Take Ozempic? Here are the side effects you need to be aware of

The weight-loss drug Ozempic exploded into public consciousness last year, and a social media-fueled desire for the drug has led to shortages for patients with type 2 diabetes.

Now, people are increasingly recognizing the drug’s side effects, which can include loose skin, known as the «Ozempic face.»

«Any rapid weight loss will reduce the volume of fat in many parts of the body, especially the face, leading to sagging tissue and skin,» said Dr. Lyle Leipziger, chief of plastic surgery at North Shore University Hospital and the Long Island Jewish Medical Center. . «Slow, gradual weight loss can allow for facial skin retraction, so it’s not as damaging as rapid weight loss.»

Recent articles in People and the New York Times note that the unwanted side effect can be corrected, but often with expensive fillers and cosmetic surgery.

«The goal of weight loss is to improve health,» said Dr. Vadim Sherman, medical director of bariatric and metabolic surgery at Houston Methodist Hospital. «You can reduce fat and weight, but the consequence is that the skin is already stretched.»

This is perhaps the most visible effect, but it is not the only one, and it is certainly not the most serious potential consequence. People taking the drug may experience problems such as vomiting and pancreatitis, although side effects are generally rare.

Most side effects have been documented in clinical trials of people taking the drug for an approved purpose, said Dr. Latasha Seliby Perkins, a family physician in Washington, DC, and a member of the American Academy of Family Physicians. We don’t necessarily know what happens to those who take these drugs because they want to lose some weight, which is not one of its FDA-approved uses.

Ozempic (a brand name for semaglutide) was originally approved in 2017 to lower blood sugar in people with type 2 diabetes. But clinical trials soon revealed a helpful side effect: weight loss. This is especially important for people with type 2 diabetes, many of whom are medically considered overweight or obese.

So in 2021, the Food and Drug Administration granted another approval, this time for weight loss, but only in people with a body mass index of 27 or higher with at least one related health condition and those with a BMI of 30 or more. The drug’s trade name was changed to Wegovy and higher maximum doses were approved.

Wegovy and Ozempic both belong to a class of drugs known as GLP-1 agonists, which work in several ways, including suppressing GLP-1 receptors in your brain to reduce your appetite. GLP stands for glucagon-like peptide-1, which is a hormone involved in blood sugar control. Other GLP-1 agonists include Rybelsus (semaglutide), Saxenda (liraglutide), and Mounjaro (tirzepatide).

Drug shortages for people who really need them

The weight loss associated with Ozempic and related drugs has made them attractive to people who do not have type 2 diabetes or who do not meet other FDA criteria for using the drug. This has created a shortage for the people who need it most and should be taking it: people with type 2 diabetes.

«When a drug contains a weight loss component, it is beneficial for people with type 2 diabetes,» Perkins said. Not necessarily for others.

In the longer term, not having this drug could lead to kidney, heart, and eye disease and even death for people with type 2 diabetes, although there are other drugs on the market that can be used to help lower blood sugar. «Diabetes can really affect people’s lives,» Perkins said.

Recently, the comedian Chelsea manager said she didn’t even know the drug she was taking to lose 5 pounds was Ozempic. (She stopped using it when she realized she was not a candidate for the drug.)

This raises an important point: you need to know what medications you’re taking and read their package inserts, said Dr. Kelly Johnson-Arbor, medical toxicologist and acting executive director of the National Capital Poison Control Center.

For those who find the many creases and fine print intimidating, take heart. You really only need to scan the beginning, Johnson-Arbor said.

«The front page is usually a good place for a general overview,» she said. At the very top is a box with all the important health warnings (like cancer) and then further on warnings and adverse effects.

Here are some of the side effects of Ozempic and drugs in the same class.

Nausea, vomiting, diarrhea, abdominal pain

Gastrointestinal symptoms are among the most common side effects of GLP-1 agonists, Johnson-Arbor said. This is not surprising considering that Ozempic, Wegovy and other similar drugs act on various aspects of the digestive system. «Your digestive tract is a little more sensitive to this drug,» Perkins said.

In clinical trials, nausea occurred in 20% of people taking a 1 mg dose of Ozempic, 16% of people taking a 0.5 mg dose, and 6% of people taking a placebo. Vomiting and diarrhea were less common, but still occurred in about 9% of people taking the 1mg dose, compared with 2% taking a placebo.

Diarrhea and vomiting can cause another side effect: dehydration. «When you vomit, your body has to use some of its water source to flush out food,» Perkins explained. «The same with diarrhea.»

Often these effects are mild, but they can cause people to stop taking the drug, Sherman said. The best measure of your hydration level is your urine output – you should go to the bathroom once every hour or two. If it slows down every three or four hours, call your doctor’s office for advice. Less common than that is visiting urgent care or an emergency room, Perkins said. And always stay hydrated.

For people receiving the 1 mg dose, 6% reported abdominal pain and 3% reported constipation.

Kidney damage

Sometimes dehydration from vomiting and nausea is so severe that it can lead to kidney damage, Johnson-Arbor said. A patient taking Ozempic need for temporary dialysis after increasing his dose of medication. Renal function declined in two additional people taking Ozempic, although both had underlying kidney disease due to long-standing diabetes, as did two others who were taking GLP-1 agonists.

«The kidneys do the job of filtering urine and taking in the things you need to [the] body,” Perkins explained. «You need water to flush the kidneys. If you don’t have enough water, it starts to cause damage.

Experts advise people with existing kidney disease to be cautious when using GLP-1 agonists. If you are taking any of these medications and experience nausea, vomiting, and other severe and persistent gastrointestinal side effects, seek medical attention. «It’s a good idea to have labs to see if anything else is going on,» Johnson-Arbor said.

An accelerated heart rate can be another consequence of dehydration, Perkins said.


Several acute cases pancreatitis have been reported in people taking GLP-1 agonists. Pancreatitis is an inflammation of the pancreas, the main gland involved in the production of insulin. Symptoms include nausea and vomiting, fever, rapid heart rate, and a distended and painful belly, as well as yellow skin and eyes.

«If you have a history of pancreatitis, you may want to exercise caution when considering Ozempic, although it has also happened in people without a history,» Johnson-Arbor said.

Possible risk of thyroid cancer

The researchers also observed a type of thyroid cancer called medullary thyroid carcinoma, but only in rodents given the drug. While it could be a risk in humans. The first GLP-1 agonist was only approved 20 years ago, so we don’t have much data on long-term side effects, Johnson-Arbor said.

«People should be aware that this is a rare cancer that could take years to develop,» she continued. «Do not take these drugs if you have a history of thyroid disease.» It’s also possible that this cancer is unique to rodents, which have high numbers of GLP-1 agonists in their thyroids, she added.

Signs of thyroid tumors can be a lump in the throat, difficulty swallowing, a hoarse voice, or shortness of breath.


According to Johnson-Arbor, gastroparesis «is also called delayed gastric emptying.» She explained that it is a disorder that slows or stops the movement of food from your stomach to your small intestine even if there is no blockage in the stomach or intestines.

While it can also make you feel full, it’s more likely to cause nausea and vomiting, Sherman said, adding that it appears gastroparesis and other gastrointestinal effects go away after you stop taking it. of the drug.

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