Ozempic is an FDA-approved prescription medication for the treatment of type 2 diabetes in adults. It helps improve blood sugar in adults with type 2 diabetes and is proven to lower hemoglobin A1C, a measure of blood glucose over time, according to research cited on Ozempic’s site. It also helps adults with type 2 diabetes and known heart disease lower their risk for cardiovascular events like stroke or heart attack.

The active compound in Ozempic, semaglutide, is a glucagon-like peptide-1 (GLP-1) receptor agonist. It works by activating GLP-1 receptors throughout the body and enhancing the effects of the naturally occurring hormone GLP-1.

“GLP-1 serves multiple key functions in the body,” explains Christopher McGowan, M.D., a gastroenterologist specializing in obesity medicine and endobariatrics, and founder of True You Weight Loss in North Carolina. “It boosts the release of insulin by the pancreas in response to food intake, which helps to control blood sugar. Likewise, it reduces the release of glucagon—a hormone that increases blood glucose—thereby also helping to control blood sugar.”

Ozempic is a once-weekly self-administered injection of semaglutide. It comes in 0.5 milligrams, 1 milligram or 2 milligram dosages.

Is Semaglutide Insulin?

Ozempic is not insulin. It helps your pancreas produce more insulin when your blood sugar is high. “Unlike insulin, it rarely causes low blood sugar,” notes California-based Lydia Alexander, M.D, a board certified obesity medicine specialist and president-elect of the Obesity Medicine Association, the largest organization of clinicians dedicated to preventing, treating and reversing the disease of obesity.

While Ozempic is not specifically labeled as a weight loss drug, studies sponsored by Novo Nordisk, the company that makes it, suggest people who take semaglutide—the active compound in Ozempic—may lose weight^[1][2]. In fact, the FDA approved semaglutide for weight loss in 2021 under the brand name Wegovy. However, Wegovy provides a higher dose of semaglutide than Ozempic—2.4 milligrams of semaglutide in Wegovy compared with 0.5 milligrams, 1 milligram or 2 milligrams of semaglutide in Ozempic.

As a GLP-1 receptor agonist, semaglutide enhances the effects of the naturally occurring hormone GLP-1. Dr. McGowan explains that in addition to its effects on blood glucose and diabetes, GLP-1 also impacts weight via two key mechanisms:

• Affects the hunger centers in the brain (specifically, in the hypothalamus), reducing hunger, appetite and cravings
• Slows the rate of stomach emptying, effectively prolonging fullness and satiety after meals

“The net result is decreased hunger, prolonged fullness and ultimately weight loss,” adds Dr. McGowan.

In one large clinical trial sponsored by Novo Nordisk, 1,961 adults with excess weight or obesity who did not have diabetes were given 2.4 milligrams of semaglutide or a placebo once a week for 68 weeks, along with lifestyle intervention. Those who took semaglutide lost 14.9% of their body weight compared with 2.4% for those who took the placebo^[1].

It’s important to note that the dose of semaglutide used in this study was higher than the dose provided by Ozempic. However, 2.4 milligrams is the dose of semaglutide in the FDA-approved weight loss drug Wegovy.

“Ozempic is FDA approved for the treatment of diabetes only. It is not a weight loss medication,” explains Dr. McGowan. “Its sister medication, Wegovy, is specifically approved for the treatment of weight,” he adds.

Even though Ozempic and Wegovy are essentially the same medication (just available in different doses), it should be noted that while Ozempic is typically covered by insurance, often, Wegovy is not.

High demand and subsequent inventory and supply chain strains have severely impacted the availability of Wegovy, notes Dr. McGowan. As a result, Wegovy has been repeatedly unavailable since its introduction and many people are turning to off-label use of Ozempic for weight loss. Dr. McGowan notes that this is interfering with the availability of it for those with diabetes.

While taking semaglutide may help you lose weight while you are on the drug, most people will regain much of that weight if they discontinue using it. “Studies show that stopping Ozempic completely will likely lead to regaining most of the weight lost within several months,” notes Rekha Kumar, M.D., head of Medical Affairs at evidence-based weight care program Found, and practicing endocrinologist at an academic medical center in New York City.

“GLP-1 medications [like Ozempic] are designed to be taken long-term,” explains Dr. McGowan. “They are chronic medications for the treatment of chronic conditions (both diabetes and obesity).”

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