FDA-approved for the treatment of type 2 diabetes (also known as adult-onset diabetes), which is a chronic disease affecting over 37 million Americans. It then hit the market in early 2018 and became a blockbuster drug by the year’s end, meaning that Ozempic generated a minimum of $1 billion in annual sales. In 2020, Ozempic gained FDA approval for cardiovascular disease, making this the drug’s second approved indication. By the end of 2023, Ozempic is predicted to generate a total of $12.5 billion in sales. Its popularity has caused it to face supply chain challenges and shortages throughout 2022. 

Ozempic is offered in three varying strengths (0.5mg, 1mg, or 2mg) and is administered as a weekly injection to the stomach, thigh, or upper arm. Researchers claim that it takes about four to five weeks to begin seeing or feeling results in most patients. Its most common side effects include nausea, vomiting, diarrhea, abdominal pain, and constipation. A few of the more serious side effects are thyroid tumors, cancer, pancreatitis, kidney failure, and changes in vision. According to New York Times research, Ozempic has been widely shown to also cause facial aging and malnutrition. A comprehensive list of side effects can be found in the drug’s Indication and Important Safety Information

What’s All the Buzz About?

You may be wondering why there’s so much conversation surrounding Ozempic in 2023 if it gained its first FDA approval seven years ago and has been on the market for half a decade. 

In 2022, the story of Ozempic began to change. Over the last few years, healthcare providers and pharmaceutical marketers have realized that Ozempic has the potential to solve health problems aside from type 2 diabetes and cardiovascular disease – namely, it has also been shown to be a game changer for weight loss. While Ozempic has not gained FDA approval for an obesity indication, many doctors are prescribing the drug “off-label,” or prescribing it for a usage other than what the drug was originally intended for. It’s not uncommon for providers to prescribe drugs off-label, but it’s important to note that side effects could vary depending on if a patient falls in a drug’s target group or not.  

Within the last year, the media has uncovered stories of celebrities who took (or still take) Ozempic. From Elon Musk to Sharon Osborne and Remi Bader, stars from all facets of fame (none of whom suffer from diabetes) have been taking this revolutionary drug to achieve their dream bodies. Controversy has surrounded these stories due to the Ozempic shortage, with many arguing that celebs are abusing their wealth and status to get their hands on a medication that is not even intended for them, making the drug unavailable to type 2 diabetics who need it more. 

What’s the Difference Between Ozempic and Wegovy?

Along with Ozempic, Wegovy is another one of Novo Nordisk’s products that is receiving a lot of attention lately. The two belong to the same class of drug (GLP-1 antagonists) and at a chemical level are nearly interchangeable. The only differences between the two are the prescription, dosing, and indications (or usages). Healthcare providers prescribe these two drugs interchangeably to treat a variety of conditions like diabetes, obesity, heart disease, liver disease, kidney disease, and other comorbidities. 

Obesity is a chronic medical condition that is measured by a body mass index of over 30.

Ozempic was FDA approved in 2017 to treat type 2 diabetes (which is still its primary indication), and Wegovy was FDA approved in 2021 to treat obesity. Remember, obesity is not simply defined as an overweight individual – it is a chronic medical condition that is measured by a body mass index (BMI) of over 30. Nonetheless, many Ozempic/Wegovy users do not fall into either of the need categories but are being prescribed semaglutide because they simply want to “lose weight.”

How Does Ozempic Work?

When someone has type 2 diabetes, their body either does not produce enough insulin or react to the insulin that it produces. Insulin is the protein that helps regulate blood sugar levels by facilitating cellular processes that break down glucose. When the body does not produce enough insulin, sugar will remain in the bloodstream and not become usable energy, ultimately causing that excess sugar to be stored as fat. This causes diabetics to gain weight and experience increased fatigue and decreased energy levels. When a body is insulin resistant, it must secrete higher levels of insulin to adequately regulate blood sugar – this is also referred to as a pre-diabetic state. Insulin resistance typically occurs in overweight individuals, and this is why those with type 2 diabetes and those with above-average BMIs can be treated similarly. 

All of that is a long-winded way of saying that Ozempic and its partner drug Wegovy increase the insulin function in the body and lower symptoms of type 2 diabetes or obesity. Ozempic works by stimulating the production of insulin from the pancreas to better regulate the body’s blood sugar and stimulate the conversion of simple glucose into usable energy. It also prevents blood sugar spikes by reducing the speed at which food leaves the stomach, which can minimize appetite and help you lose weight.

How Effective Is Ozempic?

While before and after photos online may beg to differ, Ozempic and similar semaglutide products are not as effective as they may seem. In fact, a study from the Journal of Pharmacology and Therapeutics discovered that over two-thirds of participants gained back all the weight they had lost on Ozempic (and more) less than a year after stopping usage of the drug. Additionally, several doctors have been quoted in magazines, on talk shows, etc., confirming that the Ozempic rebound is real. While these semaglutides can be highly effective at making the number on your scale drop while regularly using them, the minute that patients stop taking these medications, their bodies revert back to their previous weight.

This finding is problematic for a few reasons – firstly, it shows us that in order to maintain the desired result, patients must continue spending thousands of dollars on a drug that is in high demand and low supply. It adds achieving our dream bodies to the long list of personal health goals that we rely on pharmaceutical products for. Secondly, since semaglutide causes food to remain in the stomach longer, essentially tricking your brain into thinking that you’re not hungry, it can send your body into starvation mode. It has been established for a while now that starving yourself is not a healthy or effective way to lose weight, so why are we still allowing it to happen?  

Remi Bader, model and content creator, has talked about how her weight rebounded after stopping Ozempic. She originally went on Ozempic because she was pre-diabetic, insulin resistant, and gaining weight from her binge eating. After losing some weight from Ozempic, she quit the medication – and "gained double the weight back." 

"I saw a doctor, and they were like, it's 100% because I went on Ozempic," Bader said on an episode of the Not Skinny But Not Fat podcast. "It was making me think I wasn't hungry for so long, I lost some weight. I didn't wanna be obsessed with being on it long term. I was like, I bet the second I got off I'm gonna get starving again. I did, and my binging got so much worse. So then I kind of blamed Ozempic."

The Consequences of Losing “Good Weight” 

Not nearly enough people are talking about the fact that Ozempic and Wegovy leave patients with a consistent or higher fat percentage than they had before starting the drug. The type of weight that patients lose on Ozempic or Wegovy does not lead them to a healthier body. 

While Ozempic will make patients lighter, it also produces a higher fat density, making them fatter.

According to Healthline, when losing weight, anywhere from a quarter to a third of weight lost can be muscle, but the rest should be fat. Anything higher than this range puts your body composition at risk. But with Ozempic and similar drugs, the ratio is closer to 50/50. This means that along with dropping a good percentage of fat, about half of the weight that is lost on these drugs is lean muscle, which is the healthiest type of weight to have. The more weight patients lose on Ozempic, the more damage is done to their body compositions because their fat-to-muscle percentages skyrocket. So, while Ozempic will make patients lighter, it also produces a higher fat density, in turn making them fatter.

Dr. Rekha Kumar, a practicing endocrinologist in NYC and Chief Medical Officer of Found, told Healthline, “It’s important to note that lower body weight does not always mean that a person is healthier. After some weight loss is achieved and a person reaches a plateau, it is important to assess body composition.”

Some doctors are now requiring patients to complete a bone density and body composition test called a DEXA scan before going on Ozempic. Other providers are increasing education surrounding how to avoid losing muscular weight on Ozempic. Some of their tips include maintaining a regular workout routine and eating a protein-rich diet. 

The Risks of “Off-Label” Usage

While Ozempic is not FDA approved for weight loss, many doctors prescribe it to patients aiming to lose weight because of its efficacy and its perceived harmlessness. But how harmless is it, really? The short answer is that we don’t know, and neither do doctors. There has not been enough research conducted on how Ozempic would affect a sample population with lower body weights. Dr. Hwang, the chief of the endocrinology division at UNC-Chapel Hill School of Medicine, told The New York Times that “it’s possible that patients outside of the group the drug is intended for could experience more intense side effects.” Be cautious of using prescription drugs that are not intended to treat your specific condition, body, or health goals. 

Closing Thoughts

It’s time for the world to wake up and respect the intended usages of pharmaceutical products. Just because Ozempic and similar semaglutides could lower body weight does not mean that it should be used on the average person trying to drop a few pounds. Ozempic and Wegovy were manufactured with the intention of treating patients with chronic conditions like type 2 diabetes, cardiovascular disease, and obesity. When drugs are misused, patients can find themselves in a worse state than they were before visiting their healthcare provider. 

Using Ozempic and Wegovy for everyday weight loss reinforces a deeply problematic message to society that instead of looking within ourselves and changing our lifestyles, we can instead turn to pharmaceutical products to “fix” our body image issues. What celebrities and those using Ozempic for weight loss are doing is handing the power over to Big Pharma and robbing themselves of the rewarding journey of achieving a health goal on their own. Remember that just because the number on the scale may have dropped, it doesn’t mean you are a healthier version of yourself.

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