In recent years, Ozempic and its sibling drug, Wegovy, have become household names, hailed as miracle solutions for weight loss, diabetes management, and even a range of other health conditions. But beneath the glowing headlines and TikTok buzz lies a far more complicated story—one that includes risks, potential side effects, and long-term health considerations. Let’s take a closer look at what these drugs offer, what they don’t, and how to approach them with eyes wide open.

What is Ozempic, and How Does it Work?

Ozempic is a brand name for semaglutide, a glucagon-like peptide-1 receptor agonist (GLP1-RA) originally developed to help manage blood sugar levels in type-2 diabetics. Its mechanism mimics a hormone your intestine produces after eating, which promotes satiety, slows digestion, and stabilizes blood sugar levels. However, semaglutide has a much longer half-life than the natural hormone, keeping hunger at bay for an extended period.

This satiety-on-cruise-control effect has led to its approval under the brand name Wegovy for obesity treatment. The drug’s ability to promote significant weight loss has made it popular far beyond its original target audience of diabetics. But is it as good as it seems?

The Ozempic Dropout Dilemma

One of the most startling facts about Ozempic and Wegovy is their high dropout rates. A recent study revealed that more than 50% of users discontinue treatment within the first year, with that figure rising to 72% by the second year. Among non-diabetics, these numbers are even higher, with two-thirds dropping out in the first year and four out of five by the second.

Why do so many people quit?

• Side Effects: Common issues include nausea, gastrointestinal discomfort, and, in some cases, more severe problems like pancreatitis or kidney inflammation.
• Costs: At thousands of dollars per year, affordability is a significant barrier.
• Lower-than-expected weight loss: For some users, the results don’t justify the effort, cost, and discomfort. Plus these drugs become less effective over time.

The Frankenstein Version of Yo-Yo Dieting

One of the most overlooked consequences of discontinuing Ozempic is the weight cycling that often follows. Research shows that most people regain the weight they lost once they stop taking the drug. Even worse, this cycling isn’t just about regaining fat—it often comes with a loss of muscle mass and bone (lean body mass) that doesn’t recover as easily.

This phenomenon contributes to a worsening body composition, with reduced muscle mass leading to increased risks of sarcopenia and frailty as individuals age. Over time, repeated weight cycling can escalate metabolic risks and diminish overall health.

What Are the True Benefits?

The promise of semaglutide extends beyond weight loss. Studies have shown that it can reduce risks for several health conditions, including:

• Heart disease and stroke
• Alzheimer’s disease and dementia
• Liver diseases and inflammatory bowel disease

However, it’s worth noting that the absolute risk reductions for these conditions are often modest. For instance, a study on semaglutide’s cardiovascular benefits showed a relative risk reduction of 19% for heart attack, stroke, or cardiovascular death. In absolute terms, this translated to a reduction from 8% to 6.5% over several years. Losing weight without drugs will also result in these improvements. 

Questions to Consider Before Starting Ozempic or Wegovy

Before jumping on the semaglutide bandwagon, ask yourself the following:

1. Am I diabetic or obese?
• GLP1-RAs were initially designed for diabetics. For “obese-only” individuals, the benefits may be less pronounced.
2. Have I tried other options?
• Lifestyle changes like diet and exercise are still the gold standard for weight management.
3. What’s my plan to preserve muscle mass?
• Strength training is essential to counteract muscle loss during weight loss. Starting a routine before treatment is highly recommended.
4. Am I prepared for ongoing monitoring?
• DEXA or BIA body composition scans provide accurate body composition data and are more reliable than at-home scales for tracking changes.
5. Can I afford long-term treatment?
• Semaglutide’s cost can add up quickly. Ensure you have a sustainable financial plan.
6. Will I commit to long-term use?
• Weight regain is almost guaranteed upon discontinuation, so a long-term commitment is key.
7. What’s my backup plan?
• Consider alternative strategies in case of intolerable side effects or insufficient results.
8. Have I consulted my doctor?
• A thorough discussion with a healthcare provider is crucial to evaluate risks, benefits, and suitability.

The Bottom Line

Ozempic and Wegovy can be valuable tools for weight loss for some, but they are far from a magic bullet. High dropout rates, weight cycling, and muscle mass loss highlight the need for a cautious and informed approach. Rather than allowing yourself to be seduced by a seemingly effective solution, I urge you to consider your long-term health and weight management plan. A sustainable lifestyle—including diet, exercise, and regular monitoring—remains the cornerstone of long-term health. We see significant results and permanent changes in our AstonRX members each and every day, and the cost (financial and risk factors) is far less.