We have seen Ozempic rise to popularity for its robust effects on weight loss, with its use extending to both celebrities and the general public. It has become so widely utilized that Ozempic’s manufacturer suffered drug shortages earlier this year.

So, you’ve finally got your hands on Ozempic and are ready to shake off that stubborn extra weight, but maybe you are not seeing the results you are hoping for. Whether you have only lost a few pounds or none at all, there could be several things impacting your ability to use Ozempic effectively. Elements like diet, lifestyle, genetics, and health history all contribute to your body’s ability to lose weight and thus how well Ozempic will work. This article will explain why you may not be losing weight on Ozempic and what you can do to support your weight loss journey.

What is Ozempic?

Ozempic contains the active ingredient semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist. GLP-1 agonists act like the natural GLP-1 found within our body, operating like a hormone to cause insulin production and blood sugar control. It’s via this mechanism that Ozempic demonstrates efficacy in treating type 2 diabetes, a condition characterized by high blood sugar levels. Likewise, the Food and Drug Administration (FDA) approved Ozempic in 2017 for the treatment of type 2 diabetes. It is administered as a weekly injection to support insulin production and decrease blood sugar.

Ozempic’s active ingredient semaglutide, however, also has other pharmacologic effects outside of just blood sugar control. It also slows gastric emptying, a process in the body that moves the stomach contents through the digestive tract. By delaying this phenomenon, semaglutide causes you to feel fuller for longer. Because you maintain satiety for an extended period, you do not eat as much, thus losing weight. As a result, semaglutide’s weight loss properties have gained a lot of attention in recent years. In fact, the FDA approved semaglutide under a different brand name, Wegovy, at a higher dosage for long-term weight loss.

So why do people use Ozempic for weight loss? Although Ozempic does not contain as high of doses of semaglutide, it may still be effective in decreasing weight. Thus, some healthcare providers prescribe it “off-label”, meaning that it is prescribed for an indication that it is not approved for, like weight loss.

How effective is Ozempic in lowering weight?

Before understanding the data for weight loss with semaglutide, it’s important to consider the different dosing for the different brands. To review, the different brand names (Ozempic and Wegovy), indications, and dosages are included below.

Ozempic

Wegovy

FDA-approved indication
  • Type 2 diabetes
  • Lower the risk of cardiovascular events in individuals with type 2 diabetes and cardiovascular disease
  • Chronic weight management in obese or overweight adults
Dose
  • 1 mg weekly
  • Up to 2.4 mg weekly

Because Ozempic is not indicated for type 2 diabetes, there is not as much data evaluating its weight loss effects at the 1 mg weekly dose. Most of the studies evaluate Wegovy, which is 2.4 mg weekly of semaglutide. Nevertheless, the Wegovy studies can inform us of the potential efficacy of Ozempic, although Ozempic has a lower dose.

There are several studies conducted by Wegovy’s manufacturer that help to characterize its safety and efficacy profile in obese and overweight adults. This series of trials is referred to as the Semaglutide Treatment Effect in People with Obesity (STEP) program. This robust program has evaluated semaglutide’s effect on weight across disease states, age groups, and more. A summary of some of the STEP trials is included below:

  • STEP 1: In obese or overweight individuals without diabetes, a 14.9 percent decrease in body weight with 2.4 mg semaglutide versus a 2.4 percent decrease in body weight with placebo was seen.
  • STEP 2: In obese or overweight individuals with type 2 diabetes, a 9.64, 6.99, and 3.42 percent decrease in body weight was seen with semaglutide 2.4 mg, 1.0 mg, and placebo, respectively. It is important to note that the 1.0 mg dose is that of Ozempic, which induced a 6.99 percent decrease in body weight.
  • STEP 3: In obese or overweight patients, semaglutide decreased weight by 16.0 percent when combined with intensive behavioral therapy versus 5.7 percent with placebo.

There were several more STEP trials than just the ones mentioned above. It is very important to note, however, that semaglutide therapy is usually supplemented with diet, exercise, or behavioral therapy (such as with the STEP-3 study). All of these factors can influence semaglutide’s ability to induce weight loss. We will discuss these factors in the coming sections.

What can affect Ozempic’s efficacy?

Perhaps you have started on Ozempic already and are excited about the prospect of shedding some pounds. Despite the publicity and positivity surrounding its effectiveness, some individuals will struggle to lose weight even on Ozempic. This is because the efficacy of the medication and weight loss in general are dependent on several factors related to your lifestyle, health history, and genetics. Let’s review the interplay of these elements.

Genetics and metabolism

Your risk of obesity or being overweight is greater if your parents are overweight or obese. This is because your genetics affect both the amount of fat you store and where it is stored. Genetics can also contribute to your appetite and physical activity levels.

Pre-existing medical conditions and medications

Typically, lifestyle is one of the biggest contributors to obesity. However, there could also be other diseases and medical conditions that are affecting your weight. Things like endocrine disorders (e.g., hypothyroidism, polycystic ovary syndrome, etc.), depression, and stress can all impact your weight. If you are struggling with these, Ozempic alone may not help with weight loss. To lose weight, you will need to treat these conditions specifically by addressing the underlying cause.

Additionally, certain medications can cause weight gain as a side effect. The following drugs, for example, may make it difficult to shed the pounds:

  • Medications for psychotic problems, depression, and epilepsy
  • Steroids
  • Medications for high blood pressure
  • Antihistamines
  • Diabetes medications

Medication adherence

If one thing’s for certain, it’s that you must take your medication for it to be effective. While Ozempic offers the convenience of a once-weekly injection, patients may forget to take their medication as it is not a regular part of their daily routine. However, taking Ozempic consistently is paramount to getting results. Otherwise, you may not achieve therapeutic levels of the medication in your body, preventing you from seeing effects.

Dosage and treatment regimen

We have mentioned before that Ozempic has a lower dose of semaglutide than Wegovy, which is the brand medication approved for weight loss. Thus, if you take Ozempic for weight loss, you may not be seeing as robust of results as those who took the 2.4 mg Wegovy dose in the aforementioned STEP trials. If you want greater success, consider asking your doctor about the option of Wegovy.

Diet

It is essential to note that Wegovy is approved for weight management only when used in combination with a low-calorie diet and increased exercise. Thus, for maximal benefits, you should be taking semaglutide while also implementing a proper diet. This means reducing your caloric intake and eating healthy foods. Healthy foods include adding in plenty of fruits, veggies, lean proteins, and complex carbs. Avoid processed foods, inflammatory oils, sugar, alcohol, and refined carbohydrates.

Exercise and physical activity

Per the FDA’s Wegovy label, semaglutide treatment should also be supplemented with exercise. Experts recommend individuals engage in a minimum of 150 minutes of aerobic exercise a week. This can include things like jogging, swimming, brisk walking, or cycling.

Stress and sleep

A lot of us tend to put sleep on the back burner when life gets overwhelming or busy. The reality is though, however, that sleep is critical to many aspects of our health including weight. Experts suggest that adults get in between seven to nine hours of sleep each night. If you don’t, a lack of sleep can increase hunger, causing you to eat more and crave unhealthier foods. Thus, getting a consistent restful night’s sleep can make weight loss easier.

Other lifestyle habits

There are lots of other things that can make it harder to lose weight on Ozempic. For example, if you consume large amounts of alcohol or lead a very sedentary lifestyle. If you are looking to maximize the effects of your Ozempic medication, discuss with your doctor what other changes you can implement.

Conclusion

It can be frustrating when you are not getting the results you expected from Ozempic, even when everyone around you seems to be. It is important to remember that everybody and everybody is different, and aspects of your lifestyle, genetics, and health history can all impact your ability to lose weight with or without Ozempic. Diet, exercise, and sleep are paramount, but if you still are not seeing results, talk to your doctor about what else you can do to help.