How does Ozempic work for weight loss?

Ozempic helps with weight loss by slowing down how fast food travels through your digestive tract. This can help you feel fuller for a longer period of time, and reduce your appetite and how much food you eat, leading to weight loss. In clinical studies, patients lost an average of 14 lbs (6.4 kg) when Ozempic was given over a 40-week long period.

Ozempic contains the GLP-1 receptor agonist semaglutide and 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.

It's also used to help protect you from a heart attack, stroke or death if you have heart disease, and to reduce the risk of worsening kidney disease and heart-related death in patients with type 2 diabetes.

If you are looking for a medicine specifically approved for weight loss, a brand name drug called Wegovy may be an option. Wegovy contains a slightly higher dose of semaglutide (the same active ingredient 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.

Both Ozempic and Wegovy are manufactured by Novo Nordisk.

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), Bydureon (exenatide) or Januvia (sitagliptin).

Studies

Ozempic vs. placebo

Adults in two studies weighed an average of 202 lb (91.8 kg) or 219 lb (99.5 kg) at the beginning of the studies.

• In the first study that lasted 30 weeks, patients using the weekly Ozempic 0.5 mg dose lost an average of 8 lb (3.6 kg) and those using the weekly 1 mg weekly dose lost an average of 10 lb (4.5 kg), compared to those taking placebo (an injection with no medicine) who lost 3 lb (1.4 kg).
• In the second study that was 40 weeks long, patients using the Ozempic 1 mg weekly dose lost an average of 12 lb (5.6 kg), and those using the 2 mg weekly dose lost an average of 14 lb (6.4 kg).

Studies also found that people with type 2 diabetes lost at least double the weight with Ozempic when compared to Trulicity (dulaglutide) or Bydureon (exenatide), other glucagon-like peptide-1 (GLP-1) agonist type 2 diabetes medicines, when given over 40 to 56 weeks.

Ozempic vs. Trulicity

• In a 40-week long study in 1201 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.

Ozempic vs. Bydureon

• A 56-week long study compared Ozempic 1 mg with Bydureon 2 mg given weekly in 813 adults with type 2 diabetes who were also using either metformin or metformin plus a sulfonylurea, other types of oral diabetes medicines.
• Those using Ozempic lost an average of 10.6 lb (4.8 kg) when compared to a 4.4 lb ( 2 kg) weight loss using Bydureon.

Ozempic vs. Januvia

• A 56-week long study in 1231 adults compared Ozempic to Januvia, a type 2 diabetes pill from the dipeptidyl peptidase 4 (DPP-4) inhibitor class. Patients were also taking one or more additional diabetes pills.
• Patients using Ozempic 0.5 mg weekly lost 9.2 lb (4.2 kg) while those using Ozempic 1 mg weekly lost 12.1 lb (5.5 kg). The group taking Januvia 100 mg once per day had an average weight loss of 3.7 lb (1.7 kg).

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.

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.

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 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.

• Ozempic is normally started at a dose of 0.25 mg injected subcutaneously (injected under the skin) once a week for the first 4 weeks, then is increased to 0.5 mg once a week. It can be taken with or without food.
• If your healthcare provider decides you need a higher dose, it can be increased to 1 mg after another 4 weeks, and then again to 2 mg once weekly, if needed.
• The maximum dose of Ozempic is 2 mg given once per week.

Related questions

• Mounjaro vs Ozempic: Which is right for you?
• Ozempic Side Effects to Watch For
• How do Ozempic, Mounjaro, Wegovy, Zepbound compare for 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) 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.

Is Ozempic FDA-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.

Approved uses

The Ozempic brand of semaglutide is FDA-approved to be used alongside diet and exercise to improve blood sugar (glucose) control in adults with type 2 diabetes. It's also used to reduce the risk of major cardiovascular events such as a heart attack, stroke, or death in adults with type 2 diabetes with known heart disease.

Ozempic is in a class of drugs known as glucagon-like peptide-1 (GLP-1) agonists (also called incretin mimetics). It is prescribed to help lower your blood sugar levels and A1C in type 2 diabetes.

• Ozempic binds to GLP-1 receptors and stimulates insulin release from the pancreas when you need it.
• It reduces the amount of sugar released by your liver and slows down food leaving your stomach to help prevent blood sugar spikes.

The Wegovy brand of semaglutide is approved for weight loss in adults and children 12 years and older with obesity or adults who are overweight and also have weight-related medical conditions, like high blood pressure, type 2 diabetes or high cholesterol. Wegovy may be an option for you if you are looking for a medicine specifically to lose weight.

Wegovy is also approved to reduce the risk of heart attacks, strokes, and cardiovascular death in adults with heart disease and who have either type 2 diabetes (Ozempic) or are obese or overweight (Wegovy). It's also used in addition to diet and exercise.

Other GLP-1-like drugs in the same or similar classes include:

• Bydureon BCise
• Byetta
• Mounjaro
• Saxenda
• Victoza
• Wegovy
• Zepbound

Can non-diabetics use Ozempic for weight loss?

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.

While Ozempic can help with weight loss, not everyone may be able to use it. Your healthcare provider may decide another weight loss option is more appropriate, there could be a shipping delay or shortage of the medicine, or your insurance company may only cover it for treatment of type 2 diabetes and not weight loss. They may prefer you use a different medication before they will pay for it.

Your insurance may pay for Wegovy for weight loss, and you should check. Wegovy is semaglutide, the same 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.

Both drugs can also help to protect you from a heart attack, stroke or death if you have been diagnosed with heart disease. Ozempic is also approved to reduce the risk of worsening kidney disease and cardiovascular death in patients with type 2 diabetes.

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 approved). Insurance companies may not pay for “off-label” or unapproved uses of drugs, even though 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. The cost for Ozempic typically runs between $0 and $1051 per month. There are no generic alternatives for Ozempic at this time.

Related: Ozempic coupons that might help you save money

If your doctor prescribes you Ozempic “off-label” for weight loss, but your insurance does not cover it, consider these other possibilities:

• Wegovy is another GLP-1 medicine approved for weight loss that contains semaglutide, the same active ingredient as Ozempic, but it’s prescribed at a slightly higher dose.
• Check with your prescription plan to see which drugs, if any, are covered for weight loss when prescribed by your doctor. Liraglutide is another weight loss drug in the same class as Wegovy and Ozempic that is now approved as a generic option, which may be more affordable and covered by your plan.
• Your insurance may also help to cover programs for behavioral change, nutrition and exercise planning for weight loss.
• Speak to your healthcare provider to determine which other weight loss treatments may be a good option for you.

This is not all the information you need to know about Ozempic 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.