Evidence Based
Statistics show obesity has tripled worldwide[1] since the 1970s. And with it, the search for a method for significant weight loss is hotly pursued.
Obesity is associated with serious health concerns,[2] including cardiovascular disease and type 2 diabetes. Obesity treatment requires a multifaceted approach that may involve medication in addition to lifestyle management that includes regular exercise and a balanced, hypocaloric diet.
Ozempic,[3] or semaglutide, is a drug approved by the FDA in 2017 to control blood glucose levels in patients with type 2 diabetes. Some physicians prescribe it for weight loss. So, is Ozempic dosing for weight loss different from the dosing for type 2 diabetes? Read below for answers.
What Is The Ozempic Dose For Weight Loss?
Research shows 2.0 mg of Ozempic to be the most effective dose for weight loss. However, 1.0 mg was shown to be only slightly less effective during a 40-week study. Weight loss averaged 6.9 kg or 15 pounds for the 2.0 mg users and 6 kg or 13 pounds for the 1.0 mg Ozempic dose.
Ozempic Dosing For Weight Loss
Ozempic semaglutide is administered subcutaneously into the upper thigh, abdomen, or upper arm via a pre-filled injectable pen. Dosing for diabetes[4] starts at 0.25 milligrams once weekly for four weeks. Then it is increased to 0.5 mg once weekly for four more weeks. Afterward, if blood sugar control is not achieved, it can be increased to 1.0 mg.
Studies involving anti-diabetic drug effects on weight loss show promise, but how much Ozempic is needed for weight loss? In a 40-week study, the average weight loss[5] for diabetes patients who took 2.0 mg once weekly was 15 pounds. Those who took a 1.0 mg dose experienced slightly less weight loss, with an average of 13 pounds lost.
A cohort study[6] suggested that once-weekly semaglutide at 1.7 mg and 2.4 mg doses given for three to six months were associated with weight loss. These results were similar to those seen in reviewed studies[7] involving a non-diabetic semaglutide dosage for weight loss.
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Ozempic Starting Dose For Weight Loss
There are currently no separate guidelines for prescribing Ozempic for weight loss. Therefore, the Ozempic starting dose for weight loss is also 0.25 mg once weekly, the lowest dose indicated for diabetes. The dosage increases by 0.25 mg every four weeks over a 16-week period until the target dose is reached per patient tolerance. Dosages typically increase from 0.5 mg to 1 mg, up to 2 mg as tolerated.
Maximum Dose Of Ozempic For Weight Loss
The maximum Ozempic dose for weight loss is 2.0 mg[8] once weekly. Wegovy[9] is another semaglutide injection medicine whose dosage level starts at 0.25 mg and increases every four weeks to a maximum of 2.4 mg as a maintenance dose if tolerable. Otherwise, the recommendation is to return to 1.7 mg for four weeks, then try increasing to 2.4 mg again.
Both Ozempic and Wegovy have the same active ingredient, come in prefilled injectable pens, and are administered similarly. However, Wegovy is indicated for chronic weight control versus primary use for type 2 diabetes management like Ozempic.
Other Considerations For Weight Loss Besides Medication
Ozempic is currently trending due to its effect on weight loss, but what if it is not an option for you? The tried and true methods of regular exercise and eating a healthy diet cannot be ignored. Eating healthy when medical conditions are present requires special attention. Those living with diabetes must be aware of their daily carbohydrate count to help maintain blood sugar levels.
Managing a healthy lifestyle requires a multifaceted approach. Proper hydration with adequate water intake is important for optimal body function and satiety. Drinking water and exercising regularly can help shrink your belly and support weight loss efforts.
Dietary supplements may help with your weight loss journey, but which supplements are appropriate additions to your treatment plan? Some products may actually assist your wellness journey and support weight loss efforts.
What If You Miss A Dose?
When taking Ozempic, it is recommended that you stay on the prescribed once-weekly dosing schedule. A missed dose requires following specific criteria to get back on track. If a dose is missed, take Ozempic as soon as possible, within five days[10] of the missed dose.
Experts recommend that if a missed dose occurs five days past the normal schedule, skip the missed dose and wait until the next scheduled day to resume your Ozempic injection.
In each case, patients can resume their regular once-weekly dosing schedule unless there is a significant lapse in their regimen due to unavailability or other factors. An Ozempic for weight loss dosing chart following a prolonged lapse[11] of missed dose is as follows:
- If ≤2 doses are missed, reinitiate at 1 mg once weekly.
- If 3–4 doses are missed, reinitiate at 0.5 mg weekly.
- If ≥5 doses are missed, reinitiate at 0.25 mg once weekly.
Do Medical Conditions Affect The Dosage?
Ozempic was designed to be utilized alongside a healthy diet and regular exercise to improve glycemic control in persons with type 2 diabetes. The desired effect of these lifestyle changes is to decrease body weight and subsequently improve health markers. However, not every person with diabetes meets the criteria to take this drug, and certain medical conditions prohibit its use.
Contraindications[12] for Ozempic include a personal or family history of medullary thyroid carcinoma, Multiple Endocrine Neoplasia syndrome type 2, acute gallbladder disease,[13] or a serious hypersensitivity to semaglutide.
Ozempic, like most pharmaceutical drugs, is associated with risks and warnings. A dose-dependent and treatment-duration-dependent increase in the incidence of thyroid C-cell tumors was noted, but it is unknown if Ozempic causes thyroid tumors in humans.
Adverse Reactions To Ozempic
Diabetic retinopathy and pancreatitis were also notable conditions in clinical trials. Postmarketing reports[14] of acute kidney injury or renal failure have also been noted. Allergic reactions may occur. Gastrointestinal disorders, including the nausea mentioned above, vomiting, diarrhea, constipation, and abdominal pain, were listed as the most common adverse effects reported.
There is limited data regarding the safety of semaglutide for breastfeeding and pregnant women. Ozempic may be indicated if diabetes is poorly controlled during pregnancy and the benefits outweigh the risks. Poorly controlled diabetes during pregnancy can have adverse effects on both the mother and the fetus. It is recommended to discontinue Ozempic use two months before a planned pregnancy to allow semaglutide to wash out of the body.
Drug Interactions
Ozempic stimulates the pancreas to secrete the naturally occurring insulin hormone when blood sugar rises. Therefore, patients taking an insulin secretagogue or using insulin should be cautious when taking it in combination with Ozempic since it could cause hypoglycemia.
Ozempic causes delayed gastric emptying, which slows digestion and could affect the absorption of other medications. Although nothing medically significant was found during clinical trials,[15] it is still noted as a potential interaction.
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Is It Possible To Overdose On Ozempic?
Any medication not taken as directed can cause adverse health effects or even death. Taking too much Ozempic, whether accidental or flagrant misuse, has been documented to cause unwanted gastrointestinal system[16] effects.
Due to the nature of how Ozempic functions in the body, taking too much could cause hypoglycemia. It also lowers blood pressure[17] which, if not taken properly, could cause dizziness.
It is always recommended to take medications as directed and to contact a poison control center or call 911 if an overdose is suspected.
Conclusion
Ozempic was authorized for blood sugar control in type 2 diabetes patients and is often used in weight management for obesity. Research indicates significant weight loss[18] when using injectable semaglutide. For this reason, Ozempic semaglutide has been prescribed for off-label use in chronic weight management in addition to type 2 diabetes management to control blood sugar.
Studies have also shown positive effects on heart disease risks, like lowering blood pressure in patients without diabetes. This helps improve health markers and decrease the incidence of cardiovascular events.
It is contraindicated for patients with a personal or family history of MTC and Multiple Endocrine Neoplasia syndrome type 2 or with hypersensitivity to semaglutide.
Taking Ozempic should be discussed fully with your healthcare provider to determine the benefits and risks of using it to lower blood sugar and achieve your weight loss goals.
Frequently Asked Questions
The starting dose for Ozempic is 0.25 mg for four weeks, then increases to 0.5 mg for another four weeks. 1.0 to 2.0 mg is effective for weight loss. The maximum dosage is 2 mg.
The maximum Ozempic dosage is 2.0 mg. Studies showed that 1.0 mg was slightly less effective than 2.0 mg for weight loss.
Ozempic, if prescribed, should be used in combination with a healthy lifestyle for weight loss, including regular exercise and a healthy diet.
Studies show some patients saw weight loss within the first month of using Ozempic, but more studies show longer use three to six months was more beneficial.
+ 18 Sources
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- Health Risks of Overweight & Obesity (2023). [online] National Institute of Diabetes and Digestive and Kidney Diseases. Available at: https://www.niddk.nih.gov/health-information/weight-management/adult-overweight-obesity/health-risks.
- Center (2020). Ozempic Drug Trial Snapshot. [online] U.S. Food and Drug Administration. Available at: https://www.fda.gov/drugs/drug-approvals-and-databases/drug-trial-snapshot-ozempic.
- Novo Nordisk. Ozempic. 2019, rsc.niaid.nih.gov/sites/default/files/1.14.2.2-package-insert-ozempic.pdf.
- Frías, J.P., Auerbach, P., Bajaj, H.S., Fukushima, Y., Ildiko Lingvay, Macura, S., Søndergaard, A.L., Tsvetalina Tankova, Nikolaοs Tentolouris and Buse, J.B. (2021). Efficacy and safety of once-weekly semaglutide 2·0 mg versus 1·0 mg in patients with type 2 diabetes (SUSTAIN FORTE): a double-blind, randomised, phase 3B trial. The Lancet Diabetes & Endocrinology, [online] 9(9), pp.563–574. doi:https://doi.org/10.1016/s2213-8587(21)00174-1.
- Wissam Ghusn, De, A., Sacoto, D., Cifuentes, L., Campos, A., Feris, F., Hurtado, M.D. and Acosta, A. (2022). Weight Loss Outcomes Associated With Semaglutide Treatment for Patients With Overweight or Obesity. JAMA network open, [online] 5(9), pp.e2231982–e2231982. doi:https://doi.org/10.1001/jamanetworkopen.2022.31982.
- Bergmann, N., Davies, M.J., Ildiko Lingvay and Knop, F.K. (2022). Semaglutide for the treatment of overweight and obesity: A review. Diabetes, Obesity and Metabolism, [online] 25(1), pp.18–35. doi:https://doi.org/10.1111/dom.14863.
- Nih.gov. (2023). DailyMed – OZEMPIC- semaglutide injection, solution. [online] Available at: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adec4fd2-6858-4c99-91d4-531f5f2a2d79.
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- Whitley, H.P., Trujillo, J.M. and Neumiller, J.J. (2023). Potential Strategies for Addressing GLP-1 and Dual GLP-1/GIP Receptor Agonist Shortages. Clinical Diabetes. [online] doi:https://doi.org/10.2337/cd23-0023.
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