Should I try Ozempic?
You may have heard about the latest study that claims weight loss injections like Ozempic are a gamechanger. But do they really work? Let’s find out.

Is It Really A Gamechanger?
At first glance, the study this latest study is impressive. It is a multicenter, double-blind, randomized trial with over 17 thousand participants (all of whom have a BMI over 27 and a history of cardiovascular disease), half of whom received 2.4mg Semaglutide every week (whilst the other got a placebo).
They were followed up for around 3 years and 7% of them went on to have a heart attack, stroke, and/or fatal cardiovascular event. The actual difference between the two groups was a 1.5% reduction in risk. Because 20% of a small number is an even smaller number.
I should also mention that 17% of people in the Semaglutide group had to discontinue the drug during the trial due to side effects.
Should you start taking weight loss injections to prevent heart disease?
In the press release (that pretty much every paper quoted, because why do your research when you can just print what Novo Nordisk tell you to print) Prof John Deanfield compared Semaglutide to statins (cholesterol lowering medication) and said:
“This fantastic drug really is a gamechanger. This [study] suggests that here are potentially alternative mechanisms for that improved cardiovascular outcome with semaglutide beyond weight loss … Quite clearly, something else is going on that benefits the cardiovascular system,”
Er no John, that’s not the case at all. We give statins to people for primary prevention of heart disease – that it to say we give them to people who have never had a cardiovascular event before. This trial was only conducted on people who have.
And there were numerous limitations to this study that mean you’ve a long way to go before claiming it’s the equivalent of taking a statin. We still don’t know the long-term risks. And one measly study funded by and written by Novo Nordisk does not a game-changer make.
How Does Ozempic Work?
Not so long ago, in a secure pharmaceutical lab that wasn’t exactly in a galaxy far, far away (it was in Denmark) a weight loss drug was born. It actually started life with a very different purpose – to treat diabetes. But it turns out that this particular drug (a GLP-1 analogue) had a few tricks up its sleeve that its manufacturers soon realised they could take advantage of.
Not only does the hormone GLP-1 increase insulin levels and reduce insulin resistance, but it also reduces appetite and increases satiety (a sense of fullness). Furthermore, it delays stomach emptying, reduces gut motility, and increases stomach acid levels (remember this later when we get onto the subject of side effects).
Drugs like Ozempic work by mimicking the hormone GLP1. Within a few years, Novo Nordisk (the Danish drug manufacturer) rebranded their first GLP1 analogue (Victoza) as Saxenda, a weight loss injection. A few years after that, they rebranded their other diabetic drug Ozempic as Wegovy, an even more effective weight loss injection.
So is it Ozempic or Wegovy?
Within months, the FDA approved. And the world went crazy for it. The irony is that most people talk about Ozempic which is why I started doing it too. But Ozempic (1mg Semaglutide) is no way near as effective as Wegovy (2.4mg Semaglutide) when it comes to weight loss. We’ve known this since March 2021, but that hasn’t stopped doctors from prescribing it.
One of the main issues is that Novo Nordisk cannot manufacture Wegovy fast enough. But people are seriously jonesing for that weight loss injection that they have heard so much about, so doctors have taken it upon themselves to prescribe it anyway.
Even though Ozempic is not licensed for weight loss, doctors can prescribe as long as their patients are aware and consent to it. And this has caused a lot of confusion over the last couple of years.
Let’s clear things up once and for all.
Ozempic is primarily intended for diabetes, while Wegovy is designed for weight loss. However, depending on your location and your doctor’s awareness, some may still prescribe Ozempic for weight loss. Make sense?
Also, just when you thought things couldn’t get more complicated, let me introduce you to Mounjaro, the newcomer on the scene. He received his first FDA approval in October 2022, and we’re waiting to see how things pan out in the USA and around the globe.
He’s technically a dual GIP and GLP-1 receptor agonist called Tirzepatide and it’s not clear if things are gonna work out for him. I imagine his parents Eli Lilly are crossing all their fingers and toes.
Ps. Eli Lilly are not a Lesbian power couple; it’s the name of a pharmaceutical company. They happen to be the only other company with a weight loss injection on the market, making them Novo Nordisk’s main competition.
Will Ozempic Help You Lose Weight?
The STEP 1 study (Semaglutide Treatment Effect in People with Ob*sity) took nearly two thousand non-diabetic folks from around the world, and randomly sorted them into either Team Treatment or Team Placebo. All of the participants engaged in a 500-calorie deficit per day, 150 minutes of weekly physical activity, and monthly counselling sessions with a “weight management professional.”
Try to imagine the recruitment speech for a second:
Doctor: “Hey there, want to join our weight loss medication trial?”
Patient: “Sure, what’s involved?”
Doctor: “First, you’ll need to commit to a 500-calorie deficit diet for a year, exercise for at least 150 minutes a week, and attend monthly check-ins to make sure you’re sticking to the plan.”
Patient: “So, basically, a diet?”
Doctor: “Well, yeah, but you’ll also get to inject yourself with a drug that curbs your appetite and slows down stomach emptying. Unless, of course, you’re in the placebo group, in which case you’ll be injecting yourself with water once a week for a year.”
Patient: “And what are my odds of landing in the placebo group?”
Doctor: “50-50.”
Patient: “Any side effects?”
Doctor: “No idea. That’s the beauty of a drug trial – you’ll be our guinea pig.”
Patient: “Alright. Will it help my blood pressure? That’s why I came here.”
Doctor: “We’re mainly interested in your weight, but sure, we’ll measure your blood pressure and other stuff. You know, for research purposes. Can’t guarantee we’re going to do anything with that information though. That’s not why we’re here.”
Patient: “And what happens when the trial ends?”
Doctor: “Nothing much, it just ends, and you’re on your own.”
Patient: “So, in summary, I have to diet for a year, jab myself with an unknown drug (if I’m lucky enough to get it), endure a bunch of irrelevant tests, and once it’s all over, I’m left to fend for myself?”
Doctor: “Yep, pretty much.”
Patient: “Fantastic! Where do I sign up?”
OK, I admit I wasn’t a fly on the wall for these conversations, so I can only imagine how they went down. But here’s the deal – did it work? Is this drug really the success story we’ve been led to believe it is?
Success depends on your definition
In a nutshell, the treatment group participants lost 14.9% of their body weight compared to the placebo group, who only managed a 2.4% reduction. Before we go on, remember that the placebo group are on a calorie-controlled diet, exercising regularly and checking in once a month with a weight management counsellor.
It’s almost as if diets don’t work!
(I can hear your eye rolls from way over here.)
Anyway, the treatment group started shedding pounds right out of the gate, even before they reached the maximum dose at week 16. They reached their peak around week 60, and by week 61, participants began regaining – a slow but steady climb that continued until the trial ended eight weeks later.
Based on the STEP 1 trial, people everywhere hailed Wegovy as a miracle weight loss drug. The FDA was the first to approve it, and since then countries around the world have adopted a similar approach. All you have to do is take it for a year, and then make sure to maintain that weight loss with lifestyle interventions afterwards, right?
Wrong. When it comes to these medications, there’s no such thing as maintenance. The STEP 4 trial kind of shattered that illusion.
The maintenance myth
In the STEP 4 study, everyone took Wegovy for the first 20 weeks – 16 weeks of dose escalation and a four-week maintenance (in addition to the lifestyle measures we saw in STEP 1).
But here’s the twist – at week 20, half of the group switched over to Placebo, and the other half stayed on Wegovy. And guess what?
It didn’t matter that the placebo group maintained their calorie deficit and exercised – without Wegovy, they not only started regaining weight immediately, but they did it at a pace that would make your head spin.
And that’s a real problem because it puts the body under a lot of stress.
So I’m stuck on them for life?
The solution here is simple. People just need to remain on this drug for longer periods of time. Maybe even for life. What’s the big deal? People stay on cholesterol-lowering drugs (statins) and blood pressure medications for life, don’t they? How is this any different?
Well, let’s check out the STEP 5 trial, which was similar to STEP 1 but with a significantly smaller cohort, and this time it ran for two years instead of one.
In their conclusion, the authors claim that this trial showed “a substantial initial reduction in weight, which plateaued after approximately week 60 and was maintained for the remainder of the study”.
Which is technically true. Except when you look at the actual data, it appears to have peaked at week 68 and then crept up a little until week 104. And it also depends if you use the figure that disregards treatment discontinuation and rescue intervention. Suffice it to say, the data is far from conclusive.
Also, what happens after week 104 remains a mystery. We do know, however, that lots of folks who initially lost weight on Ozempic for their diabetes claim they gained it all back within a few years. So I guess we’ll just have to wait and see.
Can I Trust The Experts?
Surely any weight loss is a good thing, right?
Some of you might be thinking, who cares whether I maintain all of the weight loss or not. Surely something is better than nothing, right?
That’s up to you decide, but I just want to point out a few facts:
Firstly, there’s zero solid evidence of health benefits from Ozempic or Wegovy injections (beyond treating diabetes, of course), or from any form of long-term weight loss for that matter.
Secondly, you need to weight the benefits against the cost. Short-term side effects are very common and include nausea, vomiting, headaches, abdominal pain, and changes in bowel habits.
Rarer but more serious side effects include acute pancreatitis and a form of thyroid cancer.
Then there’s the psychological impacts of weight loss, which include low mood, poor concentration, food obsessions, disordered eating, and even thoughts of suicide. Whilst these weren’t discussed at length in the STEP trials, we know this to be the case from other studies.
Long term implications
The use of drugs to induce weight loss is considered a form of severe dieting, which is known to increase the risk of eating disorders up to 18-fold. When you’re Fat, your doctors often refuse to look beyond the exterior and recognize the glaring red flags because they’re too busy handing out gold stars for any weight loss they see and cheerleading for even more starvation.
So instead of managing or preventing eating disorders in Fat people, one might argue that doctors encourage or even prescribe them.
Finally, what about the long-term physiological risks of these medications? We’re talking about meddling with a perfectly healthy pancreas and the intricate insulin pathways within your body.
Could this interference lead to long-term damage and potentially accelerate the road to insulin resistance by prematurely exhausting the pancreas? And while we’re at it, how about the risk of pancreatic cancer?
These are all valid questions that we won’t have satisfying answers to for at least the next two decades because the data just isn’t there.
Follow the money
Whether you’re for or against weight loss injections, you cannot deny the worrying conflicts of interest when it comes to how these drugs are being marketed and prescribed.
Just look at the Ob*sity Action Coalition (OAC), an organization supposedly “dedicated to giving a voice to those affected by ob*sity and helping them on their path to better health through education, advocacy, and support.”
Novo Nordisk has been a platinum corporate sponsor for the OAC, donating a minimum of $500,000 annually since 2013. And the OAC are absolutely everywhere. If you want to find out how they are using this money, check out their policy platform.
Allow me to summarise:
Ob*sity is an epidemic that MUST be addressed.
- It’s a complex, multifactorial, chronic disease (blah blah blah)
- Weight loss is “difficult but necessary” and since diets don’t work, consider drugs or surgery.
- “Health insurance should provide care for ob*sity as a standard benefit” (convenient)
- “Companies should provide comprehensive ob*sity prevention and treatment programs for their employees and employ incentive programs where possible.”
- “Government should take the same serious action” and spend money on research and treatment programs.
- “Individuals need to be encouraged to discuss their weight and its impact on their health with their healthcare providers”
- Through “increased messaging” Fat people need to eat less and exercise more
There’s More
In addition, Novo Nordisk has spent a small fortune on marketing their drugs to the general public AND to the healthcare professionals who prescribe them. Many of their practices have been unethical, and at times illegal.
Should Wegovy be the success that experts are claiming it will be, Novo Nordisk will be worth $430 billion. That’s significantly more than the country of Denmark’s GDP.
We’ve seen what happens when drug companies are allowed to make decisions that prioritise profits over patients. You don’t have to look back far to find similar marketing practices – just check out the history of Purdue and Oxycontin.
In Conclusion
people who take Wegovy lose quite a bit of weight in the first year. We don’t really know what happens beyond two years (which is usually when we start to see significant weight gain). We have no idea how much harm this medication has the potential to cause, and so far there’s no evidence whatsoever that it improves health.
Also, the world has gone crazy for Ozempic even though it’s not a licensed weight loss drug, is far less effective than Wegovy, and is actually needed for the treatment of diabetics.
Whether you chose to try Ozempic or not, I strongly recommend you join this masterclass first.