Ozempic is a medication used to treat type 2 diabetes that has been in the headlines for its off-label use as a weight loss medication. Why all the interest? It turns out that Ozempic contains the same active ingredient (semaglutide) as Wegovy®, an FDA-approved medication for weight loss. A study of adults with overweight or obesity taking Wegovy demonstrated on average 15% body weight loss at 68 weeks. These results were truly impressive as they exceeded the published results of other weight loss medications on the market (typically with only ~5-10% body weight loss at one year). Unfortunately, the demand for Wegovy quickly exceeded its supply leading to the off-label use of Ozempic as a replacement.
What is Ozempic (Semaglutide)?
Ozempic is a once-weekly injectable medication that is FDA-approved for the treatment of type 2 diabetes in combination with healthy nutrition and physical activity. It is also FDA-approved to reduce the risk of major cardiovascular events (e.g heart attack, stroke, or death) in adults with type 2 diabetes and known heart disease. It contains the same active ingredient (semaglutide) as Wegovy, an FDA-approved medication for weight loss. Therefore, if a patient is a candidate for Wegovy and is not able to obtain that medication (due to lack of insurance coverage, supply issues, etc.), a doctor might prescribe Ozempic even if the patient does not have type 2 diabetes; this is considered off-label use. Note prescribing medications off-label is a fairly common practice (accounting for 10-20% of prescriptions) and it is legal for prescribers to do.
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How Does Ozempic (Semaglutide) Work?
Ozempic is a type of glucagon-like peptide-1 (GLP-1) receptor agonist. It works by mimicking the hormone GLP-1 that our bodies naturally produce. GLP-1 acts on the pancreas to stimulate the release of insulin which lowers blood sugar and acts on the brain to decrease appetite and cravings. GLP-1 receptor agonists have been widely used for the treatment of type 2 diabetes, and more recently they have gained attention for their use as weight loss medications. At this time, Saxenda® (liraglutide) and Wegovy (semaglutide) are the only GLP-1 receptor agonists that are FDA-approved for weight loss.
The most common side effects of Ozempic include nausea, vomiting, diarrhea, constipation, stomach upset, and heartburn. Rare but more serious potential side effects include gallbladder disease and pancreatitis. It is always important to monitor for side effects and discuss with your healthcare provider should they arise. Ozempic should not be used if you are pregnant or have a personal or family history of medullary thyroid cancer or MEN 2A/2B syndrome. To find out if you are a candidate for Ozempic, have a conversation with your medical provider.
The board-certified and obesity-trained medical professionals at Form may prescribe FDA-approved medications for patients who are appropriate candidates. To be eligible, you must have a body mass index (BMI) of 30+ or 27+ with a weight related condition, be over the age of 18, and have already tried nutrition and lifestyle changes to lose weight in the past. To ensure patient safety, Form medical providers review records from each patient’s primary care doctor, order laboratory studies (if needed), and meet with patients directly to discuss treatment options in detail. They also meet with each patient monthly to evaluate how the patient is doing on the medication and if dose adjustments need to be made. Typically the dose of Ozempic is gradually increased in order to minimize side effects, and if a patient is not tolerating the medication well a lower dose may be used. Form patients also have direct access to their medical provider via chat in the Form app should any questions arise in between visits.
Why People Use Ozempic (Semaglutide)
Clinical trials of Ozempic (semaglutide 0.5 mg and 1 mg) for the treatment of type 2 diabetes found more weight loss with Ozempic compared to other commonly used diabetes medications (e.g. insulin glargine, sitagliptin, extended-release exenatide, dulaglutide) and better improvement in hemoglobin A1c levels. Ozempic 2 mg was later approved as it was found to be more effective in lowering hemoglobin A1c at this higher dose and resulted in more weight loss. In a more recent study, Wegovy (which contains the same active ingredient as Ozempic) demonstrated an average of 15% body weight loss in subjects with overweight and obesity in combination with nutrition and physical activity changes. Furthermore, Wegovy helped lower blood pressure, hemoglobin A1c, fasting blood sugar, and cholesterol levels. Soon after Wegovy’s release, there were issues with its supply, and as a result many providers began prescribing Ozempic in its place to help patients lose weight.
Form doctors are board-certified in obesity medicine and experienced in using FDA-approved medications, in combination with lifestyle changes, to help their patients achieve their health and weight loss goals. Dr. Katia Jean-Baptiste, a board-certified obesity medicine physician at Form explains, “Even though Ozempic is only FDA-approved for type 2 diabetes, it has the active ingredient semaglutide, which is highly effective for weight loss, and my patients and I are very pleased with the success they have experienced with Ozempic.” Another Form doctor, Michelle Cao, MD adds, “My patients have really responded well to Ozempic. For the treatment of diabetes we have seen significant reductions in hemoglobin A1c and glucose levels. As a weight loss tool, Ozempic provides great support for hunger and cravings.”
Form’s Approach to Medical Weight Loss with Ozempic® (Semaglutide)
At Form, our medical providers treat each patient as a unique individual. At the initial visit, your Form doctor will aim to understand your specific circumstances and the factors that are affecting your weight such as nutrition, activity levels, genetics, stress, sleep, medications, and more. Your doctor will create a personalized plan that addresses your unique needs. Importantly, medications to treat obesity are always used in combination with nutrition and lifestyle changes, and our patients are supported with the tools to implement these changes including routine visits with their Registered Dietitian and access to the Form app that allows for food logging, weight tracking and direct communication with their care team. Research shows that this combination of intensive lifestyle treatment and medication can help patients lose more than twice as much weight as with medication alone. In fact, our approach to weight loss has helped patients lose on average ~15% body weight at 12 months.
About the Author
Lauren Lemieux, MD, FACP, ABOM diplomate
Dr. Lauren Lemieux completed her Internal Medicine residency and fellowship in Clinical Nutrition at UCLA. She is board certified in Internal Medicine and diplomate of the American Board of Obesity Medicine, and as a Physician Nutrition Specialist. She is also a fellow of the American College of Physicians. Dr. Lemieux is passionate about helping her patients reach their health goals using personalized nutrition, lifestyle and weight management strategies.