Why Doesn't Ozempic Work For Me - T-Tees - Your Answers Await, Life's Questions Unraveled

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Ozempic, a medication that’s designed to help manage insulin levels, became a household name after several people on social media spoke out about using it for weight loss. While Ozempic is currently only approved by the Food and Drug Administration for insulin management, a known side effect is weight loss—and it’s often prescribed just for that.

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If you’re on Ozempic, whether to manage your insulin levels or for weight loss, and aren’t seeing the results you want, it’s understandable to wonder, “Why am I not losing weight on Ozempic?” Especially given just how much chatter has been around the medication’s impact on weight loss.

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So, what might interfere with potential weight loss from Ozempic? Doctors break it down.

What is Ozempic, and how does it work?

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

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

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Ozempic contributes to weight loss two ways, Dr. Ali explains: It makes patients feel less hungry and also slows the emptying of their stomach to make them feel fuller, longer. Ozempic notes on its website that the medication “may help you lose some weight,” noting that patients in clinical trials lost up to 14 lbs on the drug.

The FDA has approved a semaglutide medication called Wegovy for weight loss, and that’s why Ozempic is often used off-label for this indication, too, Dr. Ali says.

So, why am I not losing weight on Ozempic?

A lot has to do with lifestyle changes, says Christina Inteso, Pharm.D., a clinical pharmacy specialist at Corewell Health. “All of the FDA-approved weight loss medications, including semaglutide, are approved as an add-on to a reduced calorie diet and increased physical activity,” she says. “These medications were studied with lifestyle changes, plus the medication.”

If someone on Ozempic doesn’t make lifestyle changes, like eating a healthy, nutrient-dense diet and exercising regularly, they might not see as much weight loss as was shown in clinical trials, Inteso says.

“I have seen this happen, more commonly than I’d like, where people think they can just take the medication, not make changes to their eating or physical activity habits, and still lose 10% of their body weight,” Inteso says. “While these medications are effective, there still is no magic weight loss pill that will allow for that quite yet.”

Dr. Ali echoes that sentiment. “The common reason I see in patients who are not having expected weight loss [on Ozempic] is that they’re really not changing their diet.”

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While experts agree that a lack of lifestyle changes is the main reason someone may not see weight loss results on Ozempic, Dr. Ali says there could be an issue with dosing.

“The way these medications work, we start with a lower dose and increase the dose over a period of months,” he says. “Some patients see results right away; others need to be at a higher dose to see results.” Dr. Ali says it can take several months to get to the right dose for any given patient.

There can also be other factors at play, Inteso says. “Sometimes people might not see an effect from the weight loss medication and that could also be that it’s not the right weight loss medication for them,” she says. “For example, if someone struggles with food cravings, but they are given a medication that makes them feel full, the food cravings will still be there and the individual may struggle to combat those cravings even if they do feel full.”

How to lose weight on Ozempic

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

But if you feel like you’re doing everything right, it’s a good idea to have another conversation to check in and see what could be going on. “If someone is on a maximum dose and is still not seeing results, we have to reevaluate things,” Dr. Ali says. “We encourage them to keep a food log and look at the types of calories they’re getting. Speaking to a dietitian or nutritionist to switch to a healthier diet is also usually recommended.”

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

Basically, it’s important to talk to your doctor—and keep checking in with them—to help you reach your goals.

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