That’s why some people don’t lose weight with Ozempic

Ozempic, a drug designed to help manage insulin levels, has become a household name after several people on social media talked about using it for weight loss. Although Ozempic is currently only approved by the Food and Drug Administration for the management of insulin, a known side effect is weight loss and it is often prescribed for just that.

If you’re taking Ozempic, whether to manage your insulin levels or to lose weight, and aren’t seeing the results you want, it’s understandable to ask yourself: Why am I not losing weight with Ozempic? Particularly considering how much chatter has spread about the impact of medications on weight loss.

So, what might be interfering with Ozempic’s potential weight loss? Doctors analyze it.

What is Ozempic and how does it work?

Ozempic, which contains semaglutide, is an injectable drug typically prescribed to patients with type 2 diabetes to help manage blood sugars.

Ozempic is designed to be used in conjunction with a diet and exercise program, according to Medline Plus. The drug specifically works by activating something called GLP-1 receptors in your body, explains Mir Ali, MD, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California. This promotes the production of insulin in the body, which helps in blood sugar management. But one of the side effects is that it suppresses people’s appetite, Dr. Ali says.

Ozempic contributes to weight loss in two ways, Dr. Ali explains: It makes patients feel less hungry, and it also slows stomach emptying so they feel fuller, longer. Ozempic notes on its website that the drug can help you lose weight, noting that patients in clinical trials have lost up to 14 pounds with the drug.

The FDA has approved a semaglutide drug called Wegovy for weight loss, which is why Ozempic is often used off-label for this indication as well, says Dr. Ali.

So why am I not losing weight with Ozempic?

A lot has to do with lifestyle changes, says Christina Inteso, Pharm.D., clinical pharmacy specialist at Corewell Health. All of the FDA-approved weight-loss drugs, including semaglutide, are approved as an adjunct to a calorie-restricted diet and increased physical activity, she says. These drugs have been studied with lifestyle changes, more the drug.

If someone taking Ozempic doesn’t make lifestyle changes, such as eating a healthy, nutrient-rich diet and exercising regularly, they may not see the same weight loss shown in clinical trials, Inteso says.

I’ve seen this happen, more commonly than I’d like, where people think they can just take the drug, without making any changes to their eating or physical activity habits, and still lose 10 percent of their body weight, says Inteso. Although these drugs are effective, there is still no magic weight loss pill that allows it.

Dr. Ali echoes this sentiment. The common reason I see in patients not expecting weight loss [on Ozempic] is that they aren’t actually changing their diet.

While experts agree that a lack of lifestyle changes is the main reason someone might not see weight loss results with Ozempic, Dr. Ali says there could be a problem with the dosage.

Depending on how these drugs work, we start on a lower dose and work our way up over a period of months, she says. Some patients see results immediately; others must take a higher dose to see results. Dr. Ali says it can take several months to arrive at the right dose for any given patient.

There may be other factors at play as well, says Inteso. Sometimes people may not see any effects from the weight-loss drug, and that could also be because it’s not the right weight-loss drug for them, she says. For example, if someone struggles with food cravings, but is given a drug that makes them feel full, the cravings for food will still be present, and the individual may have difficulty fighting that craving even though they feel full.

How to lose weight with Ozempic

If you’re taking Ozempic or another semaglutide drug, Dr. Ali says it’s important to have a conversation with your doctor about what type of diet and exercise program is recommended for you, and to follow that guidance.

But if you feel you’re doing everything right, it’s a good idea to have another conversation to check in and see what might be going on. If someone is taking the maximum dose and still not seeing results, we need to reevaluate the situation, says Dr. Ali. We encourage them to keep a food diary and watch the types of calories they are getting. Talking to a dietitian or nutritionist about switching to a healthier diet is also usually recommended.

If you suffer from obesity and aren’t seeing the weight-loss results you want with Ozempic, Inteso says it could simply be that this isn’t the right drug for you. We know obesity is caused by a variety of factors, and things like your individual genetic makeup could be preventing you from losing weight, she says.

Basically, it’s important to talk to and continue seeing your doctor to help you achieve your goals.

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