Ozempic: Are the Risks Worth the Potential Benefits?
Ozempic has taken the world by storm over the past few years. Everyone from the Hollywood elite to our government overlords and even your average soccer mom is trying out semaglutide to get rid of that stubborn weight that just won’t seem to come off. Most of these people are having some pretty good results, which only pushes the narrative that Ozempic is the miracle cure to obesity that we’ve all been looking for.
We don’t have a ton of data on this new drug yet, but that’s not stopping people from hopping on the semaglutide, Ozempic, Rybelsus, and Wegovy trends, possibly to their own demise. Today, we will talk about how semaglutide works, the benefits, and the known risks.
What is Ozempic?
Ozempic is the brand name of Novo Nordisk’s semaglutide. Semaglutide is a glucagon-like peptide-1, modified with a small chain. Wegovy and Rybelsus are just different brand names of this drug, kind of like how Vasoline is a brand name for petroleum jelly. They’re all the same thing: semaglutide.
And these aren’t the only GLPC-1 agonists, there are quite a few on the market right now, but none have had the same success that Ozempic has had thus far. Here are a few:
Dulaglutide (Trulicity)
Exenatide (Byetta, Bydureon)
Liraglutide (Victoza, Saxenda)
Lixisenatide (Adlyxin)
Albiglutide (Tanzeum)
Tirzepatide (Mounjaro, Zepbound)
These drugs all work very similarly, just to varying degrees. For the purposes of this article, we’re going to focus on semaglutide though. Just know that these are all GLP-1 agonists, and they all have similar mechanisms of action giving you roughly the same outcome and possibly the same side effects.
How Does Ozempic Work?
Ozempic is a GLP-1 agonist. GLP stands for glucagon-like peptide, and an agonist is something that acts like something inside the body. Semaglutide stimulates the GLP-1 receptors and signals the body to produce more insluin when blood sugar is high, delays gastic emptying, and reduces appetite. This all leads to lowered blood sugar, which is why it was seen as a great drug for diabetics. This also helps with weight loss, which is why you’ve seen such a boom in its usage.
For the average person, semaglutide signals the body that you’re not hungry. This has a direct effect on the amount of calories that you ingest, often leading to weight loss. Fewer calories typically equate to weight loss.
What Are the Possible Side Effects of Ozempic?
Like anything else, there is a trade off when it comes to semaglutide. While most people will see the benefits, we also need to look at the possible side effects. We’re going to break these down to common and more manageable side effects, less common yet still serious side effects, rare but significant side effects, and possible side effects not fully seen yet.
Common Side Effects
Many users of semaglutide have reported unwanted side effects and here are a few. These are seen as non-serious, non-life threatening, manageable, and “worth it.”
Nausea
Vommitting
Diarrhea
Constipation
Abdominal Pain
Fatigue
Headache
The above side effects are common with many medications, and most of these are also common in someone dieting at a caloric deficit in an effort to lose weight. Most users of this drug see these side effects as worth it.
Less Common But Serious Side Effects
These side effects are less common, but still happen often enough to be notable. These range from very serious and possibly life-threatening, to life-altering.
Pancreatitis
Acute inflammation of the pancreas has been observed, though trials like SUSTAIN 6 showed similar rates to placebo (around 0.2%). Symptoms include severe abdominal pain radiating to the back, nausea, and vomiting. A causal link isn’t fully proven, but it’s a known risk with GLP-1 agonists.
Gall Bladder Issues
Cholelithiasis (gallstones) occurs in 1.5-2% of users, and cholecystitis is less common. Rapid weight loss may contribute.
Stomach Paralysis
Post-marketing reports and a 2023 study suggested a 3.67x higher risk compared to other weight loss drugs, causing delayed digestion, nausea, and bloating.
Bowel Obstruction
Linked to a 4.22x increased risk in some analyses, potentially due to slowed gut motility.
Low Blood Sugar
Rare in monotherapy (less than 1%), but more common (up to 10%) when combined with insulin or sulfonylureas.
Acute Kidney Injury
Seen in patients with pre-existing kidney issues or dehydration from GI side effects, though not directly caused by semaglutide.
Increased Heart Rate
A mean increase of 1-4 beats per minute, with some experiencing jumps of 10-20 bpm (26% vs. 16% in placebo groups).
Diabetic Retinopathy
In a 2-year trial, 3% of Ozempic users with type 2 diabetes had worsening retinopathy vs. 1.8% on placebo, possibly due to rapid glucose improvement.
These side effects, while less prevalent, can be debilitating for users of semaglutide. That last one there eventually leads to blindness. If you’re someone who wants to lose some vanity weight, are these less common, but possible outcomes really worth it?
Rare But Significant Side Effects
These side effects are completely unwanted, and life-threatening to some users of semaglutide. While they’re significantly less common, you need to take these into account as you decide whether semaglutide is for you, or not.
Thyroid C-Cell Tumors
Rodent studies showed dose-dependent tumors, leading to an FDA boxed warning. Human relevance is unconfirmed, but it’s contraindicated in those with a history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Symptoms to watch for include neck lumps or hoarseness.
Allergic Reactions
Anaphylaxis and angioedema have been reported rarely.
Suicidal Ideation
Noted in weight management trials, though causality is unclear. Patients with a history of depression should be monitored.
Ileus
Added to FDA labels in 2023 after post-marketing reports of intestinal paralysis, sometimes leading to obstruction.
These side effects are fairly rare, but again you have to ask yourself, is losing that weight worth all of this when you can just eat healthier and exercise? It’s crazy the things that we’ll overlook in our quest to find the easy way out.
Possible Side Effects Not Yet Seen
These side effects haven’t been seen just yet, but that’s possibly only because we have but a small amount of data with this drug. These are all hypothetical based on understanding the current side effects, and the mechanism of the drug.
Long Term Cancer Risks
Thyroid Cancer: While rodent studies raise concerns, a 2023 meta-analysis of 37 trials and 19 real-world studies (46,719 patients) found no increased cancer risk over 18 months. However, GLP-1 RAs like liraglutide have been tenuously linked to thyroid cancer in French insurance data over 1-3 years. Decades-long human data is lacking.
Pancreatic Cancer: Chronic pancreatitis is a risk factor for pancreatic cancer, and though acute pancreatitis is rare with semaglutide, prolonged use might theoretically increase this risk. No evidence supports this yet, but it’s a concern for long-term surveillance.
Neurological Effects
Cognitive Decline and Neurodegeneration: Animal studies suggest GLP-1 RAs might protect against Alzheimer’s by reducing beta-amyloid plaques, but paradoxical reports of vivid dreams or mood changes in users hint at unknown brain effects. A 2024 European study on psychiatric events with GLP-1 RAs didn’t find strong evidence, but long-term impacts on the nervous system remain uncharted.
Depression and Anxiety: Suicidal ideation signals suggest possible mood alterations, but whether this extends to broader psychiatric conditions is unknown.
Cardiovascular Unknowns
While semaglutide reduces major cardiovascular events (e.g., heart attack, stroke) in high-risk patients, the slight increase in heart rate could, over decades, strain the heart in susceptible individuals. Long-term studies beyond 2-3 years are needed.
Gastrointestinal Damage
Chronic Gut Motility Issues: Gastroparesis and ileus reports suggest semaglutide’s slowing of digestion might, over time, lead to permanent gut dysfunction or increased risk of conditions like small intestinal bacterial overgrowth.
Colostomy of GI Issues: Anecdotal ER reports on X mention severe GI outcomes, but these lack peer-reviewed backing. If true, they could signal rare, delayed complications.
Metabolic Rebound
After discontinuation, users regain about two-thirds of lost weight within a year (per a 2023 Novo Nordisk study). This yo-yo effect might destabilize metabolism, potentially worsening insulin resistance or cardiovascular risk long-term, though data is preliminary.
Reproductive Effects
Limited pregnancy data shows fetal risks in animals, and women are advised to stop semaglutide 2 months before conception. Effects on fertility, hormonal balance, or offspring health after prolonged use are unknown.
Immune System Impact
Allergic reactions hint at immune activation, but whether chronic use could trigger autoimmune conditions (e.g., via gut microbiome changes) is unexplored.
Bone Density
Rapid weight loss can reduce bone density, and though not yet reported with semaglutide, other weight loss drugs have shown this effect over time. Long-term skeletal impacts are a theoretical risk.
Here’s the Problem
This drug hasn’t been around all that long. This is very much a Covid jab type situation, where there are a ton of unknowns because our data sampling is so small, and there hasn’t been nearly enough time for many of these possible side effects to rear their ugly heads.
As a society, we’ve been so unbelievably conditioned to believe that we need a pill for everything. Anxiety? Pill. Depression? Pill. Overweight? Pill. Cholesterol high? Pill.
The current data suggests that between 45.5 million and 75.8 million Americans are currently on a prescription drug that could be completely eliminated if we were to adjust our lifestyles. Things like getting better sleep, eating healthier, getting at least some exercise, and managing stress more effectively would reduce our dependency on Big Pharma and save between 52.8 billion and 88.1 billion dollars. That’s almost a trillion dollars over the course of 10 years!
I don’t want to look at this from a numbers standpoint though, that’s dehumanizing and commoditizing human beings. It’s cancerous and one of the reasons that we’re in this position right now. Think of someone that you care about, someone that is a part of your every day life. Hell, maybe it’s you.
How much better would that person’s life be if they weren’t dependent on a prescription medication? How much happier would they be if they felt better? How much more money would they have in their pocket? How much would their day-to-day life improve?
We’ve come to rely entirely too much on these prescription drugs that merely manage the problems that we create for ourselves. This is all 100% self-inflicted misery. Semaglutide falls into this category as well. For every “benefit” you’re looking at a mess when it comes to possible side effects. And the most recent anecdotes show that this metabolic rebound (including hunger like you’ve never felt before) damn near ensures that they’ll be on these meds FOREVER, or gain every pound that you lost when you come off.
The Verdict on Ozempic
While I can see some value in this drug, it’s really not doing anything for you that you couldn’t do on your own. It makes you less hungry, that’s the mechanism by which it helps you to lose weight. Some self discipline, some moving around, and some understanding of short term sacrifice for long term success would go a long way.
If you weigh 5-600 pounds, then maybe this intervention is a necessity. There’s a lot that goes into getting that big. However, if you’re looking to lose that last 20-30 pounds, or even upwards of 50 pounds, then you’re better off steering clear of this drug, at least until we have a better understanding of the long term consequences of its use. The possible long term consequences could kill you. Is easier weight loss worth possibly losing your life?
