The weight loss industry accounts for billions of dollars spent on supplements and medications every year.
Ozempic, a prescription medication traditionally used for blood sugar management, has been making waves in recent years as a treatment option for weight loss. Ozempic is often combined with metformin in the context of managing blood glucose levels, and each of these prescription medications has been associated with weight loss in its own right.
So, what does the research tell us about combining metformin and Ozempic for weight loss? Would this combination be safe and effective?
Can You Take Metformin And Ozempic Together For Weight Loss?
Yes, metformin and Ozempic can be used together. They have commonly been prescribed together for individuals managing diabetes, and there is no direct drug interaction that would be a cause for concern. Each medication has its own set of precautions to be aware of, however.
The two medications have not been evaluated directly to determine whether a combination would provide significantly improved results. Consulting with your doctor can help you determine whether it may be safe and beneficial to consider using both metformin and Ozempic for your individual needs.
Metformin And Ozempic For Weight Loss
Neither metformin nor Ozempic is specifically approved for weight loss. Both have been associated with weight loss, however, and it is possible your healthcare provider may consider how these weight loss benefits will outweigh any risks associated with therapy.
How Metformin Works
Metformin increases insulin sensitivity and has been a commonly used medication for individuals managing type 2 diabetes and polycystic ovary syndrome. Improving insulin sensitivity helps to improve sugar absorption in key areas of the body utilizing your body’s natural insulin. When insulin works more effectively, this helps stabilize and manage blood sugar levels. Moderate weight loss[1] has also been observed in individuals using metformin.
How Ozempic Works
Ozempic is a glucagon-like peptide-1[2] or GLP-1 medication. Ozempic helps regulate the body’s supply of insulin and slows down digestion by keeping meals in the stomach for a longer period of time. The net effect for diabetes management is an improved response to meals with less likelihood of blood sugar spikes. Your body is able to respond better to an influx of glucose. Significant weight loss has also been observed in individuals using Ozempic.
Can Metformin And Ozempic Be Combined?
Semaglutide, the active ingredient in Ozempic, has been evaluated for potential drug interactions with metformin directly. No safety issues[3] resulting directly from the combination were discovered when these two medications were used together. However, each medication carries its own set of precautions.
Metformin has also been considered a first-line medication for treating diabetes in years past in combination with other medications. Combining metformin with GLP-1 medications has also been a common practice in clinical research. During the SUSTAIN trials,[3] semaglutide was evaluated for safety and efficacy, specifically as an add-on to metformin therapy.
How Much Weight Can You Lose?
Weight Loss Using Metformin
Among individuals seeking to lose weight specifically, a recent review article[1] examined the effects of metformin in individuals with a body weight considered overweight or obese. The article reviewed multiple trials and determined that, on average, individuals lose about 3 kg or 6.6 pounds after using metformin for six months.
This is a modest decrease in weight. When the risks of therapy and potential benefits are evaluated, many clinicians may choose to reserve metformin for overweight individuals who are also:
- Managing diabetes.
- Determined to have an elevated risk of developing diabetes.
- Managing polycystic ovary syndrome or PCOS: Hormonal changes can make abdominal fat particularly difficult to address, which is one of the potential complications of PCOS. Metformin has been a helpful treatment option for many individuals managing PCOS.[4]
Weight Loss Using Ozempic
While Ozempic is not FDA-approved as a weight loss drug, its active ingredient, semaglutide, is utilized in Wegovy.[5] The FDA has evaluated and approved Wegovy specifically for weight management. The difference between Wegovy and Ozempic is the dosage, with Wegovy providing up to 2.4 milligrams of semaglutide and Ozempic providing up to 2 mg.
Studies evaluating 2 mg of semaglutide have often been conducted in populations who are managing diabetes. In these studies, weight loss has been evaluated alongside measures of diabetes management like A1c, a measure of blood glucose control over a three-month period. The SUSTAIN trials[6] did suggest an average weight loss of 6.9 kg or 15.2 pounds after 40 weeks using 2 mg of Ozempic.
While lower doses of semaglutide have not been evaluated as closely for weight loss, there is some evidence of benefits. For example, one study[7] was designed to examine the effects of semaglutide on cardiovascular risk in individuals managing diabetes. The average weight was reduced by about 4%-5% for participants using 0.5 mg or 1 mg of semaglutide. This suggests lower doses of semaglutide may still support weight loss efforts.
A common question is, “How long does it take to lose weight?” General recommendations for a healthy rate of weight loss call for about one to two pounds each week. When semaglutide had been evaluated for weight loss, the target dose was reached at 16 weeks, and evaluations continued for over a year to ensure results were sustained over time.
Weight Loss Using Both Metformin And Ozempic
Studies have not generally focused on comparing Ozempic vs. Metformin regarding weight loss. This is partially because GLP-1 medications have shown a comparatively stronger response[8] for weight loss when multiple studies are considered side by side.
In many trials[9] demonstrating the potential for weight loss, semaglutide was added to metformin specifically for individuals managing diabetes. While metformin is often safe to use individually, no studies have been done on the effect of using it in conjunction with Ozempic specifically for weight loss. If you are considering doing so, be sure to consult a medical professional.
Weight Loss Benefits
Semaglutide[9] has been more reliably associated with clinically significant weight loss of 5% or more. Significant weight loss has been associated with various benefits:[10]
- Improved quality of life.
- Lower risk of developing cardiovascular disease.
- Lower rates of diabetes.
- Improved mobility.
- Lower risk of developing sleep apnea.
The benefits of the amount of weight loss provided by semaglutide are somewhat more established than some other diabetes drugs. Because of this, some healthcare providers may recommend semaglutide or other GLP-1 medications first. It should be noted that the cost[11] of Ozempic and other medications in this class can present a very significant barrier, however.
In these studies, the medications were paired with positive lifestyle changes involving diet and exercise. Staying hydrated is also important. There are a number of ways to accomplish this, including water infusions that provide additional nutritional value.
Foods To Avoid While Taking Ozempic And Metformin Together
Regardless of whether weight loss medications are considered, making positive lifestyle choices related to diet and exercise is always recommended. In addition to simply tracking calories, the types of foods you eat also matter and may also affect the likelihood of side effects if you’re using weight loss medications.
Processed Foods
Heavily processed foods are often high in fat, salt, and refined sugars. For those interested in losing weight without exercise, a primary strategy is transitioning from fast food or processed foods to more fresh produce and whole grains.
Refined Carbohydrates And Sugars
Tracking your carbohydrate intake can be beneficial. It is important to remember that your body processes certain sources of carbohydrates differently.
Sugary beverages like sodas and many baked goods can cause unhealthy blood sugar spikes. More heavily processed bread and pasta can also cause blood sugar spikes because of low amounts of fiber to slow down digestion, which releases sugar from food. Identifying a target for total carbohydrate intake can be helpful.
Side Effects
Precautions For Taking Metformin And Ozempic Together
There are no specific drug interaction[3] concerns related to using metformin and Ozempic together, with the exception of insulin and insulin mimetics. There is a risk for the combination of Ozempic and insulin for severe hypoglycemia.
Metformin Side Effects And Precautions
Side Effects
Metformin is generally safe and well-tolerated, but there are some precautions to be aware of. The most common side effects are gastrointestinal:
- Upset stomach.
- Nausea and vomiting.
- Diarrhea.
These can sometimes be avoided by taking metformin with a meal or using an extended-release product version. Despite metformin’s common use for managing blood sugar levels, it is not associated with lowering blood sugars to unsafe levels.
Precautions
A precaution to consider prior to using metformin is the potential for developing lactic acidosis.[12] This is a metabolic imbalance caused by changes in blood glucose levels. A buildup of lactic acid can become severe and require hospitalization or can be fatal in some cases.
The risk of developing lactic acidosis is higher for individuals with:
- Reduced kidney function.
- Reduced liver function.
- A history of alcohol abuse.
- Older age.
- A use of glucose-modifying medications.
- Use of a keto diet.
Metformin has also been associated with lower levels of vitamin B12,[13] which can tire you quickly or make it difficult to catch your breath. If you have a history of B12 deficiency or are a vegan or vegetarian, it is important to inform your doctor before considering metformin therapy.
Ozempic Side Effects And Precautions
Side Effects
The most common side effects associated with Ozempic are also gastrointestinal and align closely with metformin:
- Upset stomach and abdominal pain.
- Nausea and vomiting.
- Diarrhea.
Many who stop using the medications are unable to continue because of an upset stomach, nausea, or diarrhea. Slowly lowering the dose can be helpful.
Precautions
It is crucial to discuss your medical history with your doctor, as there are some precautions[14] and potential reasons to avoid therapy with Ozempic:
- Individual or family history of thyroid cancer.
- History of pancreatitis.
- Pregnancy or breastfeeding.
- Presence of gallbladder disease.
- Concurrent use with insulin: risks severe hypoglycemia.
Your doctor may also review your kidney function before starting the medication.
Conclusion
Both metformin and Ozempic can be effective for weight loss. However, studies only looked at the weight loss effects of each drug individually, but not together. The two medications do not interact with each other directly. Consulting with your doctor can help you determine whether it may be safe and beneficial to consider using both metformin and Ozempic. Finally, remember that weight loss medications are not the only solution to weight loss. Lifestyle changes such as healthy hypocaloric diets and regular exercise are essential for long-term weight loss.
Frequently Asked Questions
Yes, Ozempic can be taken safely by individuals who do not have diabetes. Individuals with a history of thyroid cancer or pancreatitis should be mindful of increased risks in these areas.
Weight loss efforts are always better supported by positive lifestyle changes in diet and physical activity. Talking with your doctor about how to achieve your goals safely is important. Losing one to two pounds each week is recommended.
It is important that your diet and exercise habits also align with your weight loss goals. Or, maybe your dosage is not high enough. Talking with your doctor or a registered dietitian can help.
