How Fast Do You Lose Weight on Ozempic? A Realistic Expectation

In the last few years, interest in weight loss medications has skyrocketed, with popular medications like Ozempic becoming part of everyday conversations about weight and health. However, Ozempic has specific criteria for use and is not approved for all adults who wish to lose weight. Learn more about who qualifies for Ozempic, how the medication works for weight loss, and how fast a person can lose weight while using Ozempic or a similar medication below.

What is Ozempic?

Ozempic is a prescription medicine approved by the Federal Drug Administration (FDA) for adults with type 2 diabetes. The purpose of Ozempic is to lower blood sugar when used in combination with diet and exercise and reduce the risk of cardiovascular events like heart attack and stroke. It is an injection taken once per week, on the same day, and at approximately the same time, as prescribed by a healthcare provider.

Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist and the active ingredient in Ozempic. Ozempic helps people with type 2 diabetes control blood sugar by helping the pancreas increase insulin secretion and lower glucagon secretion, which are key hormones in blood sugar control. Semaglutide also causes a minor delay in the time it takes for the stomach to empty, which slows down the rate at which glucose enters the bloodstream.

How does it work for weight loss?

Ozempic is not FDA-approved for weight management or weight loss, but users of Ozempic have lost weight in studies. In a study comparing the effects of a once-weekly 2.4 mg dose of semaglutide to a placebo group, participants receiving the semaglutide lost weight and reduced their energy intake due to:

• Decreased appetite
• Reduced hunger
• Increased satiety or feelings of fullness
• Reduced strength and frequency of food cravings or food noise
• Better control of eating

By week 20, the average energy intake at lunch was 35% lower in the group receiving semaglutide than in the placebo group.

However, weight regain once semaglutide is stopped is likely, and long-term usage of semaglutide medication may be necessary to maintain weight loss. In the STEP 4 randomized clinical trial with semaglutide, people assigned to the study group who stopped treatment at 20 weeks gained weight, while the people still assigned to a treatment group continued to lose weight. Among those assigned to the semaglutide group for 68 weeks, 64% lost at least 15% of their initial body weight, while participants who switched to placebo at week 20 experienced an average weight change of +6.9%.

How fast do you lose weight on Ozempic?

Ozempic is not approved by the FDA as a weight loss medication, and using the drug for weight loss would be off-label. Wegovy is another medication with the active ingredient semaglutide that is approved by the FDA for weight loss. Both Ozempic and Wegovy help users lose weight through similar mechanisms, but Ozempic is only approved by the FDA for managing type 2 diabetes and should be used under medical supervision.

Though Ozempic isn't intended for weight loss, adults prescribed the medication for type 2 diabetes do demonstrate weight loss in clinical trials. In the 24 weeks between January 6, 2016, and June 22, 2016, participants in the SUSTAIN 7 trial assigned to the semaglutide 0.5 mg group lost an average of 4.6 kilograms (~10 pounds), and participants assigned to the semaglutide 1.0 mg group lost 6.5 kilograms (~14 pounds). After 40 weeks in the SUSTAIN FORTE trial, participants had an average weight loss of 6.4 kg (~14 pounds) with semaglutide 2.0 mg and lost an average of 5.6 kg (~12 pounds) with semaglutide 1.0 mg.

Note that rapid weight loss from any cause can be harmful, and semaglutide users frequently experience gastrointestinal side effects, such as nausea, vomiting, diarrhea, and fatigue. Some people stop semaglutide drugs due to the side effects despite the potential for significant weight loss.

Who can use Ozempic for weight loss?

Ozempic is available by prescription for people with type 2 diabetes only. Though people lose weight as a secondary effect when using Ozempic, it's prescribed to help manage blood sugar and reduce the risk of cardiovascular complications in people with type 2 diabetes.

People who wish to lose weight with medication and do not have type 2 diabetes should speak to their healthcare providers about other weight loss medications. Wegovy is a semaglutide injectable that is FDA-approved for weight loss in people with obesity, classified as a body mass index (BMI) of 30 kg/m2 or greater, or overweight, classified as BMI of 27 kg/m2 or greater. Per the FDA, people who are overweight meet the criteria for Wegovy if they also have at least one weight-related issue, such as high cholesterol, high blood pressure, or type 2 diabetes. A healthcare professional will be able to assess your medical history and suitability for any drug before starting treatment.

Factors that can impact weight loss with Ozempic

In any weight loss journey, whether assisted with medication or not, overall lifestyle changes such as eating a healthier diet, regularly exercising, and managing sleep and stress affect weight loss outcomes.

Nutrition

An important component of weight management is creating a calorie deficit, either by decreasing caloric intake below your daily calorie needs or increasing exercise.

People using Ozempic often experience reduced appetite and cravings, which helps greatly decrease calorie intake. However, a healthy diet containing plenty of vegetables, fruits, whole grains, healthy fats, and adequate protein should still be the goal.

Reducing portion sizes and extra calories from added sugars and high-fat foods can help create a calorie deficit. Eating a higher protein diet may help promote weight loss and preserve lean muscle mass during weight loss, though more research is needed.

Exercise

To promote general physical health for all adults, the Centers for Disease Control recommends 150 minutes of moderate-intensity exercise each week, including two additional muscle strengthening sessions focusing on all the major muscle groups. Moderate-intensity exercise includes brisk walking or riding a bike at a pace where you can talk comfortably.

Strength and resistance training help preserve lean body mass during weight loss, so they should be prioritized for people actively trying to lose weight. Increased exercise may also help increase weight loss, decrease total body fat, and decrease visceral adipose tissue, which is a type of fat found deep in the abdomen.

High levels of physical activity are also associated with long-term weight loss, so Ozempic users should exercise to help maintain the weight lost with the medication.

Sleep and stress

Sleep and stress also impact weight loss efforts and are important variables to consider when losing weight.

Inadequate or poor-quality sleep can make weight loss and maintenance more challenging. In a study that examined the effects of sleep on weight maintenance one year after weight loss in obese adults, researchers found that participants who had short sleep duration and lower sleep quality regained more weight. Poor sleep health may slow down weight loss efforts. In another study on adults with overweight and obesity, researchers found that better sleep health was associated with greater weight loss and fat loss.

Stress levels may also impact weight loss and weight management. Cortisol is a hormone released during stress, and some studies have found that long-term increased levels of cortisol are associated with overweight and obesity. In one study of hair samples from 2,499 study participants in Brazil, high hair cortisol levels were found in 34.2% of people classified as obese and in 41.2% of people classified as overweight.

Tips for weight loss with Ozempic

Since weight management and weight loss aren't approved uses for Ozempic, any desired weight loss from using Ozempic should be discussed with a healthcare provider.

As with any healthy weight loss plan, Ozempic users should try to eat a healthy diet and meet physical activity guidelines. For most people, a healthy, balanced diet includes a variety of protein, vegetables, fruits, whole grains, dairy or dairy substitutes, and healthy fats. Since sugary and highly processed foods tend to be higher in calories and lower in nutrients, aim to decrease these foods and include more whole foods that naturally contain more fiber and nutrients.

Sufficient sleep and stress management are associated with increased weight loss, so these areas should be prioritized when trying to lose weight, whether with medication or not.

Bottom line

Ozempic is effective for weight loss, but it's a medication only FDA-approved for people with type 2 diabetes. When losing weight with Ozempic or a similar medication, it's still important to eat a healthy diet, increase physical activity levels, focus on sleep duration and quality, and manage stress. Work with a healthcare provider who knows your health history if you're unsure if you qualify for weight loss medication or should use it.