How Does Ozempic Work?

Ozempic is the brand name for semaglutide, a prescription medication currently Food and Drug Association (FDA)-approved for helping lower blood sugar levels as part of treatment for type 2 diabetes mellitus, along with exercise and healthy diet changes. Though the medication is not currently FDA-approved for weight loss, many people who take Ozempic for type 2 diabetes also lose significant weight. Let's examine what Ozempic is, how it works, how it can lead to weight loss, and its potential side effects.

What Is Ozempic?

Ozempic was originally developed to help treat type 2 diabetes patients as part of an approach that involved diet and exercise changes, as well as to reduce the risk of stroke and cardiovascular issues for those already afflicted with cardiovascular disease. Ozempic isn't used to treat diabetic ketoacidosis and type 2 diabetes, and it's not for those who have had pancreatitis in the past. Ozempic can be used on its own or in combination with other medications used to treat diabetes, such as Metformin.

Ozempic comes as a liquid and is administered as a subcutaneous injection via disposable pens that are pre-filled with four doses. Patients can self-inject Ozempic, and it is administered once a week. Ozempic is offered in three different strengths: 2 mg per 1.5 ml solution, 4 mg per 3 ml, and 8 mg per 3 ml.

How Does Ozempic Work?

Technically speaking, Ozempic belongs to the class of medications called “glucagon-like peptide-1 (GLP-1) agonists.” GLP-1 is called an “incretin” and is a hormone in the intestines that regulates blood sugar. GLP-1 agonists reproduce or enhance the effects of GLP-1, which occurs naturally in the body. The mechanism of action of GLP-1 agonists is to stimulate the pancreatic beta cells to secrete meal-dependent insulin. This limits glucagon secretion, which increases blood sugar, slows gastric emptying, reduces appetite, and lowers food intake by increasing the feeling of fullness.

In addition, scientists speculate that GLP-1 agonists such as Ozempic may directly affect hunger centers in the brain, which explains the drug's efficacy in promoting weight loss. The primary effect of Ozempic and other GLP-1 antagonists is to minimize blood sugar spikes after eating by stimulating the pancreas to release insulin and bind to GLP-1 receptors. The drug's mechanism of action is on the insulin produced after eating a meal, so the incidence of hypoglycemia strictly from a GLP-1 antagonist is far less.

Type 2 diabetes treatment includes Ozempic or GLP-1 antagonists and other medications. You can expect a reduction in A1C from 0.5% to 1.2% when taking a GLP-1 antagonist medication, and more significant reductions occur with longer-acting types. Ozempic also reduces the amount of sugar the liver releases and slows gastric emptying, mitigating glucose spikes.

Weight Loss With Ozempic

The FDA has only approved Ozempic for treating type 2 diabetes. However, scientists and medical professionals have noted that significant weight loss also occurs with the administration of Ozempic, leading it to be prescribed off-label as a weight loss drug. The FDA is currently reviewing Ozempic to determine its safety and efficacy as a weight loss medication used along with diet and exercise changes.

Another branded form of semaglutide is currently approved for weight loss, so if and when the FDA approves Ozempic as a weight loss drug, it will be the second in its class for treating obesity. Ozempic promotes weight loss by slowing down gastric emptying, which helps you feel fuller for longer. In addition, with lessened blood sugar swings, you're less likely to overeat once the spike in glucose begins to drop.

With Ozempic, the treating provider must slowly titrate the dosage to mitigate any side effects, so it takes some time to reach the target dose. The dose is typically increased every four weeks. The starter dose is 0.25 mg once a week for four weeks, then 0.5 mg a week for four weeks, and then incremental changes until the target dose of 2.4 mg weekly is reached — usually in about 20 weeks.

In studies of Ozempic, weight loss increased proportionally to the dosage increases, with weight loss continuing after reaching the goal dosage. While weight loss using this medication can be significant, it takes some time to see noticeable changes. Eating a healthy diet and adding an exercise routine will garner the best results.

Ozempic Side Effects

Like any other medication, Ozempic does have potential side effects. The most common side effects include nausea, vomiting, stomach discomfort, constipation, and diarrhea. There are some steps you can take to mitigate these stomach-related side effects, such as:

• Consuming foods with high water content, such as jello, broths, and soups.
• Only drinking ice-cold, clear drinks.
• Sticking to low-fat, bland foods, such as crackers, bread, and rice.
• Avoiding lying down after eating.
• Staying away from fried, greasy, and sweet foods.
• Eating slowly.

Less common side effects include vision changes, gallbladder issues, pancreas inflammation, kidney issues, allergic reactions, and hypoglycemia (low blood sugar). While extremely rare, there's a slight possibility of severe side effects, such as thyroid tumors that could be cancerous. Contact your prescribing doctor immediately if you experience hoarseness of voice, shortness of breath, swelling or a lump in your neck, or difficulty swallowing.

Risks and Warnings

You need to make sure your physician is aware of some issues before beginning treatment with Ozempic, such as any current or past issues with your kidneys or pancreas, any history of diabetic retinopathy, or if you're currently breastfeeding, planning to breastfeed, or are pregnant. In addition, if you or a family member have ever been diagnosed with medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2, you shouldn't use Ozempic.

As always, discuss all medications, supplements, and vitamins you're taking with your doctor to determine whether there could be any negative interactions. If you're located in the South Florida area (Boca Raton, Delray Beach, Miami, Fort Lauderdale, Jupiter) and would like to discuss how Ozempic can help you, call our biostation team at 561-462-4894 or complete our convenient online form. A team member would be happy to answer any questions or schedule you for a consultation. You can also request a consultation online to get started.