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Commercials are everywhere. So are social media testimonials and celebrity rumors: Every moderately famous person who loses a few pounds is said to be doing so. In just a few years, Ozempic (semaglutide) has become shorthand for major weight loss.
This injectable medication, the best-known drug in a category that includes Wegovy and Rybelsus (both semaglutides), and Mounjaro and Zepbound (tirzepatides), has been a game-changer in weight management.
If you are looking for help in that area, you have no doubt asked yourself: How much weight can you lose with Ozempic?
Semaglutides and tirzepatides belong to a family of drugs known as incretin mimetics that, among other things, make you feel full faster and longer after eating. They work by activating receptors for an intestinal hormone called GLP-1 (glucagon-like peptide) that helps regulate blood sugar levels and digestion.
“The medications stimulate pancreatic islet cells, where insulin is produced, slowing stomach emptying,” explains Spencer Kroll M.D., Ph.D., FNLA, board-certified internal medicine physician and author of The ozempica diet. “Medicines also inhibit food cravings and intake.”
And he adds: “In patients with type 2 diabetes, there is an altered insulin response to GLP-1.” These medications address this insufficiency and help restore proper pancreatic function.
Due to their action in the body, these medications can:
Semaglutide and tirzepatide were originally developed as diabetes drugs. For now, Wegovy (semaglutide) and Zepbound (tirzepatide) are the only ones approved by the FDA specifically for weight loss.
The other medications are prescribed “off label,” or not as directed, for weight loss.
In addition to stimulating pancreatic GLP-1 receptors like semaglutide, tirzepatides such as Mounjaro and Zepbound have an additional mechanism of action: they also stimulate GIP (glucose-dependent insulinotropic polypeptide) receptors. Both types of incretin receptors are involved in blood sugar control and are found naturally in the intestine.
But it is important to remember that these medications have inherent limitations.
“The average weight loss with these medications is approximately 15 percent of total body weight”says Kroll. “That compares best to all other known weight loss strategies, where the average weight loss is typically 5 to 10 percent of total body weight.”
Here is a scale of average weight loss with semaglutides based on starting weight:
But there is no guarantee. Pharmaceutical-assisted weight loss doesn’t have a great track record for sustainability. And again, this latter class of weight loss medications has not been extensively tested in non-diabetics, so it is unclear whether the weight loss is consistent or long-lasting, particularly once the medications are stopped.
Additionally, for optimal results, weight loss medications are usually prescribed in conjunction with a healthy diet and resistance training, which are proven methods for losing weight on their own.
Because side effects are potentially serious and are experienced somewhat at a relatively high rate (see below), taking these medications indefinitely is not only expensive but possibly dangerous. Additionally, taking a GLP-1 agonist like Ozempic does not address many of the root causes of weight gain, including inactivity and the use of addictive and nutrient-poor substances. ultra-processed food and sugar.
The new class of weight-loss drugs has a number of worrying consequences ranging from common side effects to unknowns about their long-term use. Anyone considering them should discuss the potential risks with a doctor before using them.
“The most common concern about these medications and their side effects is related to their action on the gastrointestinal tract,” says Kroll. “By stimulating the pancreas, medications can sometimes cause pancreatic inflammation or pancreatitis.
“Other common, but less concerning, side effects are changes in bowel habits, manifesting as diarrhea or constipation,” says Kroll. “There may also be a feeling of nausea, especially when medications are started or the dose is adjusted.” These effects occur even in 50% of users.
Up to 45% of weight lost As a result, these medications can be derived from lean mass (muscle), which can have negative effects on metabolic health (e.g., slower metabolism) and physical strength.
To protect muscle mass, users must perform resistance training and consume adequate amounts of calories, protein, and micronutrients while using the medication, which may be difficult to achieve with suppressed appetite.
Some users of semaglutide and similar medications have reported “Ozempic face” and “Ozempic butt”: sagging skin as a result of rapid weight loss.
If you’re looking for proven, sustainable weight loss that won’t break the bank, science has repeatedly found that you can expect it from a well designed diet and exercise plan.
“The most effective way to lose weight sustainably is through lifestyle changes. That means a change in diet and increased physical activity,” says Kroll. “GLP-1 medications may not cause sustained weight loss any more than any other type of diet, medication, or supplement.”
He warns: “Those patients who have discontinued GLP-1 agents have seen weight regain. “The key to sustained weight loss is lifestyle modification, sometimes in combination with these newer, very effective medications.”
The fact is that pharmacology still has to improve pillars of weight maintenance.
“Sustainable weight loss is usually achieved by creating a calorie deficitwhich can be achieved by consuming fewer calories than you burn,” says Gloria Cobre, MDregenerative medicine doctor in Temecula, California.
Some good strategies include:
Another key factor, says Tumbaga, is support. When working to lose weight and seeking guidance from a health professional, dietaryeither support groups can help maintain motivation and accountability.
It’s the type of support you can find at BODi, with workouts for each type of fitness levelover 1000 delicious whole foods recipes to help you eat healthy without feeling deprived, and mindsetmotivational classes and communities that will help keep your mind strong and support you in your weight loss journey.