Ozempic for Weight Loss: This Diabetes Medication Should Not Be Used As a Diet Drug

Published in Teen Vogue

Society seems to have a generational trend cycle when it comes to weight loss and appearance politics. The late ‘90s and early 2000s brought on an obsession with diet pills and diet culture, which passed itself on to the early 2010s when images of skinny, white, blonde teenagers reigned supreme on Tumblr. Eating disorders and the language around them were rampant and the predominant aesthetic was that of the “sad girl” (think Arctic Monkeys’ AM album, sweaters pulled down to the shoulders to expose the protruding collarbone, black-and-white images from Polaroid cameras, and Dr. Marten boots). The end of 2010, however, brought about the body-positivity and acceptance movement. Slowly but surely, the internet moved away from glorifying skinny bodies and weight loss to a more neutral and accepting perception of our bodies. Plus-size models started to appear more on the runway, and the word “inclusivity” rose to the top of our vocabulary.

But we seem to be back to the beginning again. TikTok, now one of the biggest facilitators of trend cycles, seems to have turned back in the direction of the ‘90s and early 2000s when thinness was the ultimate goal. This is evident in many ways — runways seem to be less inclusive and early-aughts style is having a resurgence. But one of the biggest indicators is a renewed interest in weight-loss drugs: Both online and in the media, we’ve seen the rise of Ozempic.

Ozempic, a brand name for the injectable form of a drug called semaglutide, i meant to treat type 2 diabetes — and it can also suppress the appetite and lead to weight loss. Ozempic was rumored to be the secret behind several recent celebrity weight-loss “transformations,” and TikTok videos featuring creators talking about and taking Ozempic have millions of views, with even more comments from users asking how to get their hands on the drug. The result? A shortage of Ozempic. Wegovy, which includes the same active ingredient as Ozempic but at a higher dose, is not specifically a diabetes drug and was approved for weight-loss prescription in 2021. NPR reports the drug is not intended for cosmetic weight loss but is meant to manage weight-related conditions. The shortages impact both drugs, and some people who may have been prescribed Wegovy for weight loss were taking Ozempic, according to NBC News. That, however, has left many who need the drug to manage diabetes at a loss.

Those promoting Ozempic for cosmetic weight loss claim that it offers a fast, no-frills option for slimming down. In other words, it’s apparently the so-called miracle drug we’ve all been waiting for. Of course, that’s not the full picture: Ozempic may trigger weight loss, but only while a person takes the drug. One study found that the majority of people gained back most of the weight they lost while using semaglutide one year after stopping the medication.

The drug suppresses the appetite by slowing the rate at which your stomach empties, according to Forbes, and by impacting the hunger centers in the brain to reduce overall appetite. Pamela Hu, MD, an instructor in pediatric diabetes, endocrinology, and metabolism at Yale University School of Medicine, described taking semaglutide as similar to taking any drug to treat chronic disease: “Many of our colleagues use the analogy of treating any chronic condition like hypertension,” she told Teen Vogue. “ If you’re going to take an antihypertensive medication, it will lower your blood pressure but only while you’re taking it. Similarly, with obesity, when you’re taking an anti-obesity medication, you’re able to change your physiology a little bit, but it only works while you’re on the medication.” Dr. Hu added that thinking of a medicine like semaglutide purely as a weight-loss medication can also be problematic. “I like to use the terminology that it’s an anti-obesity medication and we’re thinking about the treatment of obesity as a chronic, neurometabolic disease, rather than simply about body image.”

Holly Lofton, MD, the director of the weight management program at NYU Langone Health, told NBC News that for some patients, once they stop taking a drug like Ozempic, their appetite might feel bigger than it was before they lost weight. Experts do not recommend it for cosmetic weight loss. (Wegovy is recommended for weight loss, but not for short-term cosmetic reasons.)

“While this has received significant attention in the media, Ozempic and related GLP-1 medications are not designed to be used [for short-term, cosmetic weight loss], can lead to potential adverse events, and ultimately the weight that is lost will be regained,” Christopher McGowan, MD, a gastroenterologist specializing in obesity medicine and endo bariatrics, told Forbes. “Further, this off-label use of Ozempic is greatly impacting the availability of the medication for those who need it most.”

Beyond the physical impact, Janet Lydecker, PhD, an assistant professor of psychiatry at the Yale School of Medicine, noted that if people experience quick weight loss, it can lead to more weight bias and disordered eating. “When weight loss comes on more quickly that can reinforce some of the weight bias that we see,” she said.“There’s this idea that I can lose weight quickly [via a medication], so I clearly wasn’t trying hard enough earlier or even that if I put on weight again I can just go back to taking [Ozempic].”

Dr. Lydecker said weight-loss trends fueled by a desire to look a certain way only exacerbate the already confusing messaging around bodies and can lead to more harm in the journey to health and wellness. “The trend scares me because it’s marketing this sort of idealistic lifestyle and we don’t want that to be the goal,” she said. “When weight loss occurs for appearance, for power, for popularity, for happiness, that’s when we start to see some of those diet-culture trends and disordered eating.”

Perhaps more concerning is how closely the obsession with Ozempic for cosmetic weight loss echoes the rise of Fen-Phen — a harmful diet pill that was widely prescribed and called a “miracle” drug in the '90s. With a combination of fenfluramine or dexfenfluramine (appetite suppressants) and phentermine (an amphetamine), demand for the drug soared and many doctors doled out prescriptions. But with little safety data initially, it was soon discovered that Fen-Phen could lead to dangerous heart conditions and the medication was pulled from shelves.

Like any other prescription medication, Ozempic has potential side effects, largely including gastrointestinal issues. And while the drug has been deemed safe for use to control type 2 diabetes, cosmetic weight management is an off-label use. Since any weight-loss benefits are only realized while you’re taking the drug, patients seemingly have to take it indefinitely and it’s unclear what the long-term use of semaglutide may look like. “These are newer medications, so we don’t have long-term outcome studies, especially in young people and pediatric patients,” Michelle Van Name, MD, an assistant professor in pediatric endocrinology and diabetes at Yale School of Medicine, told Teen Vogue. “We also don’t have data on [taking semaglutide for cosmetic weight loss], right? It’s been studied and indicated for people with either type 2 diabetes or the medical problem of overweight and/or obesity.”

Ozempic was approved by the FDA in 2017 and patients taking the drug for up to two years were included in safety trials. Wegovy was approved in 2021 and studied in four separate 68-week studies. This is, of course, not to say that semaglutide does or even might carry the same risk as Fen-Phen. The medications are fundamentally different. While these drugs may prove largely safe in the short and long term, the attitude toward them as a quick weight-loss aid does seem to echo what drove the Fen-Phen craze in the ‘90s — an all-too-quick willingness to take a drug that some say promises fast and easy weight loss without a critical look at the reality of that statement or the potential side effects.

Dr. Van Name emphasized that successful weight-management strategies are multifaceted and need to be approached with a holistic mindset. While some on social media seem to be promoting the belief that you need only one miracle drug to lose weight, these medications are meant to be part of a broad-based strategy. “These medications are designed to be used as part of a multidisciplinary treatment plan for the disease of obesity. You’re supposed to add it on to lifestyle modifications just as you would in hypertension or in type 2 diabetes,” she told Teen Vogue. “There are so many pieces of treatment, including addressing any sleep disorders. Mental health concerns need to be addressed and any disordered eating needs to be addressed. You're going to have less of a successful management plan if you’re ignoring key pieces that relate to your physiology.”

For teens who are already struggling with self-image and body image, this endless cycle of diet trends and desperate weight-loss strategies can be very detrimental, the same way it was years ago. “We see such drastic attempts to lose weight because the pressure is so strong… This could lead to major consequences with weight-loss medications that might not be appropriate for teens,” said Dr. Lydecker.

Ozempic isn’t a miracle drug. Its use for quick weight loss is just another tool in the same diet culture that has been pervasive for pretty much all of the 20th and 21st centuries and doesn’t seem to be going away anytime soon. Instead of leading to better health and more satisfaction, our obsessive cycle of dieting and being skinny is leading to disordered eating and the abuse of prescription medication. It is also a part of dangerous messaging to youth that implies they should stop at nothing, including injecting diabetes medicine, to achieve what our society lauds as the perfect body.