How does Ozempic work for weight loss?
Key Takeaways
Ozempic (semaglutide) works by acting like a natural hormone found in your body called glucagon-like peptide-1 (GLP-1). It helps with weight loss by slowing down how fast food travels through your digestive tract, reducing your appetite and leading to weight loss. It also plays a role in regulating your blood sugar and natural insulin levels.
In clinical studies, patients lost an average of 14 lbs (6.4 kg) when Ozempic 2 mg was given over a 40-week long period, but your individual results may vary.
Approved Uses
Ozempic is approved to treat type 2 diabetes to help you manage your blood sugar control. It helps prevent large blood sugar spikes, and you may feel less hungry when you do not have wide swings in your blood sugar.
Studies have found that people who use Ozempic to treat type 2 diabetes often lose weight as a secondary benefit, even though it's not approved for this use.
It's also approved to help reduce the risk of major cardiovascular (heart) events such as a heart attack, stroke or death in adults with type 2 diabetes mellitus with known heart disease.
It may also be prescribed to reduce the risk of kidney disease worsening, kidney failure (end-stage kidney disease) and death due to cardiovascular (heart) disease in adults with type 2 diabetes mellitus and chronic kidney disease.
It's not known if is safe and effective for use in children.
Both Ozempic and Wegovy are manufactured by Novo Nordisk.
Is Ozempic approved for weight loss?
Ozempic is not FDA-approved for weight loss, but was shown in studies to help people lower their blood sugar and lose weight when it was used to treat type 2 diabetes.
The primary benefit studied in the majority of Ozempic studies was the mean change in A1C (long-term blood sugar control) in patients with type 2 diabetes. Weight loss was looked at as a secondary endpoint in Ozempic studies, with people losing on average 14 lbs. after about 7 to 12 months.
If you are looking for a medicine specifically approved for weight loss, a brand name drug called Wegovy may be an option.
Wegovy injection contains a slightly higher dose of semaglutide (the same active ingredient that's in Ozempic), but is FDA-approved to help people with obesity or who are overweight lose weight and keep it off over the long-term. Wegovy is also approved for other uses as noted.
How much weight can you lose with Ozempic?
Results from studies in patients with type 2 diabetes show that people lost up to 14 lbs (6.4 kg) on average using the 2 mg weekly dose over 40 weeks when compared to a placebo.
Significant weight loss has also been seen when Ozempic was compared to other diabetes treatments like Trulicity (dulaglutide) or Januvia (sitagliptin).
Studies
Ozempic is given as a once-weekly injection under the skin in the stomach area, the thigh, or the upper arm using an autoinjector pen. It’s used on the same day each week and you can take it with or without food. Your healthcare provider can teach you or a caregiver how to inject the medicine so it can be used at home.
The results below are from clinical studies that can give you an idea of how much weight people lost when using Ozempic for blood sugar control.
Ozempic used alone vs. placebo
- In a study that lasted 30 weeks in 388 adult, the mean baseline body weight was 89.1 kg, 89.8 kg, 96.9 kg in the placebo, Ozempic 0.5 mg and Ozempic 1 mg arms, respectively.
- Patients using the weekly Ozempic 0.5 mg dose lost an average of 8 lb (3.8 kg) and those using the weekly 1 mg weekly dose lost an average of 10 lb (4.7 kg), compared to those taking placebo (an injection with no medicine) who lost about 3 lb (1.2 kg).
Studies also found that people with type 2 diabetes lost at least double the weight with Ozempic when compared to Trulicity (dulaglutide), another glucagon-like peptide-1 (GLP-1) agonist type 2 diabetes medicines, when given over 40 to 56 weeks.
SUSTAIN 7
- In a 40-week long study (SUSTAIN 7) in 1,201 adults with type 2 diabetes who were also taking metformin, people using Ozempic 1 mg lost close to 13 lb (6 kg) compared to 6 lb (2.7 kg) for the group using Trulicity 1.5 mg weekly.
- The lower 0.5 mg weekly dose of Ozempic also led to more weight loss than the 0.75 weekly dose of Trulicity: 9.3 lb (4.2 kg) vs. 4.6 lb (2.1 kg) on average.
SUSTAIN 4
- SUSTAIN 4 was a 30-week long study in 1089 insulin-naïve adult patients with type 2 diabetes on metformin ± a sulfonylurea. Two groups received Ozempic 0.5 mg or 1 mg. The other group received study-titrated Lantus (insulin glargine). The average weight of patients at the start of the study was 206 lbs (94 kg).
- Overall, patients in the Lantus group gained about 2 lb (1 kg) at 30 weeks, compared to a weight loss of 7.1 lbs (3.6 kg) and 10.4 lbs (4.7 kg) with the 0.5 or 1 mg Ozempic dose, respectively.
SUSTAIN FORTE
- SUSTAIN FORTE was a 40-week long study in adult patients with type 2 diabetes on metformin ± a sulfonylurea. The groups received either Ozempic 1 mg or 2 mg. The average weight of patients at the start of the study was about 219 lbs (100 kg).
- Overall, patients in the Ozempic 1 mg group lost 12.5 lb (5.7 kg) and those in the 2 mg group lost about 14 lb (6.4 kg). The difference between treatment arms (1 mg or 2 mg) in body weight change from baseline at week 40 was not statistically significant.
In Ozempic studies, not all people lost weight and some people did gain weight. You may also be taking other medicines like a sulfonylurea (like glipizide or glyburide), or insulin, which can also add to weight gain. Metformin does not usually lead to weight gain, and may help promote weight loss in some individuals.
Studies suggest that higher doses of Ozempic or semaglutide may lead to greater weight loss. The Wegovy brand of semaglutide contains a higher dose of semaglutide, is FDA-approved for weight loss and may result in a greater weight loss for you. In studies with Wegovy, adults lost around 15% of their body weight, equal to about 35 lb (16 kg).
People respond to medicines differently, so your weight loss may not be the same as others. Treatments for type 2 diabetes are used in addition to an appropriate diet and exercise regimen for the best effect. Talk to your healthcare provider about the best medicine to help you lose weight and keep it off.
Related questions
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How long does it take to lose weight with Ozempic?
Ozempic starts to work right away, but you may not see significant weight loss for several months. Ozempic has led to weight loss and blood sugar control in studies ranging from 30 to 56 weeks in length, when used in addition to diet and exercise.
It has been shown to lead to weight loss in patients with type 2 diabetes, but Ozempic is not specifically FDA-approved as a weight-loss medication.
Learn more: How long does it take for Ozempic to work?
How can you lose the most weight with Ozempic?
Staying active and eating a healthy diet low in fat, sugar and calories is the best way to lose weight with Ozempic. Your doctor may suggest you meet with a dietician to help learn about meal planning and food choices.
An exercise routine on most days of the week can boost your weight loss, your mood and help you meet your targets. If you have not exercised in a while, or have any health conditions, speak with your healthcare provider about the best way to ease into an exercise routine. Working with a trainer or a physical therapist may prove beneficial, especially at the outset.
Also, follow your doctor’s dosing instructions exactly. You will start treatment with lower doses to help you tolerate the stomach side effects like nausea, vomiting, diarrhea, stomach pain or constipation. These side effects are typically mild to moderate and lessen over time.
Some foods may worsen your nausea or other stomach side effects while taking Ozempic. If you are experiencing stomach side effects, try:
- Eating smaller meals and eating more slowly
- Avoiding foods high in fat, fried or greasy foods, and unhealthy "fast-foods"
- Cutting back on spicy or acidic foods, or caffeine, if they bother you
- Avoiding or limiting alcoholic beverages (no more than one serving per day for women or two servings per day for men)
- Drinking plenty of fresh water throughout the day
- Limiting excessive sugar intake.
These foods or drinks may also affect your blood sugar control and slow down weight loss.
Learn More: Taking Ozempic: What foods should you avoid?
It may take about 2 to 3 months to reach your Ozempic maintenance dose, so going slowly, as directed, can help you tolerate the medicine and prevent you from having to stop treatment altogether. Higher doses have been shown to lead to greater weight loss.
Does Ozempic cause side effects that lead to weight loss?
Stomach side effects are common when starting treatment with Ozempic but decrease over time in most patients. At the beginning of treatment this may affect your appetite. In one study, 58% of patients (231 of 402) receiving a semaglutide 1 mg dose experienced mild to moderate gastrointestinal side effects.
The most common side effects reported in at least 5% of patients treated with Ozempic are:
- Nausea
- Vomiting
- Diarrhea
- Abdominal (stomach area) pain
- Constipation
In Sept. 2023, the FDA updated the warnings for Ozempic to emphasize that an intestinal blockage called an ileus has been reported as a possible side effect. An ileus results in the failure of the intestinal contents to pass through the gut.
An ileus may lower your appetite and cause symptoms like nausea, vomiting, stomach pain, and bloating, which may make eating uncomfortable or irritating. Contact your healthcare provider right away if you have stomach side effects that worry you.
Can I use Ozempic for weight loss if I don't have diabetes?
Yes, in many cases non-diabetics can use Ozempic for weight loss. Studies with semaglutide, the active ingredient in Ozempic, have shown weight loss can occur in people with or without type 2 diabetes.
Your healthcare provider may decide to prescribe Ozempic "off-label" for you for weight loss. Off-label means it's not specifically approved by the FDA for this use or listed in package labeling, but your doctor has decided it may still have a positive benefit and can prescribe it. However, in most cases your insurance will not approved this use if you don't have type 2 diabetes because weight loss alone is not FDA-approved for Ozempic.
But your insurance may pay for Wegovy for weight loss, and you should check. Wegovy is semaglutide, the same active medicine that's in Ozempic, but is specifically approved for weight loss in adults and children 12 years and older. It can be used in people with or without type 2 diabetes and it's given at a slightly higher dose than Ozempic.
In the 68-week long STEP-2 study in adults with overweight or obesity and type 2 diabetes, Wegovy 2.4 mg injected once a week was shown to lead to significantly greater weight loss (about a 10% weight loss) compared to a placebo (3.4% weight loss).
In another Wegovy study in adults with either obesity or overweight (average starting weight of 232 lb), and weight-related medical condition patients received either Wegovy 2.4 mg or placebo (an inactive injection). The average weight loss in the 68-week long study showed about a 35 lb (15%) weight loss with Wegovy compared to 6 lb (2.5%) with placebo.
How do you qualify for Ozempic for weight loss?
In the U.S., you will most likely qualify for Ozempic coverage for weight loss if you are also being treated for type 2 diabetes. Most insurance companies do not cover this product for weight loss alone because it is not specifically approved by the FDA for that use, even if your doctor has written you a prescription.
Ozempic use for weight loss is considered “off-label” (not an FDA-approved use). Insurance companies may not pay for “off-label” or unapproved uses of drugs, even though they may be effective.
Because Ozempic is a medicine typically used long-term, costs can be significant if you must fully pay with cash for this medicine for weight loss. There are no generic alternatives for Ozempic at this time.
Related: Ozempic Price Guide and Coupons
This is not all the information you need to know about Ozempic (semaglutide) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.
References
- Pratley RE, Aroda VR, Lingvay I, et al; SUSTAIN 7 investigators. Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): a randomised, open-label, phase 3b trial. Lancet Diabetes Endocrinol. 2018 Apr;6(4):275-286. doi: 10.1016/S2213-8587(18)30024-X
- Ahmann AJ, Capehorn M, Charpentier G, et al. Efficacy and Safety of Once-Weekly Semaglutide Versus Exenatide ER in Subjects With Type 2 Diabetes (SUSTAIN 3): A 56-Week, Open-Label, Randomized Clinical Trial. Diabetes Care. 2018 Feb;41(2):258-266. doi: 10.2337/dc17-0417
- Ahrén B, Masmiquel L, Kumar H, et al. Efficacy and safety of once-weekly semaglutide versus once-daily sitagliptin as an add-on to metformin, thiazolidinediones, or both, in patients with type 2 diabetes (SUSTAIN 2): a 56-week, double-blind, phase 3a, randomised trial. Lancet Diabetes Endocrinol. 2017 May;5(5):341-354. doi: 10.1016/S2213-8587(17)30092-X
- Kommu S, Berg RL. Efficacy and safety of once-weekly subcutaneous semaglutide on weight loss in patients with overweight or obesity without diabetes mellitus - A systematic review and meta-analysis of randomized controlled trials. Obes Rev. 2024 Sep;25(9):e13792. doi: 10.1111/obr.13792
- Ozempic (semaglutide) [Package Insert]. Revised 1/2025. Novo Nordisk. Plainsboro, NJ. Accessed Jan 6, 2025 at https://www.novo-pi.com/ozempic.pdf
- Davies M, Færch L, Jeppesen OK, et al; STEP 2 Study Group. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet. 2021 Mar 13;397(10278):971-984. doi: 10.1016/S0140-6736(21)00213-0.
- Ozempic (semaglutide) injection—Compelling weight loss across doses. NovoMedlink. Accessed Sep 15, 2025 at https://www.novomedlink.com/diabetes/products/treatments/ozempic/efficacy-safety/ozempic-and-weight.html
- Frequently Asked Questions (FAQs). Ozempic.com. Accessed Sep 15, 2025 at https://www.ozempic.com/faqs.html
- Drug Safety Drug Safety-related Labeling Changes (SrLC). Ozempic. FDA. Accessed Sep 15, 2025 at https://www.accessdata.fda.gov/scripts/cder/safetylabelingchanges/index.cfm?event=searchdetail.page&DrugNameID=2183
- ​Wegovy (semaglutide) [Package insert]. Revised 08/2025. NovoNordisk. Accessed Sep 15, 2025 at https://www.novo-pi.com/wegovy.pdf
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How long does it take for Ozempic to work?
Your blood glucose (sugar) levels should start to fully decline within the first week after you start using Ozempic (semaglutide) at your regular dose. However, the full effect can take 8 weeks or longer, as this is a long-acting medication that is injected only once per week. Continue reading
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