Ozempic® for weight loss claims are everywhere—the drug that became popular as a celebrity trend and crossed into the mainstream. The big question I get is, does ozempic work for weight loss or is it just another trend? This is especially true for women with PCOS, hypothyroidism, or those going through perimenopause.
Ozempic or Semaglutide is used to treat type 2 diabetes and facilitate weight loss, which makes it an increasingly popular choice for polycystic ovary syndrome (PCOS). PCOS is an endocrine (hormone) condition where blood sugar dysregulation worsens the hormonal imbalances that cause symptoms like weight gain, acne, irregular periods, and unwanted hair growth.
PCOS requires a holistic lens, and I've helped so many women feel better with a natural approach that includes nutrition, lifestyle changes, and supplementation. But it's also true that everyone may respond differently depending on the root cause of their condition, and sometimes medication can be a helpful part of treatment.
You'll hear those that swear it changed their life and others who shun it as another unnecessary medication promoting diet culture. My perspective is somewhere in between: for some people, it can be a valuable tool, but the foundational aspects of wellness still matter as much (if not more).
Here's what I want you to know about Ozempic, including potential benefits and side effects you should watch out for, so you can make an informed decision about this drug and your health. In this article I’ll also discuss PCOS and other conditions in which women are reporting Ozempic to be helpful for.
What is Ozempic?
Ozempic is the brand name version of semaglutide, which is also the active ingredient in Wegovy®. It was first approved in 2017 by the FDA to treat type 2 diabetes in adults and reduce the risk of cardiovascular-related issues, and it's also used off-label for weight loss. Wegovy became approved for weight loss in 2021.
In the United States, these are prescription drugs that you will need to meet with a licensed healthcare provider to have them prescribe.
Semaglutide is a glucagon-like peptide-1 (GLP-1) agonist, which means it initiates or turns on the production of a hormone called gastrointestinal peptide GLP-1 (I'll detail how this works below).
To qualify for weight loss drug therapies like Ozempic, a doctor may look for criteria such as a body mass index (BMI) ≥30 kg/m or BMI of 27 to 29.9 kg/m with weight-related comorbidities, even if someone doesn't have type 2 diabetes.
In order to have Ozempic covered by insurance, the FDA criteria must be met. This includes having type 2 diabetes or being overweight and having weight related issues, like high blood pressure or high cholesterol.
Otherwise, the cost of Ozempic is about $892 for a month's supply and Wegovy is over $1,300.
Controls Blood Glucose Levels in Adults with Type 2 Diabetes
Studies on Semaglutide show it helps with weight loss and controls blood glucose levels in adults with type 2 diabetes.
A semaglutide injection administered once a week at home with increasing dosages has been shown to support weight loss, blood sugar, and blood lipid (cholesterol and triglycerides) improvements.
A study conducted on non-diabetic adults with a BMI over 30 found that individuals in the semaglutide group achieved an average weight loss of nearly 15% of their body weight, equivalent to approximately 34 pounds. In comparison, the placebo group experienced a weight loss of only 2.4%, or around 6 pounds, after 68 weeks. It is important to note that both groups received lifestyle interventions alongside the treatment.
In fact, many clinicians have found that Ozempic works best when combined with lifestyle interventions. That means if you’ve been employing lifestyle strategies then you may find better results if you start Ozempic. And if you haven’t, but have already started the drug, this is your sign to focus on lifestyle and nutrition (more on that soon).
This study also found that people who took semaglutide saw improvements in markers for cardiometabolic risk factors. However, it's important to mention that these participants also reported experiencing more side effects like nausea and diarrhea, which we'll discuss in more detail later.
How Does Ozempic Work?
Ozempic and Wegovy are designed to be injected once per week. As GLP-1 agonists, they target areas of the brain that help regulate appetite and food intake while also helping to lower blood sugar and slow gastric emptying.
Let's look at how this works in a bit more detail.
Ozempic Induces Satiety and Stimulates Insulin Production
GLP-1 is produced in the body and is released in response to food consumption, stimulating the pancreas to secrete insulin. GLP-1 agonists like Ozempic bind to GLP-1 receptors, effectively triggering the pancreas to release additional insulin. Ozempic also helps with fullness or satiety by decreasing how quickly food leaves the stomach and targets brain receptors that affect hunger and appetite.
Insulin is the hormone that helps move sugar out of the blood (called glucose) and into your cells for storage and energy. Insulin resistance means the cells don't open up to receive glucose as they usually would, so the pancreas keeps pumping out more insulin and blood sugar can remain high.
Over time, insulin resistance can become type 2 diabetes, as the body produces even more insulin to lower blood sugar. Insulin resistance can also lead to health complications like:
- Weight gain
- Heart problems
- Fertility issues
- Metabolic syndrome
Ozempic helps stabilize blood sugar for people with blood sugar dysregulation by stimulating the pancreas to release more insulin to help with insulin sensitivity.
Can You Take Ozempic for PCOS Weight Loss?
As many as 70% (perhaps more) people with PCOS have a degree of insulin resistance regardless of weight status. This is in part why PCOS weight loss can be so challenging. In cases of insulin resistance, your doctor may prescribe Ozempic for PCOS weight loss.
Higher insulin levels and blood sugar can add to the hormone imbalances seen in PCOS as insulin stimulates the production of androgens, which cause PCOS symptoms like hirsutism, oily skin, hair loss, and acne.
PCOS also increases the risk of metabolic and cardiovascular health concerns, possibly due to insulin resistance, so addressing it on multiple fronts is critical.
Ozempic Fertility Considerations
Both insulin resistance and weight also contribute to infertility. However, GLP-1 agonists are not recommended for those trying to conceive. In fact, it is recommended that you take an effective contraceptive to prevent pregnancy if you use these drugs.
Studies suggest that in some cases, extra adipose (fat) tissue can make it harder to become pregnant because it can interfere with hormone balance and add to inflammation. Because GLP-1 agonists may help by supporting weight reductions that decrease fat tissue while lowering blood sugar levels, many people are requesting this treatment.
At this time, it is recommended that you do not try to conceive while on this drug and wait more than 2 months from discontinuing before trying to become pregnant.
Additionally, it is unknown if GLP-1 enters the breast milk in significant amounts. Discuss with your doctor other options if you are currently breastfeeding.
Does Ozempic Help PCOS?
Since Ozempic addresses blood sugar, weight, and lipids — three significant risks of PCOS, it could be a tool for treatment. While not explicitly approved for PCOS, Ozempic for weight loss and improved insulin sensitivity is sometimes used off-label to treat PCOS.
Research suggests that lifestyle is still essential for PCOS, but GLP-1 agonists can support weight and glucose metabolism challenges to reduce inflammation and oxidative stress in the body.
A systematic review found that GLP-1 agonists like Ozempic could be beneficial for PCOS as they not only address weight and blood sugar but also may lower androgens and improve fertility and ovulation for women with PCOS.
Does that mean everyone with PCOS should automatically use Ozempic? No, I've worked with many women who've done well without it. Still, Ozempic has its place and can be helpful in situations where diet and lifestyle changes alone aren’t enough to get blood sugar under control and reduce the risk of long-term health problems.
The bottom line: Ozempic is one tool to address PCOS symptoms, but it doesn’t negate the need for nutrition and lifestyle interventions.
Pros and Cons of Ozempic
So far, I've presented research benefits, but there's more to consider when deciding to use Ozempic. True informed consent means understanding the potential risks and side effects along with the potential benefits.
Pros of Ozempic
The studies above are the main benefits or pros of Ozempic, but there are also a few other reasons people may choose to use Ozempic, including:
- Weekly Injection: Some other injectables require daily injections, while Ozempic is administered once a week.
- Non-Stimulant: Ozempic is not a stimulant like some other popular weight loss medications, so it doesn't cause the same risks for addiction or heart problems.
Ozempic Side Effects
The following are some of the potential risks or side effects. Some, like the digestive symptoms, are more common than others and may only be short-term as the body adjusts:
- Thyroid cancer risk factor: The risk of thyroid cancer was seen in an animal study and not necessarily in people, but nonetheless, it is a risk you should be made aware of. In fact, some doctors won’t prescribe Ozempic if you have a history of thyroid cancer.
- Nausea and vomiting: Nausea and vomiting are frequently reported as side effects of Ozempic, making it challenging to consume adequate nutrition.
- Constipation: Another common side effect is constipation, likely due to slower gastric emptying. This is part of how it keeps you feeling full and reduces appetite, but it can also create an uncomfortable side effect.
- Lack of long-term studies: Ozempic for weight loss was approved in 2017, so we don't have a lot of long-term use data yet.
- Risk of weight regain: Weight regain is common once you stop taking Ozempic, so talk to your doctor about a plan for maintaining the benefit once you stop the medication. The patients I’ve seen do best are those that have a solid foundation of lifestyle practices.
- Potential Muscle Loss: In a perfect world, if you lost weight, you'd only lose fat and not muscle mass, but that's not always the case. With Ozempic, muscle loss is common, especially when someone eats less and takes in much less protein. This side effect can be overcome in most people eating adequate amounts of protein and strength training regularly.
- Gallbladder, kidney, or pancreas inflammation: This is a rare complication but does happen and can be very serious.
Can You Take Ozempic While Pregnant?
There is no recommendation on the safety of these medications during pregnancy due to lack of evidence. If you’re pregnant or planning to become pregnant, talk to your doctor about any medications you are taking
Lifestyle Habits to Pair with Ozempic
As discussed previously, lifestyle and nutritional therapies can help with side effects and the research shows, enables people using Ozempic to have the greatest benefit. Yes, weight and metabolic shifts with Ozempic are impressive, but long-term change requires lifestyle shifts. Many of these studies suggest that eating, movement, and behavior change must be a part of the equation with weight loss medications, or they aren't effective.
If you and your doctor decide Ozempic is a good plan, here are some lifestyle habits to pair with it for long-term success.
Nutrition
Eating a nourishing diet is essential for hormone balance to support PCOS. Still, it sometimes becomes challenging for people taking Ozempic because their appetite is so low or they are dealing with digestive side effects.
Here’s a free hormone balancing recipe guide to help.
Anyone taking Ozempic should prioritize the following:
- Protein: Protein needs must be considered to combat that loss of muscle mass I described above. Protein helps build lean muscle fibers, so eating enough protein (usually 1.0 to 1.2 grams for each kilogram of body weight) from meat, fish, poultry, beans, soy, and dairy can help make sure you get enough.
- Vitamins, minerals, and antioxidants: Eating a diverse array of fruits and vegetables, especially those rich in vitamins A, C, D, E, and K, as well as minerals like magnesium and zinc, are critical for PCOS and blood sugar balance. An easily absorbable multivitamin can also help you meet your needs.
- Healthy fats: Sometimes, high-fat foods can exacerbate digestive symptoms, but healthy fats from fish, nuts, and seeds help combat inflammation, balance hormones, and keep your metabolism running.
- High-fiber carbs: Grains, legumes, fruits, and veggies are all fiber-containing carbs that support blood sugar and a healthy gut.
If nutrition feels challenging, I’ve got you. Get started with my free Hormone Balancing Starter Kit, which includes a free meal plan with recipes to rebalance and optimize your hormones.
Exercise
Exercise is also essential for anyone struggling with hormone related symptoms, weight gain, and PCOS, —with or without Ozempic. It helps with lean body mass, mood, and cardiovascular fitness. Exercise also makes cells more insulin sensitive, making it easier for insulin to move glucose into the cells.
A combination of resistance training with cardio helps balance hormones, increases fatigue-fighting endorphins, boosts energy levels, and reduces stress.
Supplements to Consider
There are several supplements that can be used in conjunction with Ozempic or on their own, along with the above mentioned nutrition and lifestyle therapies. As always, discuss with your doctor, especially if you are taking any medications currently.
Myoinositol
Myoinositol has been shown in several studies to aid in weight loss. This is in part because it improves thyroid function and insulin sensitivity. In fact, in one study on postmenopausal women with metabolic syndrome, it was shown to decrease insulin resistance by about 70%. This is significant since this is a group that would typically be prescribed Ozempic.
Myoinositol has been shown to provide benefits like improving sleep, which is an essential part of weight loss.
I recommend a variety of supplements for PCOS depending on the individual, but inositol is one that has a lot of research to back it and minimal side effects.
Inositol benefits for PCOS include improved insulin sensitivity, fertility and pregnancy outcomes, metabolic health, and inflammation.
There are two primary types of inositol you'll hear about in PCOS research:
- Myo-inositol (MI)
- D-chiro-inositol (DCI)
Myoinositol Plus by Dr. Brighten contains a blend of MI and DCI in a 40:1 ratio. This unique combination may help support ovarian function, improve egg quality, and promote a regular menstrual cycle. Myoinositol Plus also contains blood sugar and PCOS-supportive nutrients like Vitamin D, chromium, and zinc for a comprehensive PCOS formula.
Vitamin D
Vitamin D deficiency is well understood to be associated with obesity. Studies have shown that supplementing with vitamin D, in addition to nutritional therapies, can help with weight loss in people who would be candidates for Ozempic.
The relationship between vitamin D and calcium has also been shown to be beneficial in weight loss. It is recommended that vitamin D be coupled with K2 in order to support calcium absorption and bone health.
I’ve formulated our Vitamin D3/K2 to provide the necessary balance to improve vitamin D levels in the body.
Takeaway: Ozempic for Weight Loss
Ozempic can fit into a treatment plan for individuals facing challenges with weight loss, diabetes, high cholesterol due to weight, and PCOS. While it may not be a one-size-fits-all solution, its ability to improve insulin sensitivity and reduce inflammation makes it a potentially valuable part of a well-rounded treatment approach. By combining Ozempic with a comprehensive lifestyle and nutritional plan, women may see significant improvements in weight loss and PCOS symptoms.
Any treatment should always be done under the guidance of a healthcare professional who considers your unique needs.
References
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- Ingelfinger JR, Rosen CJ. STEP 1 for Effective Weight Control - Another First Step?. N Engl J Med. 2021. 384(11). 1066-1067.
- Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine. 2021. 384(11). 989-1002.
- Perreault M. Obesity in adults: Drug therapy. UpToDate. 2023.
- Bednarz K, Kowalczyk K, Cwynar M, et al. The Role of Glp-1 Receptor Agonists in Insulin Resistance with Concomitant Obesity Treatment in Polycystic Ovary Syndrome. Int J Mol Sci. 2022. 23(8). 4334.
- Freeman AM, Pennings N. Insulin Resistance. StatPearls. 2023.
- Chen W, Pang Y. Metabolic Syndrome and PCOS: Pathogenesis and the Role of Metabolites. Metabolites. 2021. 11(12). 869.
- Abdalla MA, Deshmukh H, Atkin S, Sathyapalan T. The potential role of incretin-based therapies for polycystic ovary syndrome: a narrative review of the current evidence. Ther Adv Endocrinol Metab. 2021. 12:2042018821989238.
- Smits MM, Van Raalte DH. Safety of semaglutide. Frontiers. 2021.
- Wilding JPH, Batterham RL, Calanna S, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021. 384(11). 989-1002.
- Kalra B, Kalra S, Sharma JB. The inositols and polycystic ovary syndrome. Indian J Endocrinol Metab. 2016. 20(5). 720-724.
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