If drug names like Ozempic and Wegovy ring any bells for you, it may be because you’ve heard about their role in promoting weight loss. These drugs are part of a class of drugs known as glucagon-like peptide-1 receptor agonists or GLP-1 receptor agonists.
If you’re interested in learning a bit more about what they are, how they work, and what the research says about their use, you’ve come to the right place.
Before we talk more about what these drugs are, a quick reminder: it’s always best to discuss with your doctor what prescription medications may or may not be right for you.
Read on for a closer look at the science behind these drugs and the different opinions surrounding their increasingly popular role in weight loss.
What is GLP-1?
GLP-1, or glucagon-like peptide-1, is a peptide hormone made by the small intestine and helps reduce glucose levels by stimulating insulin and reducing glucagon secretion. This hormone slows stomach emptying and allows glucose from food to enter the bloodstream more slowly.
As a a result, people taking this drug may see lower blood sugar levels. GLP-1 may also affect hunger centers in the brain that impact appetite regulation and reduce hunger.
Types of GLP-1 Agonist Medications
Due to the way they interact with glucose and insulin function in the body, GLP-1 agonists are a class of prescription drugs often used in treatment of diabetes mellitus or type 2 diabetes. In addition to being antidiabetic medications, some may also be prescribed by doctors for the treatment and management of obesity.
There are currently seven drugs considered GLP-1 receptor agonists. These include:
- Dulaglutide (Trulicity)
- Exenatide extended release (Bydureon)
- Exenatide (Byetta)
- Semaglutide (Ozempic, Wegovy)
- Liraglutide (Victoza, Saxenda)
- Lixisenatide (Adlyxin)
- Semaglutide (Rybelsus)
If all of these drugs influence GLP-1 in similar ways, what makes each of them unique?
- There are small variations in chemical structure as well as different dosage and delivery methods that may play a part in how they are approved for use.
- Some are taken twice-daily, others extended-release (ER) taken once-weekly; others may be taken once-daily.
- Except for oral semaglutide, all the other drugs are subcutaneous injections.
How Do GLP-1 Agonists Work?
Though the different dosages and types may impact the body in a variety of ways, generally GLP-1 agonist medications have some of the following effects:
- Delay gastric emptying and slow the speed at which food leaves the stomach and glucose may enter the blood, thus reducing post-meal glucose levels
- Suppress appetite
- Improve satiety
- Decrease inappropriate glucagon secretion
- Promote the proliferation of pancreatic beta cells, which produce insulin
GLP-1 receptor agonists may also have the ability to restore the body’s insulin-secretion function in the pancreas, which can contribute to improvements in glucose regulation and body weight reduction in those with diabetes.
Studies have also shown that these drugs interact with other parts of the body, potentially positively affecting cardiovascular health. Heart disease risk factors such as high blood pressure and high cholesterol may be favorably impacted.
What’s the Difference Between Ozempic and Wegovy?
The name “GLP-1 receptor agonist” may feel like a mouthful. This class of drugs, manufactured by Novo Nordisk and more commonly masquerading under the names Ozempic or Wegovy, influence a specific hormone in your body, called GLP-1.
What is Ozempic?
Ozempic (semaglutide) is an injectable drug that is FDA-approved for use in type 2 diabetes, but not for use in weight loss. If you’ve been prescribed Ozempic for weight loss and don’t have diabetes, this is considered off-label use.
What is Wegovy?
Wegovy is also a semaglutide injection, though typically a higher-dose version (compared to Ozempic) and approved by the FDA for use in weight loss. Even though semaglutide is the active drug in both cases, Wegovy is not approved to treat diabetes.
This is because Ozempic drug trials were focused on how this drug impacted blood sugar, while Wegovy drug trials were focused on how this drug impacted weight. However, due to recent shortages with Wegovy access, many people who are interested in using this drug for weight loss have turned to Ozempic.
Wegovy is available at a higher dosage than Ozempic, and it has been more common for people to report side effects with Wegovy in clinical trials.
Is Ozempic Good for Weight Loss?
Whether you’re looking to lose those few stubborn pounds and tone your body or tackle a bigger weight loss goal, there are many reasons you might be feeling stuck on your weight loss journey.
Obesity rates have almost tripled since 1975, which researchers say is due to a combination of factors, including:
- Increased access to energy-dense food coupled with reduced physical activity
- Sleep deprivation
- Circadian desynchronization
- Chronic stress
- A rise in the use of certain medications known to result in weight gain, including some anti-epileptic and psychotropic drugs
- Other genetic and environmental factors
As a result, prescription drug companies have sought their own way to target the treatment of obesity. When it comes to prescription drug interventions, however, many weight loss medications have led to their fair share of controversy over the years.
It’s not uncommon, for example, to see some weight loss drugs negatively impact blood pressure and hypertension or for weight gain to return after someone stops taking a certain weight loss drug.
While semaglutide, the active compound found in many of these drugs, is shown to be effective for short-term weight loss, Ozempic is not currently authorized for use as a weight loss aid. Wegovy, on the other hand, is approved by the FDA for use in weight loss.
During clinical trials, adults taking Wegovy lost nearly 15 percent of their starting body weight on average. In a separate trial, adolescents lost about 16 percent of their starting body weight on average.
According to weight loss research, it may take about five months to reach the target dosage. During this time, adults taking a weight loss drug in clinical trials lost an average of about 10 percent of their starting body weight. They lost an additional eight percent within 15-months.
While this research suggests that drugs like Ozempic and Wegovy do appear to be effective when it comes to shedding a few extra pounds in the short-term, what effect can they have over a longer period of time? Let’s discuss some of the potential safety concerns of these drugs.
Are Ozempic and Wegovy Safe for Weight Loss?
Although some healthcare providers may prescribe these drugs for extended periods, not many research studies have looked at how safe and effective they are for long-term use.
In addition to safety concerns, weight regain is one of the biggest issues critics voice in using drugs like Ozempic and Wegovy for weight loss. Some researchers have highlighted findings that have shown that people tend to regain all of the weight they lost after stopping these drugs.
Earlier versions of GLP-1 drugs such as exanetide (Byetta) increased the risk for pancreatic cancer or certain types of thyroid cancer and even instances of autoimmunity. Research on this topic is currently still ongoing, however, and it may take time to determine what the long-term effects of these drugs are.
What are the Dangers of Taking Ozempic or Wegovy?
According to the FDA, Wegovy is indicated for chronic weight management in patients with a BMI of 27 kg/m2 or greater who have at least one weight-related ailment or in patients with a BMI of 30 kg/m2 or greater.
Some researchers believe those who have a goal for more significant weight loss may be relatively better candidates for prescription weight loss drugs compared to those with more modest weight loss goals. But what about the side effects of using drugs like Ozempic or Wegovy?
Since GLP-1 drugs mimic the action of a peptide produced in the GI tract, the majority of reported side effects are associated with the digestive tract. According to the manufacturers of Ozempic and Wegovy, the main side effects may include:
- Nausea, vomiting, and diarrhea that could lead to an acute kidney injury
- Rapid heart rate
- Allergic reaction to the medication
In addition to these side effects, there are two other main concerns to be aware of.
1) Cancer and Thyroid Concerns
Semaglutide is also not recommended for people with a personal or family history of medullary thyroid carcinoma (MTC) or in those with Multiple Endocrine Neoplasia syndrome type 2. This is because in animal studies, higher doses of semaglutide were found to increase the risk for developing thyroid C-cell tumors.
Some researchers are raising additional concerns around pancreatic cancer risk and GLP-1 agonist drugs. This is because clinical trials have not been long enough to assess pancreatic cancer risk, and the risk may still be present.
2) Pancreatitis Concerns
Acute pancreatitis, including potentially fatal hemorrhagic and necrotizing types of pancreatitis, have been documented in those taking some GLP-1 agonists. The reason for this reaction is not fully known at this time, but has led doctors to avoid prescribing these drugs in those with a history of pancreatitis.
Additionally, experts say those with more severe gastrointestinal diseases such as gastroparesis and inflammatory bowel disease (IBD) should avoid these medications.
Are There Other Metabolic Effects of Taking GLP-1?
Some researchers have pointed out that the common digestive side effects of the drug (diarrhea, vomiting, loss of appetite) may be contributing to their supposed weight loss “success” and are not ideal ways to support metabolic health at its foundation.
According to some scientists, people can reduce their risk of metabolic disorders by 29 to 45 percent with more foundational dietary and lifestyle changes. On the other hand, with drugs such as Wegovy, some of the underlying metabolic imbalances may persist.
Others may argue that for people who have a large percentage of weight to lose and struggle getting started with a more foundational approach to weight loss, drugs like Wegovy can give them a “jump start” or help get their foot in the door on healthier habits by helping them control their appetite in the beginning.
Regardless, researchers and manufacturers of Ozempic and Wegovy do say that these drugs are most successfully used in conjunction with healthier diet and lifestyle changes.
If you are trying to lose weight and looking for a long-term solution with low risk for side-effects, teaming up with a personal dietitian can help.
Only you and your doctor can decide whether or not prescription weight loss drugs may be worth considering for you. Regardless of the method you may use to lose weight, keeping it off over the long-term may still depend on healthier diet and lifestyle choices.
What Foods Increase GLP-1 Levels Naturally?
Is there any way you can naturally support your body’s production of GLP-1? Some studies have shown that boosting protein at meals may be helpful. Consuming adequate protein is important for weight loss for many reasons, and this is one more.
Encouraging a healthy microbiome might be another promising way to support your own production of GLP-1. One preliminary study showed that probiotics - specifically Lactobacillus reuteri - may enhance the release of incretin hormones like GLP-1. More studies are needed to fully understand this effect.
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