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Everything you need to know about Ozempic (and Wegovy) for weight loss

The topic of think pieces, group chats, gossip blogs, and more, the swirl around Ozempic for weight loss sometimes overshadows the most important thing: that it can be a game-changer for people living with overweight and obesity. Here’s why.
Published June 29, 2023

Over the last year or two, the word Ozempic has become cultural shorthand for the entire category of prescription weight-management medications—and technically, it’s not even in that category. Initially developed for type 2 diabetes, Ozempic is a brand name for semaglutide, a drug so effective for weight loss that it got its own version just for that, Wegovy, and spurred a whole new generation of weight-management medications. Let’s catch you up on how semaglutide works, the difference between Ozempic and Wegovy, and what makes someone a good candidate for either.

How do Ozempic and Wegovy (semaglutide) work for weight loss?

Semaglutide, which is what’s known as a GLP-1 agonist, works by mimicking a hormone called glucagon-like peptide, or GLP-1, that's already in your body. This hormone is naturally released when you eat and it tells your body to increase insulin to bring blood sugar levels back down. Semaglutide also slows the emptying of the stomach and signals the brain that you are full. By taking semaglutide, you activate the GLP-1 receptors in your body for a prolonged period of time, helping to manage your blood sugar, slow down the emptying of your stomach, and reduce your appetite.

These actions combine to help you feel full for longer and reduce how many calories you eat. The result? On average, 15% weight loss in a little over a year (an average of 33 pounds in 68 weeks), according to a study in the New England Journal of Medicine. “It’s evolved our field at a pace few of us could have anticipated,” says Dr. Amanda Velazquez, M.D., director of obesity medicine at the Center for Weight Management and Metabolic Health at Cedars-Sinai Medical Center in Los Angeles.

These medications also support a more nuanced approach to obesity treatment—that losing weight isn’t simply a matter of willpower or discipline. “People sometimes think that taking these medications is the easy way to lose weight,” says Allison Grupski, PhD, a clinical psychologist and head of behavior change at WeightWatchers. “But that way of thinking minimizes the complications of obesity. There are a lot of biological factors that impact the way we think about food, the way we focus on food, and the cravings we have. Two people can sit in front of the same plate of food and have different brain reactions to that food. It’s not that one person has more willpower; it’s that they are experiencing food differently.”

That said, it’s still important to combine semaglutide with healthy habits to maximize the benefits. “Pairing the medication with lifestyle changes supports your whole health,” says Dr. Kimberly Gudzune, M.D., medical director for the American Board of Obesity Medicine and an associate professor of medicine at Johns Hopkins. “We know that a nutritious diet high in fruits, vegetables, and lean protein is good for your body regardless of weight. And we know physical activity is good for your body regardless of weight.” A weight loss program like WeightWatchers can help you stick with those habits in a way that supports semaglutide.

What’s the difference between Ozempic and Wegovy?

While both Ozempic and Wegovy are the same drug, semaglutide, given by weekly injection, there are some key differences between the two. Ozempic was FDA-approved in 2017 for controlling blood sugar in those with type 2 diabetes. Then, in 2020, Ozempic received a label expansion, approving its use for those with cardiovascular issues—who may or may not be living with obesity—to reduce the risk of heart attack and stroke.

Wegovy, on the other hand, is FDA-approved for chronic weight management. It was approved in 2021 for adults who are either living with obesity (having a body mass index of 30 or greater) or living with overweight (a BMI of 27 or greater) plus at least one qualifying health condition, such as high blood pressure, type 2 diabetes, or high cholesterol.

The two versions of semaglutide also come in different dosages: Ozempic maxes out at 2mg per dose, while Wegovy is approved to be given at a slightly higher dose of 2.4mg.

Who should use Ozempic or Wegovy (semaglutide) for weight loss?

If you qualify for semaglutide and have been unable to lose weight through lifestyle modifications such as diet and exercise, you may be a candidate for semaglutide. “People sometimes describe that before taking semaglutide, they were constantly thinking about food, but once that noise was quieted, they found it easier to make the [lifestyle] changes they always wanted,” says Gudzune. “That drives home that a lot of this is not in your control as much as you’d like it to be.”

As for which brand a healthcare provider will prescribe, that often depends on various factors, including insurance coverage. While Wegovy is the one approved for weight management, Ozempic may be the one that’s covered. “A large portion of people do not have insurance coverage for weight-management medications, but they might for Ozempic,” says Gudzune.

As a result, a health care provider may prescribe Ozempic even if a patient doesn’t have type 2 diabetes–this is known as off-label use. Health care providers often prescribe Ozempic and other medications for off-label use, so this is not an unusual practice. While off-label prescriptions had contributed to a shortage of the drug in the past, that situation has improved. “There’s still a delay on occasion with getting Ozempic, but nothing like it was a few months ago,” adds Gudzune.

As with any drug, deciding whether or not to take semaglutide is best done in partnership with your healthcare provider. For example, there are some people who are advised not to take the medication, including those who have a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2). It is also not recommended for people with a history of pancreatitis.

What are the side effects of Ozempic and Wegovy (semaglutide)?

While semaglutide is generally tolerated pretty well, it could come with several side effects, says Velazquez. These include (in no particular order):

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Stomach pain
  • Loss of appetite
  • Headache
  • Dizziness
  • Fatigue
  • Injection site reactions (such as redness, swelling, or itching)

Less common but more serious side effects of semaglutide may include:

  • Pancreatitis (inflammation of the pancreas)
  • Kidney problems
  • Gallbladder problems
  • Hypoglycemia (low blood sugar)
  • Diabetic retinopathy
  • Hypersensitivity reactions (such as rash, hives, or difficulty breathing)

The majority of the side effects are short-lived and go away once your body gets used to the medication dosage. But if they are intolerable, or if you experience any of the more serious side effects, it's important to let your healthcare provider know. They can help you consider the benefits and risks of continuing to use semaglutide for weight loss. A full list of side effects can be found on the Ozempic and Wegovy sites.

How much do Wegovy and Ozempic (semaglutide) cost?

This all comes down to whether or not the drug is covered by your insurance. If it is, you’re only out your copay. But if it’s not, you may be paying a lot more: The list price for Wegovy is $1,392 for a month’s supply, and Ozempic is $892. That said, you may be able to use a prescription discount card or qualify for a manufacturer-sponsored patient assistance program. To get a better idea of how much Wegovy will cost you, check with your insurer, healthcare provider, or pharmacist.

The fact that these drugs aren’t widely covered is something obesity specialists like Gudzune want to see change in the future. “Hopefully more insurance companies see the value of having weight-management drugs covered,” she says. “Treatment decisions should be made based on what the best option is for the patient rather than what they can afford.”

What happens after you stop taking Ozempic or Wegovy?

Semaglutide is designed to be taken for the long-term, even after you hit your goal weight. That’s because when you stop taking it, you will likely regain some, or all, of the weight you lost. In fact, a study published in Diabetes, Obesity, and Metabolism found that people who stopped taking semaglutide gained back, on average, two-thirds of the weight they lost within a year.

“This idea of a drug being a quick fix or jump start, those are terms we need to abandon from our lexicon,” says Gudzune. “If you think about treating high blood pressure, you don’t stop taking it once your blood pressure is controlled. The same concept applies to obesity. This is a long-term treatment for a chronic condition.”

The bottom line

Ozempic and Wegovy are different doses of the same drug, semaglutide, a GLP-1 receptor agonist that works by mimicking the action of a naturally occurring hormone in the body. When taken as a weekly injection, it helps regulate blood sugar levels, slow down the rate at which food is digested, and increase fullness after you eat. It can help people living with obesity—or with overweight and a qualifying health condition—lose on average 15% of their body weight, usually with few side effects. That said, it is a long-term treatment for a chronic condition, not something you stop taking once you lose weight.