What’s the buzz on Ozempic and Wegovy?

Published: July 10, 2023
Melody Berg
By Melody Berg, PharmD, MPH, BCPS

What are Ozempic and Wegovy?
Ozempic and Wegovy are two names for the same medication-- semaglutide. However, they are approved for different conditions.

Ozempic is prescribed for people to treat Type 2 diabetes and prevent major cardiovascular events like heart attack or stroke.

Wegovy is prescribed at a different dose to treat people who are classified as obese or overweight.

Although Ozempic and Wegovy both contain semaglutide, they have different approved uses, dosages, and differ in how they are covered by insurance.

How does semaglutide help with weight management?
Semaglutide works by increasing insulin available, helping your body use sugar better, and it also works by making you feel full faster so you don’t eat as much. When you don’t eat as much, you lose weight and blood sugar levels go down. For those with Type 2 diabetes, this means improved insulin levels in addition to a lower risk for cardiovascular disease. For those who are obese or overweight, weight loss translates to numerous health benefits.

Who should use semaglutide for weight loss?
Although semaglutide has been successful for weight loss, it is not intended to be used in place of diet and exercise. Semaglutide is for people who are obese, meaning they have a body mass index (BMI) of 30 kg/m2 or more OR overweight, which means they have a BMI of 27 kg/m2 or more, with at least one weight-related condition like high blood pressure, type 2 diabetes, or high cholesterol.

It is also approved for kids 12 years of age and older who are diagnosed as obese by their provider and to be used in addition to diet and exercise. BMI is calculated by taking your weight (in kg) divided by your height (in m2). The Centers for Disease Control (CDC) has a calculator to determine your BMI that can be found here: BMI Calculator.

How well does semaglutide work for weight loss?
Semaglutide is very effective at helping with weight loss, especially when coupled with diet and exercise. Results from early clinical studies show an average 10-16% decrease in body weight at 68 weeks of treatment, depending on whether diabetes is present and it is coupled with a strict diet and exercise program. Additionally, results show that use of semaglutide in patients without diabetes is associated with at least a 5% weight reduction in at least 85% of patients through week 68 of treatment. Results were not as drastic in overweight or obese patients with Type 2 diabetes.

Is semaglutide safe?
Although semaglutide is typically well-tolerated, no drug is free of side effects. Common side effects that patients experience include upset stomach or stomach pain, loose stools or difficulty having a bowel movement, headache, fatigue, dizziness, feeling bloated or gassy, and heartburn. On the more serious side, semaglutide has been associated with a possible risk of thyroid tumors, including cancerous ones. Semaglutide has also been associated with pancreatitis (inflammation of the pancreas) as well as gallbladder problems, including the development of gallstones. Semaglutide may also increase your heart rate and has been associated with depression or thoughts of suicide. In patients with type 2 diabetes who receive semaglutide, the drug can cause vision changes and increase the risk of low blood sugar episodes, particularly when given with other antidiabetic medications.

Another major safety concern is the use of “off-branded” semaglutide products. Because of its weight loss efficacy, demand for semaglutide has exceeded supply and some patients are obtaining compounded or non-FDA approved formulations of semaglutide without a prescription. The FDA has warned that these products are unregulated and may not contain the appropriate effective semaglutide component: FDA warning on compounded semaglutide.

How long will I need to take semaglutide? Will the weight return if I stop?
The ideal duration of semaglutide therapy for weight loss is unknown. Semaglutide is safe to continue for however long is deemed appropriate by your doctor. Some data show that stopping semaglutide results in rebound weight gain, indicating that semaglutide for weight loss may be needed long-term. You should talk to your doctor about how long you need to be on semaglutide.

Summary
Semaglutide (Ozempic) is a drug initially approved for the management of patients with Type 2 diabetes. Semaglutide (Wegovy) is also approved, for weight loss in combination with diet and exercise, in patients who meet specific criteria. With increasing semaglutide demand due to its weight loss efficacy, supply shortages have occurred. Due to this shortage, some patients have turned towards unregulated and unprescribed products that may increase patient harm. Talk to your doctor or pharmacist about semaglutide if you have questions regarding its use for diabetes and/or weight management as well as the risks and benefits of therapy.

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