'I Find Myself Asking…Is It Worth It?': TikTok's Weight Loss Drug Ozempic

Gone are the days of green juice and lemon water: TikTok has a new weight loss craze. Instead of round-the-clock willpower and self-control, this fat-melting "miracle" suppresses your cravings and reframes the way you think about food.

People cannot get enough of this "wonder drug." The hashtag has amassed over 260 million views on TikTok, and it has been endorsed widely by celebrities and influencers alike. But is it safe?

How Does Ozempic Work?

Ozempic is an injectable prescription drug that is used to manage blood sugar levels in patients with Type 2 diabetes. It is based on a naturally occurring human hormone called glucagon-like peptide 1 (GLP-1), which plays an important role in regulating appetite and blood sugar levels.

The active ingredient in Ozempic is a molecule called semaglutide, which acts as a GLP-1 agonist. In other words, it mimics the structure of GLP-1 and activates its receptors.

"GLP-1 receptor agonists induce satiety and delay gastric emptying," Dr. Andres Acosta, founder of Phenomix Sciences and an assistant professor of medicine at the Mayo Clinic, told Newsweek. "Both are essential to decrease food intake. Basically, they make you eat less."

Studies have shown that people with obesity are often less sensitive to the hormones that make us feel full. But by slowing gastric emptying, drugs like Ozempic can restore feelings of fullness in these patients.

Ozempic Side Effects

Nurse Emma, a TikTok influencer who has been using Ozempic for three months, has lost over 10 pounds since September. "For the first time—it feels in my life—I know what full feels like," she said. "I can look at the plate in front of me and know my needs have been met. It's freeing."

Megan O'Lena, who created a TikTok account in July to document her Ozempic journey, said she was surprised by how effective the drug was.

"I knew it would reduce my appetite and help me balance my blood sugar and hormones," she said. "I did not realize how much it would help reduce my cravings and drive to binge. I actually almost have a coffee aversion right now, and I'm a coffee fanatic."

Before starting on Ozempic, O'Lena said, she had tried everything short of surgery. "I've used multiple apps to track calories and macros. I've eaten Atkins, paleo, Whole30, keto, intermittent fasting.... I've done yoga and Pilates. I've trained for and run a 10K, I've lifted heavy. I even got a minor in human nutrition as a part of my undergrad," she said.

From July to October, O'Lena lost 25 pounds.

Madison Peoples had a similar experience. "It's been the only thing to successfully help me lose the weight," she said.

However, like most medications, Ozempic has its downsides.

"The side effects I have been experiencing have not been very pleasant," Emma said. "During the first 24 to 48 hours after an injection, I tend to have the worst symptoms. I have gastric irritation. The best way to describe it is similar to gastroenteritis. I experience visceral pain, hyperactive bowels and diarrhea. I also experience terrible acid reflux and uncontrollable burping.... It's truly embarrassing."

Emma said her symptoms got worse with each dose increase. "It has started to impact my life and my work. There have been nights where I have been kept awake running back and forth to the bathroom, applying warm compress and pressure to my abdomen in hopes for relief. Some days it's near impossible to drink water. It's just not something my body can get down.

"Working out has been on the back burner, as my symptoms impede on my ability to confidently perform physical activity. I find myself asking the question: Is it worth it?" Emma said.

Acosta said that these symptoms were not uncommon.

"Their most common side effects are nausea, vomiting and diarrhea," he said. "Less common side effects are risk for hypoglycemia in patients with diabetes taking other medications for diabetes. Additionally, patients with personal or family history of medullary thyroid cancer, or a rare condition called multiple endocrine neoplasia 2, should not take these medications."

Not everyone experiences these symptoms, and TikToker Jazmyn Lin reported having "zero side effects."

Ozempic was approved by the Food and Drug Administration in 2017 for medical use in the treatment of diabetes, but it has not yet been approved for weight loss. However, its sister drug, Wegovy, has.

Wegovy vs. Ozempic

"Both Ozempic and Wegovy are brand names for different doses of the injectable GLP-1 receptor agonist semaglutide," said Dr. Rita Kalyani, an associate professor of medicine, Division of Endocrinology, Diabetes, and Metabolism, at Johns Hopkins University.

The main difference is dosage. "Ozempic is available at semaglutide doses of 0.5 milligram and 1 milligram weekly and is FDA-approved to improve glycemic control in people with Type 2 diabetes," Kalyani said. "Wegovy is high-dose semaglutide, 2.4 milligrams weekly, and is approved for chronic weight management in persons who are obese or overweight, with or without diabetes."

In 2021, the FDA approved Wegovy for weight management. "In the clinical trials, the primary outcome for high-dose semaglutide—brand name Wegovy—was weight loss in people with or without diabetes," Kalyani said.

"In contrast, the primary outcome in clinical trials for semaglutide doses of 0.5 and 1 milligram weekly—brand name Ozempic—was reduction in hemoglobin A1C [blood sugar] among people with Type 2 diabetes," she said.

In other words, the most significant outcome from trials with Wegovy was weight loss, while the most significant outcome for Ozempic was control of blood sugar.

The clinical trials cited by the FDA involved 1,961 overweight or obese adults receiving once-weekly injections of Wegovy over 68 weeks, during which they lost 15 percent of their body weight.

"Both Ozempic and Wegovy represent different doses of semaglutide," Kalyani said. "Greater degrees of weight loss are seen with Wegovy. However, it is important to note that side effects are also more common with higher doses and occurred in more individuals who took Wegovy versus Ozempic in clinical trials."

Naomi Owens said that she was on Wegovy for just two months. Within that time, she lost 30 pounds. "My doctor discussed the side effects with me before I started," she said. "I had diarrhea the first week, and after that I had nothing.

"The best thing about the medication is only having to take it once a week, and it worked without me being hyperaware of the medication. No jitters or trouble sleeping. I just felt normal, with a decreased appetite," she said.

Wegovy has its proponents, perhaps most notably Elon Musk: #Ozempic has nearly 175 million more views on TikTok than #Wegovy did. This popularity is largely due to cost: Without insurance, a 28-day supply of Wegovy costs $1,350, compared with $892 for Ozempic.

But while Ozempic is still effective for weight loss, the demand for it has now outstripped the supply, and people with Type 2 diabetes are struggling to access this life-saving medication.

The FDA has listed both Ozempic and Wegovy as being in short supply, and for many patients, switching to a new drug may not be totally straightforward. For example, alternative drugs may not be covered on the patient's insurance plan.

The price tag also stops Wegovy from being a long-term option for most users. Therefore, healthy lifestyle habits and calorie control are also important for achieving and maintaining a healthy weight.

Weight loss drugs are continually evolving and represent an effective weight loss intervention for many people. But they are not a magic bullet, and the drugs are not a good fit for everyone.

"It's an amazing option for those struggling with obesity," Emma said. "If it ends up not being right for you, there is nothing forcing you to keep going. There is more to life than your waistband."