Semaglutide: Miracle Drug or Cause for Concern?
Today, I’m going a bit off-topic from my usual low-tox living posts to talk about something that’s been causing quite a stir in recent years—Ozempic, also known as Semaglutide. It's been all over the media, particularly with celebrities touting it as a "miracle" drug for weight loss. In fact, it’s almost being presented as the only drug that actually helps you lose weight. Sounds like a miracle, right? Let’s break it down.
What Is Ozempic (Semaglutide)?
At its core, Ozempic was originally designed as a medication for Type 2 Diabetes (T2DM). It helps improve blood sugar levels and reduce the risk of major cardiovascular events. In Australia, Ozempic is approved for diabetes management, but it hasn’t been approved for weight loss yet (though the higher-dose version, Wegovy, has been, but isn’t available here yet).
So, while it seems to work wonders in terms of weight loss for diabetics, we’re now seeing an influx of people—particularly those without diabetes—jumping on it purely for weight loss. And sure, it can help you lose weight, but at what cost? Let’s dive into that.
How Does Semaglutide Work?
Semaglutide works by mimicking a hormone in your body called GLP-1. This hormone helps regulate both insulin secretion and appetite. Essentially, it tells your body to produce more insulin when blood sugar levels are high and slows down the emptying of your stomach to make you feel fuller for longer. It also suppresses hunger signals in the brain. For someone with diabetes, this can be a life-changer. For someone just trying to shed a few kilos—well, it’s not so simple.
Does It Actually Work for Weight Loss?
Yes, it works—but you should be asking yourself, at what cost? Studies show that people who take semaglutide do indeed lose weight—significantly more than those on a placebo. A 2021 study in the UK found that those using semaglutide lost an average of 14.9% of their body weight compared to just 2.4% for those on the placebo. That's impressive, sure. But here’s where the story gets murky: this weight loss is often rapid and comes with many potential health risks.
The Problem with Quick Fixes
Here’s the thing—rapid weight loss doesn’t just affect the fat on your body. It impacts muscle mass, skin elasticity, and overall body function. With all that weight melting off quickly, your skin can lose its elasticity, leading to sagging in the face and neck. Not exactly the "glow-up" people are hoping for. And let’s not forget about the impact on muscle mass—the faster you lose weight, the more likely you are to lose muscle too, which isn’t great for your long-term health.
The Negative Effects: More Than Just Nausea
Let’s talk about the serious side effects, because these need to be at the forefront of this conversation.
Common, Yet Unpleasant Side Effects
Semaglutide isn’t a walk in the park for everyone. According to the New England Journal of Medicine Up to 74.2% of people taking Semaglutide in a clinical trial reported gastrointestinal issues. Some of the other more common side effects can include:
Nausea and vomiting
Diarrhoea and constipation
Fatigue
Now, most of these are pretty standard for many medications. But, in a U.S. clinical trial, about 3% of people had to stop taking the drug because they couldn’t handle these side effects. Another 8% had to either reduce their dose or stick with the same dose but just to avoid these symptoms.
The Severe, Risks
Now, here’s where things get a bit more scary. There is a lot of conflicting information and studies but some of the severe adverse effects reported in various studies include:
Gallbladder issues like gallstones
Pancreatitis (inflammation of the pancreas).
Thyroid cancer—A connection between Semaglutide and medullary thyroid cancer (a rare and aggressive form of cancer) has been flagged in some studies. This is a huge red flag that people need to be aware of, especially considering thyroid issues are not typically on the radar for those using this drug. An article by John Hopkins University stated that the risk increases the longer you are on the medication and is around 50% higher than someone not on the medication.
Gastroparesis or stomach paralysis—this is where your stomach stops functioning correctly, causing nausea, bloating, and vomiting. For some, this can become a chronic condition.
And the list goes on:
Vision problems—a rare but concerning condition called NAION (non-arteritic anterior ischemic optic neuropathy), which can lead to irreversible blindness, has been linked to semaglutide. According to a study by the Jama Network, the rate of individuals who developed NAION from Ozempic was 8.9%, compared to 1.8% for the general population.
Blood clots—A study published in Endocrine Journal, Comprehensive analysis of the safety of semaglutide in type 2 diabetes: a meta-analysis of the SUSTAIN and PIONEER trials, linked Ozempic to blood clots, including pulmonary embolism and deep vein thrombosis (DVT) both of which are extremely serious conditions. Individuals using Ozempic demonstrated a 266% increased risk of DVT.
Heart problems—I also found it interesting that while Semaglutide is marketed as reducing the risk of major cardiovascular events, a study from Amsterdam University Medical Center found that it actually increased heart rate. Although this increase wasn’t linked to major cardiac events, it’s still concerning—especially since a mere 5 bpm increase in heart rate has been associated with a 17% higher risk of mortality.
Muscle loss—losing muscle mass as you lose weight can lead to long-term physical problems like sarcopenia (muscle wasting), making it harder to maintain strength and mobility.
Bone Mineral Density—A recent study published in JAMA Network Open has raised red flags about the impact of GLP-1 receptor agonists, like Ozempic (semaglutide), on bone mineral density. The study suggests they may cause a reduction in bone density, especially in the hip and spine. This could potentially increase the risk of fractures for those using the drug long-term.
The Mental Health Impact
Let’s not forget about the psychological toll this drug can take. In fact, one 2024 European study found 481 psychiatric events between 2021 and 2023, with half of these being depression. Now, I don’t know about you, but that’s concerning. We’re talking about people’s mental wellbeing being significantly impacted for the sake of weight loss.
The Issue of Long-Term Safety
One of the biggest problems with Ozempic and semaglutide is that we just don’t have enough data on the long-term effects. This drug has only been available since 2017. So there are serious concerns about what will happen when people are on this medication for years. We don’t know enough yet about its potential to cause chronic conditions like cancer, heart disease, or severe digestive issues.
What’s Missing: Lifestyle Changes
It’s also worth noting that many people turning to Ozempic aren’t addressing the root causes of their weight problems. There’s very little emphasis on the fact that lifestyle changes—like improving diet and getting regular exercise—are often the more sustainable way to lose weight and manage health long-term. Yet, we’re all running to medication as a quick fix. Now we all know that if you eat healthy and exercise you should lose weight, however are we being told to eat the wrong things? I delve more into this in my other articles that talk about fat being the enemy where in fact good fats can actually help you lose weight.
I was listening to a podcast yesterday with Dr John Abramson, and he spoke about a study involving Metformin, a medication prescribed for type 2 diabetes. This study is one of the few that compared three groups: one taking the drug, one with a placebo, and one focused on lifestyle changes. The results showed that 31% fewer people developed diabetes when treated with Metformin, compared to the placebo group. However, the lifestyle group had even better results—58% fewer people developed diabetes than the placebo, and those who made lifestyle changes were able to maintain their benefits and weight loss for over 10 years. This clearly shows that changing lifestyle factors doubled the chance of reducing the risk of diabetes.
It’s frustrating to think about the focus being on quick fixes like drugs, while prevention—such as education around nutrition and exercise—is barely studied.
The Uncomfortable Truth About Pharmaceutical Research
Here’s another issue: 86% of medical research is funded by pharmaceutical companies. The vast majority of studies on medications like Semaglutide are funded by the pharmaceutical companies that make them. In many of the studies I read, it would state in the ‘conflict of interest’ paragraph that the study was funded and/or supported by Novo Nordisk, the makers of Ozempic. This raises the question: are we seeing the full picture? Is it ethical that most of the studies we see on the effects of drugs we might take are funded by those who make it?
96% of medical research is done on drugs and devices, while only 4% is focused on prevention. Should we not be putting more money, time and research into things that are more readily available, far cheaper and with less side effects for us? The focus seems to be on selling drugs, not promoting long-term health through lifestyle changes. It makes you wonder how much bias exists in studies that directly benefit the companies funding them.
So, Is It Worth It?
Look, Semaglutide can definitely help you lose weight. But is it worth it? From everything we know about these medicines suggests it may be hard to stop them without gaining back the weight. Not to mention again the adverse effects that is hard to determine how common they are or what the long-term risks will be. Keep in mind Semaglutide is a very young drug that only was released in 2017 so it is hard for the potential chronic illness related to this drug to have been studied well enough.
In my opinion, we need to start asking some tough questions. Shouldn’t we be addressing underlying issues before jumping to medication? And what about focusing more on sustainable, long-term solutions through diet, exercise, and mental health support?
Many people lack proper education about the food they eat and how to move their bodies for optimal health. A lot of the so-called "healthy" or "low-fat" foods marketed for weight loss can actually cause weight gain due to hidden additives and sugars. What’s needed is more education on proper diet and exercise, along with a focus on addressing the underlying causes of weight gain. This approach would be far more effective in the long run.
Ultimately, this isn’t just about taking a medication and expecting results. True health comes from balance—sustainable habits, not quick fixes. And before anyone jumps on the Semaglutide bandwagon, do your own research and decide whether the benefits outweigh the risks.