15 BURNING QUESTIONS ABOUT OZEMPIC, ANSWERED

When the U.S. Food and Drug Administration (FDA) approved Ozempic (semaglutide) in 2017 for adults with type 2 diabetes, it ushered in a new era of blood sugar and weight loss drugs. Since then, the FDA approved Ozempic's obesity counterpart, Wegovy, as well as Mounjaro and Zepbound (tirzepatide) for type 2 diabetes and chronic weight management, respectively.

In a 2023 survey by Everyday Health with more than 3,000 participants, those who lost weight were about twice as likely to have tried these drugs as people who maintained or gained weight. Despite the increasing availability of these weight loss drugs, there are still many questions around them. How do they work? What are the side effects? And do you have to stay on them forever to keep the weight off?

Below are answers to common questions like these from a handful of experts: Beverly Tchang, MD, an associate professor of clinical medicine at NewYork-Presbyterian and Weill Cornell Medicine in New York City who is board-certified by the American Board of Obesity Medicine; Erin Palinski-Wade, RDN, CDCES, a nutrition and diabetes expert who practices in New Jersey; and Tiffani Bell Washington, MD, MPH, a child and adolescent psychiatrist and obesity medicine physician, who lives in Boston.

1. How Do Ozempic and Other Popular Weight Loss Drugs Work?

Beyond its effect on blood sugar, GLP-1 is the primary driver of Ozempics weight loss effects. GLP-1 increases feelings of satiety and decreases appetite while also slowing digestion, which in turn mutes appetite as well, says Palinski-Wade. She explains that the drug delays foods exit from the stomach, keeping you feeling full longer.

Some people feel the appetite-suppressing effects within 24 to 48 hours, but weight loss and blood sugar control will take longer, Dr. Tchang says. We see people lose weight and achieve blood sugar control over several months, and these benefits are sustained over a year.

2. Who Has Had the Most Success on Ozempic So Far?

Regarding Ozempic in particular, so far its not clear if people in some demographics might be able to manage blood sugar better or lose more weight on the drug than others. We dont have that granularity of evidence yet, but we have general trends from other studies, says Tchang. Earlier intervention is better, because people then have fewer years of uncontrolled diabetes, and people who have higher baseline weight tend to lose more weight.

3. Who Shouldnt Take Ozempic?

These same restrictions hold true for Wegovy. Mounjaro and Zepbound are also not recommended during pregnancy or for people with family history of these conditions.

4. Should I Stay on Ozempic Forever?

For most people, Ozempic wont be a short-term fix. Semaglutide is a medication that people should take for a long time, not temporarily, Dr. Washington says. This is because obesity is a chronic disease, and the medication only works when you take it. When people stop taking Ozempic, she says, they tend to regain the weight they lost.

So how long can you stay on Ozempic? No time limit has been established yet. (The same goes for other newer weight loss drugs.) But as long as youre tolerating the medication well and your healthcare provider recommends it, you should be able to continue taking it.

5. I Know Ozempic Takes the Weight Off Fast. Are There Any Downsides to That?

A loss of appetite and a decrease in calorie consumption can promote weight loss. However, it can lead to a lack of balanced nutrition and an increased risk of nutrient deficiencies, says Palinski-Wade. These potential deficiencies could have lasting consequences. For example, if youre not getting enough calcium and vitamin D from your diet, you could increase your risk of osteoporosis, she notes. Rapid weight loss can also lead to reduced muscle mass, which can decrease overall metabolism, strength, and balance over time.

Ozempic and the other weight loss drugs might have some drawbacks for your appearance, too. Many people report Ozempic face, a hollowed-out facial appearance that comes from rapidly losing fat. (Unfortunately, we cant control which parts of our bodies lose fat the fastest or most noticeably.) Some Ozempic users even complain of Ozempic butt. The same principle applies: As weight comes off rapidly, it can leave your buttocks looking saggy or hollow.

6. Ive Heard About Some Pretty Yucky Side Effects With This Drug. Should I Be Concerned?

Meanwhile, for most people, the side effects of these newer weight loss drugs are not debilitating and pass quickly. Generally, these side effects are seen in the first few weeks of therapy as well as when dosing is increased, Palinski-Wade says. She recommends avoiding large meals or high-fat meals to help reduce GI symptoms.

7. What Are the Long-Term Health Effects of Ozempic?

That said, Tchang encourages caution if you have certain risk factors. A personal or family history of medullary thyroid cancer is a contraindication to Ozempic because this type of cancer was associated with Ozempic in animal studies, she says. However, it's important to discuss these concerns with your doctor, who best knows your individual circumstance.

Like Ozempic, the long-term effects of Mounjaro and Zepbound also require more data. Palinski-Wade says that thyroid tumors may eventually be a concern with these meds, too. The FDA has warned that tirzepatide can cause thyroid tumors in rats, but we do not yet know if this will be the case in humans. More research and longer-term studies are needed, she says.

8. How Does Ozempic Affect Mental Health?

If you feel that the medication is causing or worsening psychological symptoms, talk to your doctor. Its important to closely monitor a persons mood and make changes if necessary, Washington says.

9. How Can I Get Ozempic Covered by Insurance?

Insurance coverage for Ozempic (and all drugs, for weight loss or otherwise) varies by provider and plan. In many cases, if you have a valid prescription for the drug, insurance will cover at least a portion of the cost. But some insurance plans only cover Ozempic when its prescribed as a treatment for type 2 diabetes, not when its prescribed off-label as a weight loss aid. Wegovy and Zepbound, however, are FDA-approved for weight loss, and they aren't intended to be prescribed to those with diabetes.

10. What Does Ozempic Cost?

11. How Do You Get Ozempic When Its Not Covered by Insurance?

If your insurance plan doesnt cover Ozempic, you may have other options for reducing the drug's cost. Ozempic offers a savings card that allows users with private or commercial insurance to pay as little as $25 per pen for up to a three-month prescription. To access this card, your prescription must be for a one-, two-, or three-month supply, and youll need to answer a few qualifying questions online. If youre interested in another weight loss drug, check the drug's website for potential savings.

You can also ask your doctor or pharmacist for insider info on any savings or patient assistance programs in your area. Some nationwide drug discount programs like GoodRx could bring costs down.

12. Are There Cheaper Alternatives to Ozempic?

Considering the sometimes high cost of Ozempic, no one can blame you for looking for a less expensive alternative. Unfortunately, Ozempic does not have a generic alternative, Tchang says. While some websites tout knockoff versions of the drug, dont be fooled: Faux pharmaceuticals are not a safe bet.

Some specialized pharmacies offer compounded semaglutide. These custom-made meds combine the active ingredients of Ozempic with other medications tailored to individual health needs. But Tchang says this option doesnt have the safety backing of the branded drug. Compounded semaglutide has not undergone the same clinical trial rigor as brand-name Ozempic, so a patient choosing this route is taking on more risk and must rely on their own research to ensure safety and efficacy.

If you cant afford name-brand Ozempic, Tchang says there are other possibilities for weight loss meds. If Ozempic is inaccessible, patients should speak with a board-certified obesity medicine physician who can discuss other options, such as other GLP-1s or oral anti-obesity medications, which are typically more cost-feasible, she says.

13. How Do You Use Ozempic?

Ozempic is a weekly injectable drug. As for how to inject Ozempic, its relatively simple. The drug comes in a prefilled pen that is injected under the skin. Where to place the injection is largely up to you: You can use it on your abdomen, thigh, or upper arm. Before your first use, store Ozempic in the fridge. After youve used it, you can store the pen for 56 days at room temperature between 59 and 86 degrees F or in the refrigerator between 36 and 46 degrees F. Dont freeze Ozempic and be sure to keep the cap on the pen when youre not using it.

14. Ive Heard That Zepbound and Mounjaro Are Even More Effective Than Ozempic. What Do I Need to Know About These Drugs?

Determining which drug is best for you may be a matter of assessing your health goals. One primary difference between Mounjaro and Ozempic is that Ozempic is FDA-approved to reduce the risk of heart attack and stroke in people with type 2 diabetes, while Mounjaro is not. Talk to your doctor about whether Mounjaro or Ozempic is more appropriate for you.

15. What Happens When You Stop Taking Ozempic?

Palinski-Wade says this is likely to be the reality for tirzepatide drugs as well as semaglutide. In general, weight regain after stopping weight loss medications is always a possibility, she says. "These medications are a tool when it comes to weight management, not a quick fix or a cure.

Even if you stop taking your weight loss drug, you can always continue to make healthy choices that promote weight loss. To help decrease the rebound weight gain, people can continue the lifestyle changes that they hopefully learned while taking semaglutide, Washington says.

Everyday Health's Weight Loss Reframed Survey queried 3,144 Americans nationwide, ages 18 and older, who had tried losing weight in the previous six months. The study was fielded between July 10 and August 18, 2023, across demographic groups, genders, and health conditions. Survey recruitment took place via an online portal, in app, and via email. The margin of error for the sample size of 3,144 is +/-1.7 percent at a 95 percent confidence level.

The Takeaway

• Ozempic is a GLP-1 agonist drug that increases feelings of fullness and reduces appetite. Other weight loss drugs like Wegovy, Mounjaro, and Zepbound work in a similar way.
• Research shows that these drugs help many people lose weight, but people need to stay on the drugs to keep the weight off. These drugs may cause side effects like nausea, vomiting, and diarrhea.
• Pricing varies depending on your insurance. Because drugs like Ozempic are relatively new, researchers are still studying their long-term health effects.
• These drugs are not recommended for people who are pregnant or have a history of diabetic retinopathy or problems with their pancreas or kidneys.