Ozempic For Weight Loss: What to Watch Out For 

by JJ Virgin on October 24, 2023

If you’ve followed the weight-loss world over the past year, you’re probably aware of the hype surrounding Ozempic. Celebrities like Elon Musk and Amy Schumer have boasted about its benefits, including better energy, reducing the risk of heart attack, and (everyone’s favorite) weight loss.  

Ozempic and a similar medication known as Wegovy belong to a class of drugs called glucagon-like peptide-1 receptor agonists (GLP-1 RAs), which help control blood sugar and weight. While both go under the generic name semaglutide, doctors prescribe Ozempic for type 2 diabetes and Wegovy for weight management. 

Used correctly, these drugs can help you lose weight (along with other perks like better blood-sugar control). But like any prescription drug, the risks may outweigh these benefits for some people. 

GLP-1: The Hormone That Helps Manage Blood-Sugar Levels 

Primarily secreted by cells in your small intestine, your gut releases GLP-1 when you eat. By choosing foods higher in protein, fiber, and healthy fats, your gut releases GLP-1 in a steady, sustained manner.  

A high-sugar-impact meal, on the other hand, can rapidly spike your blood sugar. The quick release of glucose into your bloodstream doesn’t give your gut enough time to trigger the appropriate release of GLP-1, keeping your blood sugar high after a meal.  

When GLP-1 is released, this hormone binds to receptors in the pancreas that then promote the release of insulin and glucagon to regulate blood-sugar levels.  

Insulin is a hormone that helps store sugar to be used as energy. On the other hand, glucagon helps break down stored glucose and releases it into the bloodstream. These hormones work in tandem to maintain your blood sugar within a tight range and keep your metabolism running smoothly.1 

GLP-1 receptors are located throughout your body, including your pancreas and your brain. When GLP-1 binds to receptors in your brain, it triggers a cascade of reactions that help reduce cravings to better manage your appetite. Among those reactions, GLP-1: 

  1. Prevents your liver from making too much glucose.2 
  2. Slows the emptying of the stomach’s contents into your small intestine, which helps manage the rate at which glucose enters your bloodstream.3 
  3. Browns your fat, making that fat easier to burn off.4 
  4. Lowers inflammation in your gut.5 

Those reactions help balance blood sugar, and when you keep your blood sugar within a healthy range, you’re more likely to burn fat. Conversely, high blood-sugar levels can contribute to weight gain.6 

Research shows that impaired GLP-1 secretion plays a role in the development of type 2 diabetes.7 Medications like Ozempic were initially developed for diabetes management. They not only help control blood sugar but also reduce the risk of stroke, heart attack, and death in adults with type 2 diabetes and heart disease.  

Recently, higher-dose formulations of semaglutide have been developed for weight management in individuals without diabetes. Even before this drug came on the scene, research showed that GLP-1 RA could be effective for weight loss in people with and without type 2 diabetes.8 

How Does Ozempic Work? 

Ozempic and Wegovy mimic the effects of GLP-1, offering the following benefits: 

  1. They help stimulate the release of insulin from the pancreas, delivering glucose from your bloodstream into cells and lowering blood sugar after a meal.  
  2. They reduce the secretion of glucagon, which raises blood sugar by signaling your liver to release stored glucose. By inhibiting glucagon secretion, GLP-1 RAs prevent excessive glucose production by the liver. 
  3. Slow down how quickly food empties from your stomach into the small intestine. Delayed gastric emptying helps regulate the speed at which nutrients, including glucose, are absorbed into the bloodstream.  
  4. Work on your brain's appetite control centers, leading to a feeling of fullness so you’re less likely to reach for seconds. 

Ozempic's once-weekly regimen adds to its appeal, offering convenience and making it easier to stay on the weight-loss path. 

Ozempic for Weight Loss: Promise or Hype? 

What’s the downside? Like any prescription drug, Ozempic and Wegovy can create side effects—lots of side effects for some people. About 50% of people who initially use the drugs report side effects that include: 

  • Nausea  
  • Vomiting 
  • Diarrhea 
  • Constipation 
  • Abdominal pain 
  • Headaches 
  • Dizziness 
  • Fatigue 
  • Dehydration 
  • Low blood sugar 
  • Decreased nutrient absorption  
  • Decreased appetite (and not in a good way: you feel overly full and uncomfortable from even small amounts of food) 
  • Potential muscle loss 

Unfortunately, studies show that most Ozempic users experience rebound weight gain when they go off the drug.9 

The cost can be prohibitive, too; Ozempic can run you $1,000 or more a month. (To reduce those costs, talk to your healthcare practitioner about combining semaglutide with vitamin B12, which may be covered by your health insurance depending on your medical condition.) 

That potential for weight regain, along with a laundry list of potential side effects like muscle loss, initially made me wary of semaglutide. But a few months ago, I attended a workshop on GLP-1 RAs in New York with a doctor who had years of experience successfully prescribing these drugs with minimal downsides.   

He said the side effects had to do with how the drug was titrated. GLP-1 RAs need to be slowly increased initially, and then slowly decreased once you reach your goal health and weight.  

The ultimate goal, of course, is to no longer need Ozempic. He also mentioned that to maximize its effectiveness, you need to optimize protein and add resistance training to reduce muscle loss, which seems so common with these drugs. 

Addressing the Underlying Cause of Weight Gain 

Looking for weight-loss solutions has taken on a new urgency with increasing rates of obesity and other measures of metabolic syndrome, a group of conditions like high blood pressure and high blood-sugar levels that increase your risk of heart disease and diabetes.  

Studies show that about one in three adults have metabolic syndrome.10 Other research is even grimmer. A few years ago, the University of North Carolina at Chapel Hill released a study that showed only one in eight Americans are achieving optimal metabolic health, putting people at risk for serious diseases including diabetes and heart disease.11  

Over time, these metabolic disturbances can contribute to insulin resistance, where cells become less responsive to the effects of insulin, leading to elevated blood sugar. Insulin resistance is a key underlying mechanism of metabolic syndrome and type 2 diabetes. 

I’ve talked about weight-loss resistance—where you’re doing everything correctly, yet the scales won’t budge—for over three decades. I know how difficult and time-consuming it can be to heal your metabolism and lose weight. For some people, Ozempic could be the ticket to help speed that healing.  

Always discuss with your doctor, but semaglutide may be right for you if: 

  • You carry over 30 pounds of excess fat 
  • Your visceral adipose tissue or visceral fat (the dangerous fat that accumulates around internal organs). You’ll want to keep visceral fat to 10% of your total fat or less. 
  • If you’ve been doing everything “right” but nothing is moving the needle  
  • Your metabolism is super slow  

While I don’t believe semaglutide or any prescription drug is a cure-all for weight loss, it may help if you’re struggling with insulin resistance and weight-loss resistance. I recommend working with a functional-medicine doctor who can adjust the dosage as needed, customize your diet plan, and provide complementary lifestyle strategies for your condition. 

Though GLP-1 RAs may work temporarily for some conditions, you’ll still want to optimize other factors that support weight loss, stop weight regain, and help you get off the drug without rebound. If you’re unsure whether Ozempic might be right for you, these strategies can optimize GLP-1 production naturally (so you may not even need to use GLP-1 RAs). 

Eat by the Plate 

The best way to optimize the release of GLP-1 is with your fork, taking a protein-first approach to every meal. Every meal should incorporate the magic trifecta of protein, healthy fats, and fiber: 

  • Protein can stimulate GLP-1 secretion from intestinal cells. Your priority is to get at least 30 grams of protein in every meal.
  • Fiber interacts with certain gut receptors and triggers the release of GLP-1 
  • Healthy fats can slow down gastric emptying, keeping food in your stomach longer and triggering the release of GLP-1. Some fats, such as omega-3 fatty acids, can reduce inflammation and improve the function of the cells that secrete GLP-1 

Along with eating by the plate, taking apple cider vinegar with meals is a great way to manage blood-sugar levels to reduce stomach emptying and prevent blood-sugar spikes. What you monitor, you can improve. A continuous glucose monitor (CGM) is a wearable device that continuously tracks glucose levels in real time throughout the day and night. You can spot trends and figure out which foods don’t work for you. 

Blood Sugar Support is a synergistic blend of two blood-sugar-supporting nutrients, berberine and alpha-lipoic acid (ALA). Berberine is a plant-derived compound that helps maintain optimal blood-glucose metabolism. The antioxidant ALA provides additional support for blood-sugar balance and cardiovascular health.* 

Support Your Gut 

Keeping your gut in tip-top shape is an ideal way to optimize GLP-1 release. A weakened gut barrier that allows unwanted substances to pass through can lead to ongoing inflammation and problems like leaky gut. These and other gut conditions can impact the release of GLP-1. 

Proper release of hormones like GLP-1 requires the right balance of gut bacteria. Fiber is a great place to start. Getting optimal fiber feeds your healthy gut bacteria. Those bacteria ferment fiber into metabolically active compounds short-chain fatty acids (SCFAs). Studies show that SCFAs can enhance the secretion of GLP-1 from intestinal cells.12 

Every serving of Extra Fiber combines 12 types of soluble and insoluble fiber derived from fruits, vegetables, roots, seeds, and tree extracts including a prebiotic that supports the growth of friendly bacteria.* 

Get the Right Kind of Exercise 

Some research suggests that strength training can stimulate the release of GLP-1.13 Strength training can support weight loss in other ways, including making you more insulin sensitive, boosting muscle mass, improving your metabolism, and managing your appetite.  

While I love the gym for strength training, the convenience of the portable, lightweight TRX Suspension Trainer makes it ideal for traveling and those days when I don't have a lot of time to work out. 

I’m also a fan of Zone 2 steady-state training, or moderate-intensity exercise where you work out at a sustainable pace within 60-70% of your maximum heart rate. Exercising in Zone 2 primarily uses fat for fuel. One study found that for overweight women, endurance training like Zone 2 could improve sensitivity to GLP-1 and blood-sugar management.14 

My Resistance Training Cheat Sheet has everything you need to quickly get started on your fitness journey, including home gym essentials, an 8-week workout plan, and a progress tracker to track your sets, reps, and weights with each workout.   

Get Great Sleep 

Studies show that insufficient sleep can impair GLP-1 release and increase your risk of insulin resistance.15 Poor sleep can also disrupt the balance of appetite-regulating hormones such as leptin and ghrelin, which can affect GLP-1 secretion and its effects on appetite and blood sugar.16  

Optimal sleep—I’m talking eight hours of solid, uninterrupted sleep every night—can help maintain a balanced release of GLP-1, which in turn may help control appetite and prevent overeating. 

The Optimal Sleep Kit contains three supplements (Sleep Candy™, Magnesium Body Calm, and All-In-One Shake) that help you fall asleep faster, stay asleep through the night, and wake up feeling refreshed and well-rested.* 

Stress Less 

Chronic stress can lead to insulin resistance, impeding the ability of other hormones like GLP-1 to work efficiently and stalling weight loss. When your cells respond well to insulin, hormones like GLP-1 function better, too.  

Managing stress can help support gut health, which promotes the proper release of GLP-1 and its ability to regulate blood sugar.  

How you manage stress might include meditation, deep breathing, yoga, laughter, or long walks with your best friend. Find what works for you and do it regularly.  

Focus on Getting Healthy, Not Losing Weight 

Optimizing GLP-1 through diet and lifestyle factors creates a sustainable approach to health that outshines relying solely on medications like Ozempic. Even if you do choose medication, you’ll need to incorporate the right diet and lifestyle strategies to create lasting change.  

When you do go off Ozempic, you’ve got a practical framework to sustain those results. 

Ozempic shows promise for insulin sensitivity, steady blood-sugar levels, and enhanced appetite control, all of which support weight loss. But these drugs’ immediate allure of quick weight loss misses the bigger picture, including maintaining that healthy weight. That’s why I emphasize focusing on getting healthy. 

When you get healthy, weight loss often becomes a pleasant side effect. But there are so many other benefits of a protein-first meal approach and strength training, including mood support, more energy and focus, and hormone balance. I haven’t found a drug that touches anywhere near those benefits! 

My Metabolism Rescue Program is the ultimate way to optimize GLP-1 levels and create fast, lasting fat loss. This cutting-edge program features a comprehensive guide, an exclusive one-hour masterclass, and a hand-selected bundle of metabolism-supporting supplements (All-In-One Shake, Metabolic Reset™, and Collagen Peptides Powder).*  


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  8. Isaacs D, Prasad-Reddy L, Srivastava SB. Role of glucagon-like peptide 1 receptor agonists in management of obesity. Am J Health Syst Pharm. 2016 Oct 1;73(19):1493-507. doi: 10.2146/ajhp150990. Epub 2016 Aug 12. PMID: 27521241. 
  9. Wilding JPH, Batterham RL, Davies M, Van Gaal LF, Kandler K, Konakli K, Lingvay I, McGowan BM, Oral TK, Rosenstock J, Wadden TA, Wharton S, Yokote K, Kushner RF; STEP 1 Study Group. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022 Aug;24(8):1553-1564. doi: 10.1111/dom.14725. Epub 2022 May 19. PMID: 35441470; PMCID: PMC9542252. 
  10. University of North Carolina at Chapel Hill: Only 12 percent of American adults are metabolically healthy, Carolina study finds 
  11. National Heart, Blood, and Lung Institute: What Is Metabolic Syndrome? 
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  13. Ataeinosrat A, Haghighi MM, Abednatanzi H, Soltani M, Ghanbari-Niaki A, Nouri-Habashi A, Amani-Shalamzari S, Mossayebi A, Khademosharie M, Johnson KE, VanDusseldorp TA, Saeidi A, Zouhal H. Effects of Three Different Modes of Resistance Training on Appetite Hormones in Males With Obesity. Front Physiol. 2022 Feb 21;13:827335. doi: 10.3389/fphys.2022.827335. PMID: 35264977; PMCID: PMC8900747. 
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  15. Singh T, Ahmed TH, Mohamed N, Elhaj MS, Mohammed Z, Paulsingh CN, Mohamed MB, Khan S. Does Insufficient Sleep Increase the Risk of Developing Insulin Resistance: A Systematic Review. Cureus. 2022 Mar 26;14(3):e23501. doi: 10.7759/cureus.23501. PMID: 35494895; PMCID: PMC9036496. 
  16. Spiegel K, Tasali E, Penev P, Van Cauter E. Brief communication: Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med. 2004 Dec 7;141(11):846-50. doi: 10.7326/0003-4819-141-11-200412070-00008. PMID: 15583226. 

*These statements have not been evaluated by the Food & Drug Administration. Products mentioned are not intended to diagnose, treat, cure, or prevent any disease. The views in this blog by JJ Virgin should never be used as a substitute for professional medical advice. Please work with a healthcare practitioner concerning any medical problem or concern.