By Joy Stephenson-Laws, J.D., Founder

Ozempic is definitely having a moment. It’s all you hear about when people talk about weight loss or notice that a celebrity is looking considerably more thin these days.

"I went and got a prescription, and I got Ozempic. And I ain't letting it go ... It cuts my appetite in half. Now I only eat half a bag of Doritos," said Tracy Morgan, comedian and actor, according to this report from PEOPLE.

“Ozempic®, along with diet and exercise, is known to improve blood sugar in adults with type 2 diabetes. In adults with type 2 diabetes and known heart disease, Ozempic® reduces the risk of major cardiovascular events such as stroke, heart attack, or death. You may also lose some weight,” according to the Ozempic website.

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It is an injectable prescription medicine that is a semaglutide (which essentially decreases blood sugar). Ozempic is just a common brand name for this drug. This is where, in my opinion, it gets a bit confusing. 

According to a 2023 article published by UCLA Health, “The search for effective and safe weight loss treatment seems never-ending. But the newest anti-obesity medication, semaglutide, is still making waves more than a year after its 2021 approval by the U.S. Food and Drug Administration. The injectable drug, initially only used as diabetes medication, is the first drug since Saxenda (2014) approved to treat chronic weight management in the 70% of American adults who are obese or overweight.”

Here is some clarification, and this is why it is important to understand drugs by brand names. There are three brands (Ozempic, Wegovy and Rybelus) that fall under the umbrella of being a semaglutide. Ozempic was approved by the Food and Drug Administration (FDA) in 2017 for the treatment of type 2 diabetes, however, it has not as of yet been FDA-approved as an anti-obesity medication. So, Ozempic is not a weight loss drug even though that is what is making it so popular right now.

In 2019, the FDA approved Rybelus (which is an oral tablet and not an injection like the others) for the treatment of type 2 diabetes. Wegovy is the only semaglutide that has been approved for weight loss. When asked about his fit physique, 52-year-old Elon Musk said he owes that to fasting and Wegovy.

So essentially all three of these brands of drugs do the same thing, but they just come in different strengths and doses depending on what your doctor prescribes.

Semaglutide prescriptions are often prescribed off-label.

“Off-label prescribing is when a physician gives you a drug that the U.S. Food and Drug Administration (FDA) has approved to treat a condition different than your condition. This practice is legal and common. In fact, one in five prescriptions written today are for off-label use,” reports the Agency for Healthcare Research and Quality (AHRQ).

These drugs will likely cost you...a lot!

For celebrities, cost is obviously not an issue, however, many people are finding that their insurance does not cover these semaglutide medicines discussed (particularly if they are being prescribed for just weight loss). A 28-day supply of the medicine can cost up to $1,000 or more without insurance covering it. Lack of insurance coverage has led to people taking generic versions, but these are not FDA-approved and some doctors warn that this is not safe.

“Some companies are seeing the success of weight loss drugs like Ozempic and Wegovy and creating their own knockoff versions. But experts say those drugs might not be safe,” according to a report from NBC Washington.

“Rubino [a doctor interviewed by NBC] said the copycat versions of semaglutide are often mixed with vitamins or other ingredients that haven’t been tested and might not be safe.”

What does this all mean?

I think that remains to be seen as semaglutide continues to be prescribed off-label and as people take generic versions of this drug. I do think a key takeaway from this all is that approved weight loss drugs are for those who actually have obesity and are at risk for serious cardiovascular issues. They are not intended to just shed a few pounds to look good this summer.

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"The Hollywood trend is concerning," said Dr. Caroline Apovian, in the article I mentioned from PEOPLE. 

"We're not talking about stars who need to lose 10 lbs. We're talking about people who are dying of obesity, are going to die of obesity."

According to an article from The New York Times, “The drug has not been systematically tested in people with lower body weights, Dr. Hwang said, and it’s possible that patients outside of the group the drug is intended for could experience more intense side effects. Without more research, it’s unclear just how damaging those side effects could be.”

There are side effects and risks to taking a semaglutide.

Many report that they feel nauseous. 

"I came back from a vacation and I injected myself with it. I went to lunch with a girlfriend a few days later, and she was like, 'I'm not really eating anything. I'm so nauseous, I'm on Ozempic.' And I was like, 'I'm kind of nauseous too.' But I had just come back from Spain and was jet-lagged,” said comedian Chelsea Handler, according to the article from PEOPLE.

"I've injected about four or five of my friends with Ozempic because I realized I didn't wanna use it cause it's silly. It's for heavy people. Everyone is on Ozempic. It's gonna backfire, something bad is gonna happen."

This is definitely not a responsible way to handle a prescription drug (or any drug for that matter).

“Dr. Gabbay said he had seen some patients with such severe vomiting that they had to stop taking the medication. There is also a risk that, in extreme instances, patients could become malnourished because of how little nutrients they are able to consume,” (The New York Times).

Other potential side effects may include diarrhea, abdominal pain, constipation, vision changes, rapid heartbeat and more. There may also be a risk of bowel obstructions as these drugs do delay gastric emptying.

From a vanity standpoint, there is also “Ozempic face.” Because it may cause such rapid weight loss, and appear more obvious in people who are not very overweight, “Ozempic face” is a look that can happen from all of the facial fat that may be lost from taking the drug. A loss of fat in the face can actually cause a less youthful appearance and make a person’s face look hollow.

There is also the risk of "Ozempic babies."

“Women across the country have been bonding online over their ‘Ozempic babies’ − surprise pregnancies while taking weight loss medications, despite being on birth control or having a history of fertility issues. Now, some of them say they’re experiencing intense symptoms such as extreme hunger and rapid weight gain after quitting these drugs cold turkey to protect their baby’s health,” USA Today reports.

This is definitely concerning as we don’t know how taking these drugs can affect a developing fetus, and, of course, no one ever wants to have an unplanned pregnancy while taking birth control.

Watch out for drug interactions.

I highly recommend reading this story about a busy mom who took Ozempic along with her medication for migraines. WGN Radio reports, “...as is the case with many people, she did not obtain her Ozempic from a physician who could have warned her about what would happen when she combined it with her migraine medication.”

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Her blood sugar and heart rate dropped so low that she nearly died. She was trying to lose those last stubborn five to 10 pounds and said that her vanity and curiosity got the best of her. I cannot reiterate enough that a semaglutide is not meant for vanity purposes. It is meant for someone who is type 2 diabetic, very overweight or perhaps at a risk for a major cardiovascular event that could result in death.

As always, it is a good idea to speak with a competent healthcare professional and avoid taking generic versions. There are also specific cases in which a person should not take these drugs due to certain existing circumstances. For example, people with a history of medullary thyroid cancer, gallbladder disease or pancreatitis are specifically warned about taking semaglutide. You can read more about this here.

This is not a magic pill.

Maintaining a healthy lifestyle is important when it comes to managing weight and preventing or managing type 2 diabetes. Just because someone takes these drugs does not mean he or she is excused from the necessity of exercising and eating healthily.

Although people have talked a lot about how these drugs suppress their appetite, comedian Tracy Morgan said,“I’ve learned to out-eat Ozempic. I out-ate Ozempic. I’ve gained 40 pounds" (PEOPLE).

It really comes down to cultivating a healthy relationship with food. I also highly recommend (per approval of a doctor or competent healthcare professional) red light therapy as a non-pharmacological way to lower blood sugar by optimizing mitochondrial function and ATP production. You can read all about this from this previous pH blog.

It is also ia good idea to undergo routine nutrient testing in order to identify any nutrient imbalances or deficiencies. Many of us have these deficiencies, and this can exacerbate existing health issues and actually make our weight loss goals harder to attain. The good news is that once they are identifiedthese can be resolved with dietary changes and perhaps taking quality supplements (recommended by that competent healthcare professional).

(pH must-read - New Year, New Goals? Make Sure You Are Not Nutrient Deficient)

Enjoy your healthy life!

Disclaimer: This article is not intended to provide medical advice. Please consult with your doctor or another competent healthcare practitioner to get specific medical advice for your situation.                

The pH professional health care team includes recognized experts from a variety of health care and related disciplines, including physicians, attorneys, nutritionists, nurses, and certified fitness instructors. This team also includes the members of the pH Medical Advisory Board, which constantly monitors all pH programs, products, and services. To learn more about the pH Medical Advisory Board, click here.