There’s a common misconception floating around in regards to the very trendy medication, Ozempic (semaglutide). Contrary to popular belief, Ozempic is not a weight loss drug. It’s a glucagon-like peptide-1 (GLP-1) receptor agonist (GLP-1 AR) used to treat type 2 diabetes (T2D) and its risk factors in adults. In fact, this is the only use for which the medication is FDA-approved. Since the drug helps to regulate appetite and a common side effect is significant weight loss for many patients, it is often used off-label for weight loss purposes. With that in mind, Woman’s World asked experts for their thoughts on Ozempic and the many other medications like it, and they confirmed that there are other options that are healthier and specifically designed for weight loss.
How do experts feel about Ozempic?
Janese Laster, MD, gastroenterologist at Gut Theory Total Digestive Care, says one of the most important things people should understand is that Ozempic is a diabetes treatment, despite having become the sort of brand name for weight loss in the mainstream. With that being said, Ozempic can be very effective for the right patient population, she says.
“As a gastroenterologist, I make sure that patients think about the side effects of the medication and how it works,” Dr. Laster says. “A lot of things you see online are people complaining about ‘Oh my goodness, I had horrible constipation,’ or ‘I had muscle mass loss,’ or ‘I had nausea,’ or ‘I had vomiting.’ That’s because whoever prescribed the medication didn’t pay attention to the patient.”
This typically means a patient saw Ozempic advertised online, requested and was given the drug without a proper consultation, she explains. Since Ozempic can’t have such gastrointestinal side effects, someone taking the medication would first have to treat any existing issues they might have including chronic constipation, bloating or abdominal pain prior to starting that medication.
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“I think for the right patient, it is a great medication when somebody has consistent follow up, when somebody understands that it’s not magic, that you can’t just continue eating the same way you always have and think that this is going to be a magic drug for you, understanding that you have to make dietary changes and the goal is not to get to the point where you just stop eating which I think is why people start to lose muscle mass,” Dr. Laster says.
Similarly, HaVy Ngo-Hamilton, Pharmd.D, pharmacist and clinical consultant at BuzzRx, says she believes in the safety and efficacy of Ozempic when used correctly, but reaffirms that if a healthcare professional is prescribing the drug “for weight loss,” this is off-label use.
“I believe the ideal candidate for Ozempic is someone who has type-2 diabetes but also struggles to lose excess weight despite their effort in lifestyle changes,” Dr. Ngo-Hamilton says. “For this particular population, Ozempic not only helps them to manage their blood sugar levels but also benefits their weight loss journey, not to mention that they are probably also benefiting from Ozempic cardioprotective’s effects, as diabetes and obesity are risk factors of heart disease.”
Which drugs are better than Ozempic for weight loss?
Saxenda (liraglutide), Wegovy (semaglutide) and Zepbound (tirzepatide) are approved for weight loss, Dr. Ngo.Hamilton explains, which means their manufacturers have conducted extensive clinical trials to prove these medications’ safety and efficacy in chronic weight management when used in combination with diet and exercise. Ozempic (semaglutide), Mounjaro (tirzepatide) and other medications such as Trulicity (dulaglutide), Victoza (liraglutide), and Byetta (exenatide) are meant to be used for the long-term management of type-2 diabetes.
“When Ozempic or Mounjaro are used for weight loss, it is considered off-label use,” she says. “This term refers to the practice of a healthcare provider using their clinical judgment to prescribe a specific medication for an indication that the FDA has not approved. While off-label use is a common practice, it’s important to note that its effectiveness may vary from person to person due to our unique body compositions, health histories, and concurrent medications.”
If weight management is your main objective, Dr. Ngo-Hamilton advises Wegovy, Saxenda and Zepbound may be more appropriate. However, Ozempic can still be effective for both weight loss and diabetes if administered properly with concurrent lifestyle health changes.
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Both doctors concur that other non-brand-name medications that have been around longer and are not as frequently advertised are still often viable options for those seeking weight loss medication. Anorectic drugs such as phentermine, benzphetamine, diethylpropion and phendimetrazine are a few examples of weight loss pills which work as appetite suppressants, Dr. Ngo-Hamilton says. It’s important to understand, though, that these pills are made for short-term use.
“If somebody has chronic GI symptoms, I’m unlikely to start you on a GLP medicine,” Dr. Laster says. “There are other older medications that may be a better fit for them, like Qsymia, which is an oral medication that’s super old that has phentermine and topiramate in it, or Contrave that has naltrexone and bupropion. So depending on what each person’s phenotype is — if they are a person that gets super hungry all the time or feel like it takes a lot for them to get full, then the Qsymia may be a better option for them.”
Which weight loss medications like Ozempic are easiest to access?
A large part of the conversation around these treatments is accessibility. Dr. Ngo-Hamilton says there are some approved weight loss medications, such as Alli (orlistat), that can be purchased over the counter at the pharmacy and don’t require a prescription from a doctor or healthcare professional, making them the most accessible option.
“If you are pursuing a prescription for a GLP-1 agonist specifically for weight loss without having type-2 diabetes, your healthcare provider may be more inclined to direct you to one of the other options – Wegovy, Saxenda and Zepbound – that are approved for chronic weight management,” she says, “Often, you can even get a prescription for these medications via a telehealth appointment.”
She notes, though, that Wegovy and Zepbound can be more challenging to secure a prescription for at the moment due to recent nationwide shortages of the medication.
In terms of insurance, Dr. Laster says these medications are generally difficult to get coverage for many commercial insurers. Even for a diabetic person, she says, many insurance companies will require patients to fill out prior authorizations regarding whether they’ve tried other management programs first before requesting this drug.
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