Ozempic® for Weight Loss: Side Effects and Risks

Medically reviewed on July 14, 2023 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• What Is Ozempic®?
• Risks Associated With Taking Ozempic® for Weight Loss
• Why Do These Ozempic®Weight Loss Side Effects Occur While Taking Ozempic®?
• How to Lose Weight Safely
• Everlywell: Your Weight Loss Guide
• Related Content

Ozempic® is an antidiabetic medication used to treat type 2 diabetes. And although the medication is not approved for weight management by the U.S. Food and Drug Administration (FDA), many have turned to Ozempic® to help manage their weight loss efforts.

While the FDA hasn’t approved Ozempic® for weight loss, it has approved a medication called Wegovy®. Produced by the same company, Novo Nordisk, and containing the same active ingredient, semaglutide, Wegovy® is used to manage weight in patients who are obese or overweight with at least one weight-related medical condition. [1]

So, why are people using Ozempic® for weight loss rather than Wegovy®, and are there any side effects of using Ozempic® for weight loss? Let’s explore more below.

What Is Ozempic®?

Ozempic® is a prescription drug that is the first injectable diabetic medication approved by the FDA. Unlike Wegovy®, it has a lower dose of semaglutide—a compound that mimics a naturally occurring hormone in the body that’s responsible for suppressing appetite. [2]

So, why exactly are people turning to Ozempic® vs. Wegovy®? It all comes down to availability.

When the FDA authorized the use of Wegovy® in 2021, a high demand emptied pharmaceutical shelves, making it unavailable to many healthcare providers. [3] As a result, some healthcare providers began prescribing Ozempic® as an alternative. That said, it should be noted that Ozempic® is only approved to help lower blood sugar levels in adults with type 2 diabetes, and is not approved for weight loss. [4]

Ozempic® is approved for reducing the likelihood of specific risks in individuals with both type 2 diabetes and heart disease. These include the following [4]:

• Heart attack
• Stroke
• Death

Risks Associated With Taking Ozempic® for Weight Loss

So, is Ozempic® safe for weight loss? While it’s not technically considered a weight loss medication, it is a safe and effective treatment option for those with type 2 diabetes—and its side effects may include weight loss. [5] If you do not have type 2 diabetes, taking Ozempic® for weight loss is not recommended.

Moreover, scientific research has revealed that Ozempic®, specifically the compound semaglutide, is an effective treatment for obesity, characterized by abnormal or excessive fat accumulation that risks one's health. [6] This is one reason why many have turned to Ozempic® for weight loss efforts.

That said, taking Ozempic® may pose a number of risks, regardless of your health or weight goals. The product’s safety information warns of the following side effects [7]:

• Thyroid c-cell tumors – These tumors form within the thyroid gland and can lead to medullary thyroid cancer (MTC). Most often, treatment involves removing the thyroid, as well as radiation and chemotherapy. If you experience elevated calcitonin levels while taking Ozempic®, you should consult with a healthcare provider right away, as these elevated levels can be indicative of MTC. [8]
• Pancreatitis – In clinical studies, patients reported both acute and chronic pancreatitis when taking Ozempic®. The condition is characterized by inflammation of the pancreas and can lead to abdominal pain, fever, rapid pulse, nausea, and vomiting. The pain may also radiate to the back. If you begin to experience these symptoms while taking Ozempic®, it’s recommended to stop the medication immediately and to consult with a healthcare provider. [7]
• Diabetic retinopathy complications – In a two-year trial conducted by Novo Nordisk, researchers found that patients with both type 2 diabetes and high cardiovascular risk experienced more cases of diabetic retinopathy compared to the placebo group. Diabetic retinopathy is an eye condition that can cause vision loss and blindness. While early symptoms of this condition are nearly nonexistent, people will start to experience problems with their vision and bleeding blood vessels in the eyes as the disease progresses. As such, it’s recommended to get a comprehensive dilated eye exam at least once a year if you have type 2 diabetes and are taking Ozempic®. [9]
• Hypoglycemia – Those taking Ozempic® in conjunction with insulin may also be at a higher risk of developing hypoglycemia, or low blood sugar levels. Symptoms may include shaking, sweating, nervousness, anxiety, irritability, confusion, dizziness, and hunger. [10]
• Acute kidney injury – Ozempic® may also increase the risk of acute kidney injury or worsening chronic renal failure, which may necessitate glucagon-like peptide (GLP-1) treatment. Most often, patients who experienced effects on their kidneys had nausea, vomiting, diarrhea, and were dehydrated. Those with kidney injury may also experience swelling in the legs, ankles, and around the eyes, as well as fatigue, seizures, or chest pain. [11]
• Hypersensitivity – Immunological responses may also occur when taking Ozempic®, such as anaphylaxis or angioedema. People with immunological responses may experience trouble breathing, as well as swelling of the skin. If these symptoms do arise, stop taking Ozempic® immediately and seek treatment.
• Acute gallbladder disease – Cholelithiasis or cholecystitis may occur, characterized by swelling of the gallbladder. Symptoms can include persistent abdominal pain, fever, nausea, vomiting, sweating, loss of appetite, yellowing of the skin, and a bulging abdomen. [12]

Additional adverse reactions to Ozempic® may include nausea, vomiting, diarrhea, abdominal pain, and constipation. These reactions are the most common and occur in at least 5% of patients. [5]

The injectable semaglutide, which is the delivery method of Ozempic®, is also associated with additional side effects, including [13]:

• Belching
• Bloating
• Gaseous stomach pain
• Heartburn
• Passing gas
• Recurrent fever
• Stomach discomfort
• Yellow eyes and skin

Less common side effects include indigestion, stomach upset, and tenderness or burning in the chest and/or stomach. [13]

There’s also a risk associated with drug compounding.4 This refers to a process in which drugs are combined, mixed, or altered to create a medication tailored to specific patient needs.

While the FDA does not approve compounded drugs, certain manufacturers can compound a drug when there’s a shortage, as is the case with both Ozempic® and Wegovy®. Both drugs are listed on the FDA’s drug shortages list as of May 2023.

That said, these drugs must also meet certain requirements in the Federal Food, Drug, and Cosmetic (FD&C) Act. [4]

Unfortunately, compounded semaglutide can produce adverse effects, including:

• High blood pressure
• Increased risk of heart attack
• Increased risk of stroke

This is because, in some cases, compounders use salt forms of semaglutide, such as semaglutide sodium and semaglutide acetate. Neither are safe nor effective. [4]

Why Do These Ozempic®Weight Loss Side Effects Occur While Taking Ozempic®?

When injected, semaglutide begins to take effect immediately to lower blood sugar levels and increase insulin resistance in the body. And, as stated above, it also mimics a hormone called ‘glucagon-like peptide-1’ (GLP-1). As such, Ozempic® is referred to as a ‘GLP-1 receptor agonist’ medication, and its side effects are primarily related to its action as a GLP-1 receptor agonist.

The gut produces GLP-1 when food is ingested, signaling to the brain that the body is adequately full to curb appetite. As such, many of the side effects of Ozempic® are correlated with the hormonal reactions occurring within the gastrointestinal tract.

However, GLP-1 agonist receptors also play a role in the development of hypoglycemia, hypersensitivity or anaphylaxis (as is the case if there’s an injection site), acute pancreatitis, renal impairment, and thyroid issues. [14]

See related: Ozempic® - Foods to Avoid

How to Lose Weight Safely

While semaglutide medications can help support weight loss, they’re not approved for every patient. More specifically, Ozempic® is only reserved for patients who [15]:

• Have type 2 diabetes and need to improve blood sugar levels
• Have heart disease and need to reduce their risk of heart attack, stroke, or death

Similarly, Wegovy® also has usage restrictions [1]:

• It’s approved for adults with a body mass index (BMI) of 30 or higher and children 12 years or older who have a BMI in the 95th percentile for their age and sex.
• It’s also approved for adults who are considered overweight (with a BMI of 27 or above) and who also have a weight-related medical condition or comorbidity.

That said, if you’re looking for something to help you with body weight management or weight loss without the intervention of prescription medication, there are many ways to do it safely and naturally. Such methods include [16]:

• Eating whole foods – Fill your diet with fiber-rich vegetables and fruits, as well as oats, seeds, and whole grains. They’ll deliver essential nutrients to your body and help you feel fuller for longer. Also, consider subbing out higher-calorie, refined foods for whole food-based treats. For example, you can replace chips or crackers with carrots or bell peppers, which may provide you with more fiber and volume to help promote satiety. In addition, make sure you prioritize lean proteins to feed your muscle mass and enough healthy fats to help promote satiety as well.
• Using portion control – Becoming more mindful of your portion sizes, depending on your age, body weight, and activity level, can help you create a caloric deficit. Generally, portion control can look like: reducing pasta intake by adding a bunch of veggies and protein to your entree, having one medium slice of bread with nutrient-rich toppings, having meat that’s sized to a deck of cards, etc. While becoming more mindful of portions can be difficult for some, consulting a qualified healthcare practitioner like a Registered Dietitian for more personalized guidance and support is recommended.
• Practicing mindful eating – When sitting down to eat, avoid the screens. Instead, take a more mindful approach to eating by paying attention to your body’s hunger and fullness cues. When you begin to feel full, slow your rate of eating. You can also practice intuitive eating, which involves listening to your body to identify when it requires sustenance, and the amounts that you need for a given meal or snack.
• Staying active – Adults should aim to participate in 150 minutes of aerobic exercise and 75 minutes of vigorous exercise per week. This can help your body burn fat stores and create a caloric deficit to help facilitate weight loss efforts.

Everlywell: Your Weight Loss Guide

Because Ozempic® is not meant for weight loss, and thus reporting of side effects is more limited, it’s generally not recommended for this purpose. That said, those who do take Ozempic® to treat type 2 diabetes may experience weight loss as a potential side effect, as well as several other potential additional side effects, including gastrointestinal issues, diabetic retinopathy, and more.

For more information and personalized healthcare advice, visit Everlywell. Our online weight management program pairs GLP-1 prescriptions with consistent one-on-one visits and lab testing to help you manage your weight and related conditions. Enroll today.

Related Content

Understanding Ozempic® vs. Mounjaro® for Weight Loss

Trulicity® vs. Ozempic®: What's the Difference?

Which Foods to Avoid While Taking Ozempic®: Here's What You Need to Know

References

1. FAQs About Wegovy®® | Wegovy®® (semaglutide) Injection 2.4 mg. www.Wegovy®.com. Accessed June 17, 2023. URL. Accessed June 12, 2023.
2. Blundell J, Finlayson G, Axelsen M, et al. Effects of once‐weekly semaglutide on appetite, energy intake, control of eating, food preference and body weight in subjects with obesity. Diabetes, Obesity and Metabolism. 2017;19(9):1242-1251. URL. Accessed June 12, 2023.
3. Blum D. What Is Ozempic® and Why Is It Getting So Much Attention? The New York Times. Published November 22, 2022. URL. Accessed June 12, 2023.
4. Research C for DE and. Medications Containing Semaglutide Marketed for Type 2 Diabetes or Weight Loss. FDA. Published online May 31, 2023. URL. Accessed June 12, 2023.
5. FAQs | Ozempic® (semaglutide) injection 0.5 mg, 1 mg, or 2 mg. novoMEDLINK. Accessed June 17, 2023. URL. Accessed June 12, 2023.
6. O’Neil PM, Birkenfeld AL, McGowan B, et al. Efficacy and safety of semaglutide compared with liraglutide and placebo for weight loss in patients with obesity: a randomised, double-blind, placebo and active controlled, dose-ranging, phase 2 trial. The Lancet. 2018;392(10148):637-649. URL. Accessed June 12, 2023.
7. Safety & Side Effects | Ozempic®® (semaglutide) injection 0.5 mg, 1 mg, or 2 mg. novoMEDLINK. URL. Accessed June 12, 2023.
8. Medullary Thyroid Cancer - National Cancer Institute. www.cancer.gov. Published February 27, 2019. URL. Accessed June 12, 2023.
9. National Eye Institute. Diabetic Retinopathy | National Eye Institute. Nih.gov. Published August 3, 2019. URL. Accessed June 12, 2023.
10. CDC. Low Blood Sugar (Hypoglycemia). Centers for Disease Control and Prevention. Published January 20, 2021. URL. Accessed June 12, 2023.
11. National Kidney Foundation. Acute Kidney Injury (AKI). National Kidney Foundation. Published 2017. URL. Accessed June 12, 2023.
12. NHS Inform. Acute cholecystitis symptoms and treatments. Nhsinform.scot. Published 2019. URL. Accessed June 12, 2023.
13. Semaglutide (Subcutaneous Route) Side Effects - Mayo Clinic. www.mayoclinic.org. URL. Accessed June 12, 2023.
14. Collins L, Costello RA. Glucagon-like Peptide-1 Receptor Agonists. PubMed. Published 2020. URL. Accessed June 12, 2023.
15. Ozempic® (semaglutide) injection 0.5mg, 1 mg, or 2 mg Savings Offer | NovoCare®. www.novocare.com. URL. Accessed June 12, 2023.
16. How to lose weight safely. Nhsinform.scot. Published 2019. URL. Accessed June 12, 2023.