15 Burning Questions About Ozempic, Answered

When the U.S. Food and Drug Administration (FDA) approved Ozempic (semaglutide) in 2017 for use by adults with type 2 diabetes, it ushered in a new era of blood sugar and weight loss drugs. Since then, Ozempic's obesity counterpart, Wegovy, has become available. More recently, Mounjaro and Zepbound — both poised to possibly have even bigger health impacts — were also approved by the FDA.

These weight loss drugs are in a league of their own, and the news about them is everywhere. In a 2023 survey by Everyday Health with more than 3,000 participants, those who lost weight were about twice as likely to have tried these drugs than people who maintained or gained weight. Despite growing awareness of these injectables, many questions around them remain. How do they work? What are the side effects? And do you have to stay on them forever to keep the weight off?

Below are answers to common questions like these from a handful of experts: Beverly Tchang, MD, an assistant professor of clinical medicine at NewYork-Presbyterian and Weill Cornell Medicine in New York City who is board certified by the American Board of Obesity Medicine; Erin Palinski-Wade, RDN, CDCES, a nutrition and diabetes expert who practices in New Jersey; and Tiffani Bell Washington, MD, MPH, a diplomate of the American Board of Psychiatry and Neurology and of the American Board of Obesity Medicine who lives in Boston.

Besides its effect on blood sugar, GLP-1 is the primary actor behind Ozempic’s weight loss effects. “GLP-1 increases feelings of satiety and decreases appetite while also slowing digestion, which in turn mutes appetite as well,” says Palinski-Wade. She explains that the drug delays food’s exit from the stomach, keeping you feeling full longer.

“Some people feel the appetite-suppressing effects within 24 to 48 hours, but weight loss and blood sugar control will take longer,” Dr. Tchang says. “We see people lose weight and achieve blood sugar control over several months, and these benefits are sustained over a year.”

Regarding Ozempic in particular, so far it’s not clear if people in some demographics might be able to manage blood sugar better or lose more weight on the drug than others. “We don’t have that granularity of evidence yet, but we have general trends from other studies,” says Tchang. “Earlier intervention is better, because people then have fewer years of uncontrolled diabetes, and people who have higher baseline weight tend to lose more weight.”

These same restrictions hold true for Wegovy. Mounjaro and Zepbound are also not recommended during pregnancy or for people with family history of these conditions.

For most people, Ozempic won’t be a short-term fix. “Semaglutide is a medication that people should take for a long time, not temporarily,” Dr. Washington says. “This is because obesity is a chronic disease, and the medication only works when you take it.” When people stop taking Ozempic, she says, they tend to regain lost weight.

So how long can you stay on Ozempic? No time limit has been established yet. (The same goes for other newer weight loss drugs.) But as long as you’re tolerating the medication well and your healthcare provider recommends it, you should be able to continue taking it.

“A loss of appetite and a decrease in calorie consumption can promote weight loss. However, it can lead to a lack of balanced nutrition and an increased risk of nutrient deficiencies,” says Palinski-Wade. These potential deficiencies could have lasting consequences. For example, if you’re not getting enough calcium and vitamin D from your diet, you could increase your risk of osteoporosis, she notes. Rapid weight loss can also lead to reduced muscle mass, which can decrease overall metabolism, strength, and balance over time.

Ozempic and the other weight loss drugs might have some drawbacks for your appearance, too. Many people report “Ozempic face,” a hollowed-out facial appearance that comes from rapidly losing fat. (Unfortunately, we can’t control which parts of our bodies lose fat the fastest or most noticeably.) Some Ozempic users even complain of “Ozempic butt.” The same principle applies: As weight comes off rapidly, it can leave your buttocks looking saggy or hollow.

Meanwhile, for most people, the side effects of these newer weight loss drugs are not debilitating and pass quickly. “Generally, these side effects are seen in the first few weeks of therapy as well as when dosing is increased,” Palinski-Wade says. She recommends avoiding large meals or meals high in fat to help to lessen any GI symptoms.

That said, Tchang encourages caution if you have certain risk factors. “A personal or family history of medullary thyroid cancer is a contraindication to Ozempic because this type of cancer was associated with Ozempic in animal studies,” she says. “However, it's important to discuss these concerns with your doctor, who best knows your individual circumstance.”

Like Ozempic, Mounjaro and Zepbound are so new that data on long-term effects isn’t yet available. Palinski-Wade says that thyroid tumors may eventually be a concern with these meds, too. “The FDA has warned that tirzepatide can cause thyroid tumors in rats, but we do not yet know if this will be the case in humans. More research and longer term studies are needed,” she says.

If you feel that the medication is causing or worsening psychological symptoms, talk to your doctor. “It’s important to closely monitor a person’s mood and make changes if necessary,” Washington says.

Insurance coverage of Ozempic (and all drugs, for weight loss or otherwise) varies depending on your provider and plan. In many cases, if you have a valid prescription for the drug, insurance will cover at least a portion of the cost. But some insurance plans only cover Ozempic when it’s prescribed as a treatment for type 2 diabetes, not when it’s prescribed off-label as a weight loss aid. Wegovy and Zepbound, however, are FDA-approved for weight loss, and they aren't intended to be prescribed to those with diabetes.

If your insurance plan doesn’t cover Ozempic, you may have other options for reducing the drug's cost. Ozempic offers a savings card that allows users with private or commercial insurance to pay as little as $25 per pen. To access this card, your prescription must be for a one-, two-, or three-month supply, and you’ll need to answer a few qualifying questions online. If you’re interested in another weight loss drug, check out the drug's website for potential savings.

You can also ask your doctor or pharmacist for insider info on any savings or patient assistance programs in your area. Some nationwide drug discount programs like GoodRx could bring costs down.

Considering the sometimes high cost of Ozempic, no one can blame you if you’re looking for a less-expensive alternative. Unfortunately, Ozempic does not have a generic alternative, Tchang says. While some websites tout knockoff versions of the drug, don’t be fooled: Faux pharmaceuticals are not a safe bet.

Some specialized pharmacies offer compounded semaglutide. These custom-made meds combine the active ingredients of Ozempic with other medications tailored to individual health needs. But Tchang says this option doesn’t have the safety backing of the branded drug. “Compounded semaglutide has not undergone the same clinical trial rigor as brand-name Ozempic, so a patient choosing this route is taking on more risk and must rely on their own research to ensure safety and efficacy.”

If you can’t afford name-brand Ozempic, Tchang says there are other possibilities for weight loss meds. “If Ozempic is inaccessible, patients should speak with a board-certified obesity medicine physician who can discuss other options, such as other GLP-1s or oral anti-obesity medications, which are typically more cost feasible,” she says.

Determining which drug is best for you may be a matter of assessing your health goals. One primary difference between Mounjaro and Ozempic is that Ozempic is FDA-approved to reduce the risk of heart attack and stroke in people with type 2 diabetes, while Mounjaro is not. Talk to your doctor about whether Mounjaro or Ozempic is more appropriate for you.

Palinski-Wade says this is likely to be the reality for tirzepatide drugs as well as semaglutide. “In general, weight regain after stopping weight loss medications is always a possibility,” she says. "These medications are a tool when it comes to weight management, not a quick fix or a cure.”

Even if you stop taking your weight loss drug, you can always continue to make healthy choices that promote weight loss. “To help decrease the rebound weight gain, people can continue the lifestyle changes that they hopefully learned while taking semaglutide,” Washington says.

Everyday Health's Weight Loss Reframed Survey queried 3,144 Americans nationwide, ages 18 and older, who had tried losing weight in the previous six months. The study was fielded between July 10 and August 18, 2023, across demographic groups, genders, and health conditions. Survey recruitment took place via an online portal, in app, and via email. The margin of error for the sample size of 3,144 is +/-1.7 percent at a 95 percent confidence level.

• Ozempic is a GLP-1 agonist drug that increases feelings of fullness and reduces appetite. Other weight loss drugs like Wegovy, Mounjaro, and Zepbound work in a similar way.
• Research shows that these drugs help many people lose weight, but people need to stay on the drugs to keep the weight off. These drugs may cause side effects like nausea, vomiting, and diarrhea.
• Pricing will vary depending on your insurance. Because drugs like Ozempic are relatively new, we don’t have a clear picture of their long-term health effects.
• These drugs are not recommended for people who are pregnant or have a history of diabetic retinopathy or problems with their pancreas or kidneys.