by Sarah Graves, PhD
Medically Reviewed by:
Philip Ngo, PharmD
by Sarah Graves, PhD
Medically Reviewed by:
Philip Ngo, PharmD
Though you may have heard medications like Ozempic being touted as “miracle drugs” for weight loss, it’s important to consider several factors before deciding to try these popular drugs.
A couple of years ago, my primary care doctor prescribed me a type 2 diabetes medication that caused such horrible side effects that I could barely eat. And any food I did manage to consume, I typically vomited back up, barely digested, many hours later.
For about 6 months, I was so constantly nauseated that I struggled to get out of bed. I missed a lot of work, and my stomach was too upset to eat anything that could remotely be described as “healthy.” Meanwhile, I was too weak from a lack of nutrition to complete simple tasks like lifting my arms over my head to wash my hair.
The last straw came when I confused an intense bout of indigestion with a possible heart attack and ended up in the emergency room. Fortunately, my heart was fine. But I immediately called my doctor, and we stopped the medication that day.
The drug in question? Ozempic (semaglutide), which is also marketed as the weight loss drug Wegovy.
Ozempic and Wegovy, which are the same medication at different doses, are having a moment. Because they’ve been touted by the press and their manufacturer as “miracle drugs,” weight-obsessed celebrities are rushing to stock up.
Given this, it’s understandably tempting to want to try them. But there are plenty of reasons to consider carefully whether a trending medication is the right choice for you.
For me, Ozempic induced gastroparesis, a condition in which your stomach takes too long to empty, resulting in consistent nausea and vomiting.
My side effects might have been more extreme than those of the typical Ozempic user. Still, nausea and upset stomach are the drug’s most commonly reported side effects, as observed in the research trials and disclosed on the Ozempic website. Other common side effects include stomach pain, constipation, diarrhea, and vomiting. Side effects seem to occur most often when a person increases their dose.
For some, the side effects disappear after the first few weeks of use. But for others, like me, they may never go away or may worsen, severely affecting quality of life.
Because there are so many options on the market for managing blood sugar, there’s no reason to deal with uncomfortable side effects.
That’s particularly the case since there’s no cure for type 2 diabetes, and it’s a chronic, progressive condition. Though certain lifestyle changes can help some people put type 2 diabetes into remission, those changes don’t work for everyone, and remission isn’t the same as a cure.
The uncomfortable truth is that if you have type 2 diabetes, you’ll likely take medication for the rest of your life. So it’s worth it to keep searching for one that works for you and doesn’t make you miserable.
As mentioned, the side effects may be different for you than they were for me. Everyone’s body is different.
For example, my father briefly took Ozempic, and his stomach was consistently upset enough that he told his doctor to put him on another medication. But even though he was uncomfortable, his experience wasn’t as severe as mine.
Perhaps even more important, not all diabetes medications affect everyone’s blood sugars the same way.
Ozempic didn’t merely give me intense side effects — it also didn’t work for me. I typically experienced blood sugars in the 200s while on Ozempic, even though I barely ate.
My and my doctor’s best guess is that my body doesn’t respond well to fasting. My liver releases large stores of glucose in response to going long periods without food, and because my body doesn’t produce enough insulin to compensate for those spikes, my blood sugars shoot up.
So, ironically, my blood sugars are lower when I eat consistently than when I don’t. This is the case even though I’ve been taking metformin, which is supposed to prevent this, for more than a decade, and even though Ozempic itself is supposed to stop it.
It’s important to consider that while Ozempic may lower the A1C of many individuals with type 2 diabetes, it doesn’t work for everyone. Even without the horrible side effects I experienced, I needed a different medication to lower my A1C.
The primary reason drugs such as Ozempic have become so popular is their purported weight loss benefits, which have led many people, including celebrities without diabetes, to flock to these drugs. Ozempic isn’t even indicated for weight loss, so those who use it for that purpose are using it off-label.
But weight loss is complex. The prevailing myth of diet culture says it’s a simple matter of using more calories than you consume. But it’s never that simple.
Your body makes hormonal and metabolic adjustments to maintain your weight, and research shows that this adjustment persists years after the end of a diet.
Because medications like Ozempic and Wegovy destroy your appetite, the weight loss you may experience while using them is due to extreme calorie restriction. In other words, they’re a diet.
Although many dieters can lose weight in the short term, hence the success of Ozempic and Wegovy, a meta-analysis of 29 long-term weight loss studies concluded that virtually all weight loss attempts result in regaining at least 80% of the lost weight within 5 years.
In addition, no research has studied the effect of these medications over a period longer than 2 years. The Wegovy drug trials followed users for about a year and 4 months, so we don’t know whether the weight loss will stick.
Further, according to the Ozempic website, adults using the drug lost up to 14 pounds. And, on average, those taking Wegovy lost about 15% of their body weight, according to the STEP trials. But these could be insubstantial amounts, depending on a person’s starting weight.
For example, at my heaviest, I topped 300 pounds. That means a 15% weight loss would have been about 45 pounds for me. But that would still have left me about 86 pounds above a “normal” weight, according to the standard BMI chart.
In addition, before I got pregnant with my son, I took Victoza (liraglutide), a precursor to Ozempic. Though it upset my stomach, I didn’t have the same side effects that I later experienced with Ozempic. But it did radically decrease my appetite, and I lost 42 pounds.
I went back on Victoza after the birth of my son and experienced no weight loss. Later, I tried Ozempic, and though I couldn’t eat as much as I could on Victoza — and I threw up nearly everything I ate — I also experienced zero weight loss.
I have no idea why these drugs worked for me the first time and then never again. My best guess is that it has something to do with body weight involving a complexity of hormones or with weight loss resistance resulting from a lifetime of chronic dieting.
So, though the drug may affect you differently, it’s worth noting that it’s not necessarily a “weight loss miracle.”
Focusing on intentional weight loss to improve type 2 diabetes is ultimately more harmful than helpful.
Research suggests that yo-yo dieting — the cycle of losing weight, regaining it, and losing it again — increases the risk for cardiovascular events in women.
While it may seem like people should just avoid weight cycling, weight regain is often the inevitable result of weight loss attempts. Thus, weight cycling can occur if people focus on weight loss as the end goal.
But lifestyle factors can significantly improve type 2 diabetes regardless of weight loss.
According to research from 2021, a weight-neutral strategy — focusing on fitness and physical activity rather than weight loss — may better reduce the risk of cardiovascular events and death in people with obesity.
I can speak to this from experience. I’ve been diabetic for 16 years and, until recently, have been a lifelong chronic dieter. My mom put me on my first diet when I was in the first grade, and I’ve been dieting almost ever since. As a result, I’ve lost and regained 40–50 pounds many times over in my life, including after being diagnosed with type 2 diabetes.
That weight loss never resulted in an improvement in my A1C. But when I stopped focusing on weight loss and started focusing on health, I made significant improvements in my A1C.
The difference is all in the focus. Although healthy eating and exercise are often components of diet programs, diets center weight loss as the primary goal. But because dieting isn’t effective for weight loss, it usually means that dieters end up resorting to extreme measures such as cutting out whole food groups or fasting for days on end (both of which I’ve done).
On the other hand, when you focus on simply eating healthfully, which involves responding to your individual body’s needs instead of arbitrary external standards such as calorie counts, your A1C can improve significantly. This is because your goal is to see how certain foods affect your blood sugar, not to change the numbers on the scale.
Likewise, when you focus on how healthy movement affects your blood sugar, the goal is different than when you focus on your weight. And that means your behaviors will be different — more focused on health than weight.
Case in point: I stayed on Ozempic for as long as I did because it was supposed to help me lose weight. But after 6 months of misery, I realized not only that the weight loss would never happen but also that the side effects weren’t worth it.
Only when I let go of using Ozempic to lose weight was I able to practice a healthy lifestyle and improve my A1C. I’ve since found a medication that works for me, and I can now eat more healthy foods and exercise regularly. I’m still technically “obese,” but I’m healthier than ever.
Though most of us with type 2 diabetes must take medications to manage our condition, it’s worth remembering that, in many cases, pharmaceutical companies’ bottom line is profits, not patients.
And despite what celebrities and influencers are saying about Ozempic and Wegovy, it’s best to look at what the research says and compare the pros and cons of these medications.
Before jumping on a trend, pause and consider whether the drug is the right choice for you. Since all bodies respond differently, it may or may not work for you. But ultimately, only you and your medical team know what is most health-promoting for your body.
Medically reviewed on June 06, 2023
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About the author
Sarah Graves, PhD
Sarah Graves is a Columbus Ohio-based English professor, writing center director, and writer whose work has appeared all over the web. She’s written on such diverse topics as education, parenting, personal finance, and health and wellness. She’s most passionate about providing resources for creatives, especially young creators. You can find out more on her website or follow her on Instagram @SarahGravesPhD.