We couldn’t really avoid this one, could we? It seems like everyone’s still talking about it in our orbit, and there continue to be intense opinions and claims in the media and (likely) amongst people you know. Today we wanted to share a high-level breakdown of the pros and cons and offer our (non-judgemental, but straight forward) professional view.

We admittedly went a little deep on this one for those who want the full scoop - feel free to skip to the bottom line at the end for key takeaways.

*note: as always, this is our professional opinion and not medical advice and we always recommend discussing any questions with your doctor.

What is Ozempic?

Ozempic is the brand name for the drug semaglutide. It’s an injectable medication that was first approved by the FDA in late 2017 for the treatment of Type 2 Diabetes (its original/intended use). Once people started to catch on to Ozempic’s weight loss side effects, another, higher dose version of semaglutide (Wegovy) was approved for the treatment of obesity in 2021.

In the wake of all of this, a number of doctors started prescribing off-label use for weight loss (aka not just for obese individuals, but for anyone looking to lose some weight), and from there it’s kind of spiraled. It’s now everywhere - not just all over Hollywood (tons of celebrities have been public about their use), but seemingly being prescribed across the country to anyone who can afford it off label (it's super $$$).

How does Ozempic work / what does it do?

Ozempic (semaglutide) is a glucagon-like peptide-1 (GLP-1) agonist. It mimics the action of the hormone GLP-1 which is produced in the body (specifically released from the gut).

GLP-1 works by delaying gastric emptying, increasing insulin secretion and decreasing glucagon release (the hormone that increases blood glucose), thereby lowering blood sugar. Individuals taking GLP-1 agonists improve their glycemic control (which is expected giving the hormone's blood glucose lowering effect), but doctors also found that individuals were losing weight, which is something that is not yet fully understood from a mechanism perspective.

It is hypothesized weight loss from Ozempic is likely a result of two mechanisms:

The delayed gastric emptying, which causes people to feel fuller longer.
A central regulatory effect -Ozempic acts on the brain to reduce appetite, causing people to eat less and lose weight.

Should anyone use Ozempic?

For those who meet the criteria for its intended use (Type-2 Diabetes and/or obese), this drug can be an absolute game-changer, with profound benefits that can outweigh the potential risks/downsides.

But what about everyone else? For anyone curious about off-label use - in other words, people who are 1) not diabetic and/or 2) using it for weight loss, but don’t meet the obese criteria - it’s worth noting that this would-be miracle drug does have some risks and downsides to consider.

The downsides of Ozempic

We want to be clear that we have zero judgment about anyone using this for off-label weight loss. Has its use gotten a bit out of control? Absolutely. But there’s a spectrum too, right? We have clients who don’t necessarily meet the obese criteria, but have struggled with weight loss for their entire lives and have found that Ozempic, in conjunction with nutrition counseling for lifestyle modifications, has been the missing piece to a lifelong struggle.

But let’s be clear: there are some big time risks and issues with this drug that make us question its use for people looking to lose smaller amounts of weight without making lifestyle changes:

Rebound weight gain - one of the biggest issues with this drug is rebound weight gain. Ozempic may help you lose weight quickly, but what happens when you stop the drug? We’re seeing many people gain all the weight back (and then some) because of a) how rapid weight loss alters your metabolism and b) how it suppresses appetite in the short term but of course, doesn’t provide the tools and strategies to maintain a healthy weight once your hunger is restored. This is why we highly recommend working with an RD if you decide to take this drug (both for on and off-label use).
Lean muscle loss vs. fat loss - many doctors are seeing a negative effect on body composition. Specifically, people who lose weight on Ozempic are not only losing body fat, but more so, lean muscle mass (which is very concerning from a health and metabolic standpoint). One physician we spoke to hypothesized that this effect is even more pervasive in patients who have less weight to lose (i.e. individuals going on this medication to lose 10 lbs). In other words, it might be that the lower your starting weight, the (seemingly) more susceptible you are to losing muscle.
Short-term side effects noted - many people have reported a range of GI side effects (nausea, vomiting, indigestion, abdominal pain, diarrhea and constipation). Additionally people have reported things like hair loss, nasal irritation and headaches along with what’s now being called Ozempic face.
Safety? No long-term studies - this is a new drug, so it’s unclear whether there are long term side effects that we have yet to learn about. Researchers and practitioners are already observing potential links to less common, but serious side effects such as pancreatitis, hypoglycemia, kidney issues, gallbladder problems, thyroid tumors and/or cancer.
Suboptimal nutrition - because Ozempic decreases appetite, many people are eating super low calorie diets (and what they do eat tends to lack nutritional value), which has many worried about the overall quality of the diet.

The bottom line

If you’re not technically overweight or obese and just looking to shed a few pounds, the side effects, potential risks and likelihood of rebound weight gain could outweigh the benefits of rapid weight loss.

Here’s what concerns us most:

not enough info on long term use / side effects
apparent muscle loss / lean mass loss
individuals on this drug are often unable to maintain weight loss, and often have rebound weight gain after stopping the medication (begging the question, do you have to stay on this drug forever to maintain results?)
And that individuals’ nutritional status may suffer while taking this drug

If you’re a good candidate for this drug (diabetes, significant amount of weight to lose, or something else), it may be a good option when paired with the right lifestyle shifts for optimal health and to maintain weight loss if you stop the drug.

A few more things

Where we share all the things we’re loving, reading, listening to, cooking, discussing and purchasing as of late.

Merrill: I love this article on redefining self care in parenthood, written by my incredible therapist, Erica Clark. As someone who has historically prioritized self care, shifting how I think about it as a new mom has been an ongoing work in progress. We all, of course, know how important it is to “put our oxygen mask on first,” but what does that look like when we no longer have time, ability or perhaps interest in the old things that used to lift us up? There are so many helpful nuggets in here - short and sweet.
We both live in sunshine states so daily sunscreen is a must. We’d be lying if we said we didn’t hate the feeling or the inevitable clogged pores, and we may forever be in search of our holy grail, but we currently rotate between using these three on our faces and highly recommend: Supergoop! Mineral Sheerscreen, EltaMD UV Clear , IsClinical Extreme Protect
When it comes to the little ones, we always opt for mineral sunscreen. These are our two favorites: Thinkbaby Baby Sunscreen and Blue Lizard Baby Mineral Sunscreen.
For most of us, meeting our daily hydration needs is an EFFORT. We’ve tried a lot of cups but these remain our absolute favorite. They’re dishwasher safe, but also easy to clean by hand and for reasons we can’t explain make drinking water so easy. Not technically the most ideal for on-the-go since they’re not entirely spill proof, but we still manage to bring them with us almost everywhere.
What’s cuter than babies in bucket hats? These ones seem to be the only ones that our boys didn’t want to automatically rip off. We love them because they easily adjust in 2 places (head and chin strap) and although they aren’t 100% rip off proof, they seem to be the most tolerated.
It’s officially beach read season! Some all-time favorites: Hotel Nantucket, 28 Summers and Happy Place from the beach read queens Elin Hilderbrand and Emily Henry.
BBQ chicken is a summer staple but we haven’t quite nailed it on the grill. This is our secret to perfect BBQ chicken…do it in the oven! This recipe is perfect and easy. We love using Primal Kitchen bbq sauce since it's much lower in sugar than most brands. We also love this one - a bit higher in sugar but a real crowd pleaser.
We learned about this 4-wick candle from Merrill’s mom and sister who are interior designers and wow we’re obsessed. It’s a major splurge, but it lasts forever and we’ve both made a ritual of burning after we put our boys to sleep to unwind. It feels totally indulgent and special and self-care-esque. Also the scent is incredible - it reminds us of summer and is just so calming.