Everything You Should Know About Ozempic, From Your Anti-Diet Dietitian

Disclaimer: This blog covers body weight, weight loss, and weight stigma. Please consider if you are in a space to continue reading for your mental health and well-being. 

First of all, let’s talk about what Ozempic is. Stick with me here as I lay out some scientific terms…Ozempic also referred to as semaglutide, is a prescription medication used to treat type 2 diabetes. It is a glucagon-like peptide-1 (GLP-1) receptor agonist that stimulates insulin production and reduces glucose production in the liver. Because of that mechanism, this medication helps lower blood sugar levels in adults with type 2 diabetes, improving their HbA1c levels. HbA1c is a diabetic diagnostic test measuring blood sugar levels over three months. Of course, this medication is intended for use alongside positive dietary and physical activity changes.

So…what does all of that mean?

Contrary to popular belief, Ozempic does not directly interfere with hunger or fullness hormones like ghrelin and cholecystokinin (CCK), respectively. However, it can indirectly help reduce appetite. Ozempic reduces blood sugar levels, which can reduce hunger and food cravings by signaling to increase CCK (the fullness hormone). Ozempic also helps the body utilize insulin more effectively, reducing fat storage and lowering feelings of hunger. This occurs because fat is a metabolic tissue. Metabolic tissues are involved in metabolism, which is the process of converting food into energy. Specifically, fat is a tissue that stores energy; therefore, lower fat storage within the body can likely lead to a lower resting metabolic rate (the rate at which someone burns calories in a resting state) and can result in lower energy requirements (food intake). 

While people have started to report using Ozempic for weight loss alone and losing up to a “toddler” amount of weight, this drug is really intended for type 2 diabetes management. 

When we look at the current research, we have yet to see concerns for long-term health damage while using Ozempic, unlike another popular weight loss drug, Fen-Phen, which led to increased rates of heart disease in the 90s. However, there haven't been any long-term studies yet. Remember, people thought the keto diet wouldn’t have any long-term negative impacts when it first gained momentum, and now there’s plenty of research on how it can increase risks for heart disease. Even still, from the eyes of an anti-diet dietitian, this medication remains harmful when people seek it out solely for weight loss... 

The health and diet industries keep pushing a narrative that being in a larger body automatically makes someone unhealthy, allowing those who seek Ozempic for weight loss to likely never actually heal their relationships with food or body image. Everyone wants a bandaid for a quick fix, but what happens when that bandaid gets worn out.

According to a few studies, patients who stopped taking Ozempic gained back almost all the weight they lost while taking the medication, and sometimes more. When lifestyle, habits, and forming (reforming) healthy relationships with food and body image aren’t the priority, Ozempic is just like any other fad diet - an outdated way to view ‘health’ that is unsustainable for the everyday person. 

I even listened to a podcast today talking about Ozempic and how there needs to be better science backing the line between “a healthy weight and being too fat,” because there is indefinite research about it…but hello?? That’s because there is no research on how weight alone can determine one’s health status. It hurts me that the two people on this podcast can say words such as that and not realize they are part of the problem of perpetuating weight stigma. Weight stigma, by the way, is the negative bias and discrimination against people based on their weight or size often leading to both physical and mental health consequences.

Not to mention, there becomes a higher risk for someone to disassociate from their own body in terms of their body naturally regulating blood sugars or learning how to manage their blood sugars by being attuned to their food and physical activity choices (solely speaking about people not diagnosed with diabetes). 

Let's also talk about how a major side effect of Ozempic is gastrointestinal distress. GI distress can cause unnecessary inflammation, potentially impairing the microbiota, which is extremely important for overall health. While I won’t get too deep into all the microbiota does for our health, I will say that 90% of your serotonin (happy hormone) is produced in your GI tract along with the majority of your immune cells. From my professional knowledge, I can only imagine what will occur with long-term use of Ozempic if you’re unlucky to have the GI distress side effect many are experiencing. How will your immune system and serotonin production change? What if nutrient absorption decreases over time due to an inflamed intestinal lining? How does this actually disconnect you further from your body? These are all serious questions to consider for those who want to seek out Ozempic solely for weight loss. Questions like this help you expand your critical thinking around what diet culture is trying to sell you next. 

There’s even news about how influencers are being hired to promote Ozempic…let that sink in.

While I’m here, I also want to go over a few studies…

Effect of Oral Semaglutide Compared With Placebo and Subcutaneous Semaglutide on Glycemic Control in Patients With Type 2 Diabetes includes a list of authors on the board for or have received grant money at their institutions, from Novo Nordisk, the company producing Ozempic. This study also only included 583 participants (all diagnosed with type 2 diabetes, at that) who remained in the study for a total of 26 weeks (6.5 months), with a follow-up at week 31, which is A) not nearly a large enough sample size to generalize these results for the rest of the world's population and B) not enough time to assess any potential long-term effects of Ozempic, even though the article reported, “No unexpected safety findings were identified.“ 

Other research such as this meta-analysis, Efficacy and Safety of Subcutaneous and Oral Semaglutide Administration in Patients With Type 2 Diabetes: A Meta-Analysis, reviewed 24 trials with a total of 22,185 patients, also diagnosed with type 2 diabetes. This review of the literature highlights how Ozempic can positively manage type 2 diabetes and lower risks for cardiac events, all-cause death, and cardiovascular death. Ozempic is shown to have stomach distress as a main side effect. But once again, this study was specific to those diagnosed with type 2 diabetes. The research selection criteria also stated that a trial had to be at a minimum 8 weeks long, but did not detail the total duration of each trial. 

Other articles like Slim Chance for Permanent Weight Loss and How dieting makes some fatter: from a perspective of human body composition autoregulation help explain why dieting almost always fails. (side note, I don’t encourage the use of words such as obes*ty as it carries strong negative connotations, but you will likely see this word used in scientific articles). 

All this being said, I am not taking away from anyone’s positive experiences with a medication like this when prescribed by a caring practitioner and a team of health professionals trying to do their best for their patients. There are plenty of positive stories of people having better control over their type 2 diabetes, as well as losing weight to ease the strain on their knees instead of intending to look like Gisele Bündchen. However, for the general, healthy public I do not see this medication, or a drug like this, as a sustainable and viable approach to ultimate health and happiness. 

U.S. helpline for the National Eating Disorders Association: 800-931-2237
National Suicide Prevention Lifeline: 800-273-TALK (8255), or text the Crisis Text Line (text HELLO to 741741)