Ozempic for weight loss, also known generically as semaglutide or it’s other brand name, Wegovy (when I say Ozempic from this point on, I’m also referring to Wegovy and semaglutide).
Last time, we looked at the STEP-3 trial, which assessed Ozempic and it’s effects on non-diabetic patients. It was conducted over 68 weeks. This time, I’ll be discussing the STEP-5 Trial, this was conducted over 104 weeks (2 years)!
I’m fasting for Ramadan right now, it’s day 10 (at the time of me writing this post) and not going bad at all. I eat just about 80 grams (g) of protein for Sehri (also referred to as Suhoor; it’s the meal meal before the sun comes up).
For those of you who don’t know what Ramadan is, it’s when Muslims fast from dawn to dusk for 30 days. We abstain from eating of drinking. There are many other things associated it as well, could be a very lengthy post on it’s own lol.
Anywho, today, we’re going to go over another Ozempic trial! As I stated in my previous article, I’m not encouraging the use of Ozempic (or discouraging the use of it) I just want people to be able to make an informed decision prior to talking to their OWN HEALTHCARE PROVIDER(S).
What makes me qualified to interpret the STEP-5 trial and talk about Ozempic? I’m a licensed and practicing pharmacist. I’m not one of those self proclaimed street pharmacist who provide you with your illicit substances. I actually sent to pharmacy school.
So, let’s get into it, Ozempic for weight loss!
Ozempic For Weight Loss – Step 5 Trial – Key Things You NEED To Know
I stated this in my previous post, but if you’re a health care professional and expecting this to be a journal club, go shove an Ozempic pen up your butt. I’m writing this article to help anyone make an informed decision about this medication.
If you don’t know what a journal club is, don’t worry about it, it’s irrelevant!
The next four sections, I’m copying and pasting from my last article for completeness. If you read that article, you can jump to section five. That’s where I discuss the STEP-5 Trial.
1. How Does Ozempic Work?
There are a few mechanism by witch Ozempic works. It is a selective glucagon-like peptide-1 (GLP-1) receptor agonist! There you go, that’s how it works. All clear now, right! Haha, just kidding, I’ll explain more.
Ozempic activates GLP-1 receptors located in different areas of your body.
GLP-1 is a hormone that your body releases in your intestines when food goes from your stomach to your intestines during digestion.
GLP-1 slows gastric emptying. This means that the food you eat, is digested slower than usual. This makes it so you don’t get hungry as fast.
Secondly, there are GLP-1 receptors located in your brain as well that are associated with appetite. When the receptors are activated, your appetite is decreased!
GLP-1 acts on your pancreas as well, but that mechanism isn’t associated with weight loss, so I won’t touch on that at this time.
2. Ozempic How To Use
Ozempic is giant suppository that you have to use insert every hour. I’m just kidding! It’s an injection that you have to inject weekly. You have to slowly increase your dose weekly. Here’s the schedule for Ozempic dosing:
- Weeks 1 – 4: 0.25 mg weekly
- Weeks 5 – 8: 0.5 mg weekly
- Weeks 9 – 12: 1 mg weekly
- Weeks 13 – 16: 1.7 mg weekly
- Week 17 and beyond: 2.4 mg weekly
2.4 mg is the maximum Ozempic injection for weight loss dose.
If an individual isn’t able to tolerate 2.4 mg weekly dosing, it is reasonable to use 1.7 mg weekly.
3. Ozempic By Itself Is Recommended For Weight Loss
Ozempic for weight loss by itself? False, you will still have to attempt to live a healthy life style. It’s recommended that you exercise and attempt to eat healthy as well.
You need to be in a caloric deficit to lose weight. A caloric deficit is when you are eating less calories than your body needs. As you can tell from the mechanism of Ozempic, it will get you to consume less food.
4. Side Effects Of Ozempic For Weight Loss
There can be some major adverse effects potentially associated with Ozempic. Here is a list of them (this is NOT all inclusive). Please discuss with your health care provider for further side effects to worry about:
- Possible short term kidney injury
- Diabetic retinopathy
- Gallbladder disease
- Gastrointestinal side effects: Abdominal pain, constipation, diarrhea, nausea and vomiting.
- Increased chance of thyroid cancer – was only seen when studied on rats. Has not been confirmed in humans.
- Pancreatitis (inflammation of the pancreas)
It’s not guaranteed you’ll experience these, but there is a chance. Just some risks to keep in mind.
So, is Ozempic safe for weight loss? It should be for the most part!
5. Ozempic For Weight Loss – STEP 5 Trial
This study was published in 2022. It’s full name is, Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial.
It assessed how much weight reduction would be in participants using Ozempic against a placebo (placebo means no drug).
I. Study Characteristics
This was a randomized double-blind clinical trial. What this means is, participants were randomly assigned to receive either Ozempic 2.4 mg weekly or the placebo. Double blind, meaning, neither the investigators nor the participants knew which group they were in. This was to keep bias out of conclusion.
Participants were chosen from 41 different treatments sites across the United States of America, Canada, Italy, Hungary and Spain. This is great as the STEP-3 trial only included participants from the United States.
The study included 304 adults WITHOUT DIABETES who were considered overweight or obese. 236 (77.6%) of the participants were women. 283 (93.1%) were white.
Here are some mean (average) characteristics of participants:
- Age 47.3 years
- Weight: 106 kg
- BMI: 38.5
There were 152 participants in the Ozempic group and 152 in the placebo group. Though by the end of the trial, 132 participants remained in the Ozempic group and 111 in the placebo group. Different participants had withdrawn due to a multitude of reasons.
The dose of Ozempic started at 0.25 mg and was increased every 4 weeks up to 2.4 mg. The image below is how they went about that:
Participants were required to have a calorie reduction of 500 calories. This was 500 calories based of their calculated required calories by the study. Not choosing an arbitrary number and subtracting 500 calories.
As for exercises, participants were encouraged to exercise at least 150 minutes a week. This form of exercise could be of their choosing (walking, running, walking home after getting rejected by their crush, etc.)
Participants had behavioral therapy throughout the 104 week. This was a 30 minutes session with a dietician or equally qualified health care professional every 4 weeks.
II. Ozempic For Weight Loss Results
The two primary end point they were assessing were, what percentage of weight the participants lost and weight loss of at least 5% by the end of the 104 weeks.
Below are results in a chart format so they are easier to read:
| Co-Primary Outcomes | ||
| Ozempic Group | Placebo Group | |
| % Change In Weight | -15.2% | -2.6% |
| At least a 5% loss in body weight from baseline | 111 (77.1%) | 44 (34.4%) |
The Ozempic group lost an average of 15.2% of their weight from baseline, where as the placebo group lost around an average of 2.6%. That’s a huge difference. A difference of 12.6%!
These results were similar to the one seen in the STEP-3 trial.
To give context to that in numbers, if someone started off weighing 100 kg (220 pounds), by the end of the 104 weeks they would have lost 15.2 kg (33.4 pounds) if they were receiving Ozempic.
If they were in the placebo group, they would have lost roughly 2.6 kg (5.7 pounds) by the end of the 104 weeks.
Just as with the STEP-3 trial, these are fantastic results for the Ozempic group.
Here’s a diagram to show the progression of weight loss overtime for funsies:
You also have to remember, participants were required to be eating less calories and recommended to exercise as well.
It wasn’t just, inject Ozempic and then proceed to eat a bunch of food. Though, Ozempic will help curb your appetite as we discussed in the mechanism section.
Here is chart of other significant results are reported by the study:
| Other Significant Results | ||
| Ozempic Group (Total of 152 Participants) | Placebo Group (Total of 152 Participants) | |
| > 10% Weight Loss By the End of 104 Weeks | 89 | 17 |
| > 15% Weight Loss By the End Of 104 Weeks | 75 | 9 |
| Decrease In Waist Circumference | 14.4 cm (5.67 in) | 5.2 cm (2.05 in) |
| Decrease In Systolic Blood Pressure | 5.7 mmHg | 1.6 mmHg |
III. Ozempic For Weight Loss – Adverse Effects
How safe is Ozempic for weight loss?
First and foremost, 9 (5.9%) participants in the Ozempic group, dropped out of the trial because the adverse effects they experienced were intolerable to them. This occurred in 7 participants (4.6%) in the the placebo group. So, not a big difference, to me anyways.
Participants in the Ozempic group were more likely to experience gastrointestinal adverse effects such as nausea, vomiting, diarrhea and constipation; 125 participants in the Ozempic group (82.2%) as opposed to 82 (53.9%) in the placebo group.
I made a table of the more common adverse effects of Ozempic that stood out to me.
| Adverse Effects – Experienced By At Least 10% of Participants | ||
|
Ozempic Group (Total of 152 Participants) |
Placebo Group (Total of 152 Participants) |
|
|
Nausea |
81 (53.3%) |
33 (21.7%) |
|
Vomiting |
46 (30.3%) | 7 (4.6%) |
|
Diarrhea |
53 (34.9%) |
36 (23.7%) |
| Constipation | 47 (30.9%) |
17 (11.2%) |
|
Upper Abdominal Pain |
22 (14.5%) | 10 (6.6%) |
| Abdominal Pain | 20 (13.2%) |
4 (2.6%) |
|
Dyspepsia (Indigestion) |
20 (13.2%) | 7 (4.6%) |
| Flatulence (Excess, as you can, farting) | 20 (13.2%) |
10 (6.6%) |
|
Gastroenteritis – inflammation of the stomach and intestines |
20 (13.2%) | 4 (4.6%) |
| Eructation (increased burping) | 17 (11.2%) |
1 (0.7%) |
As you can see, they are all gastrointestinal related.
Having more gastrointestinal adverse effects makes sense due to the mechanism of Ozempic we discussed. The food you eat takes longer to digest, so it’s just sitting in your stomach for longer.
This leads to more gastrointestinal related adverse effects! These are dose related. So the the more you increase your dose of Ozempic, the more likely you are to experience these adverse effects.
In term of gastrointestinal adverse effects, they lead to 6 (3.9%) participants in the Ozempic group dropping out of the group and 1 (0.7%) in the placebo group
One of the more serious adverse effects mentioned in the STEP-3 trial we discussed last time was seen in the Ozempic group was the formation of gallstones. 20 participants on the Ozempic group experienced this. Only 3 participants in the Ozempic group experienced gallstones.
In the STEP-5 trial, 3 participants in the Ozempic group had this problem and 2 in the placebo group.
So a smaller difference here. STEP-3 did have more than double the number of participants. They also had almost triple the number of participants on Ozempic. So, it’s unclear how to interpret these results.
IV. Discussion
So as you can see, Ozempic definitely helps with weight loss. It lead to 12.6% greater weight loss compared to the placebo group.
Now, this was done along with a calorie restriction and behavioral therapy, just as in the STEP-3 trial.
One again, as I said in my previous post, a caloric deficit is a must for weight loss in my experience. I’ve never used Ozempic, but I always had to eat less calories than my body requires to lose fat. I’ve lost 50 pounds…twice, so I know a thing or two about losing weight.
Some limitations of this study, 236 (77.6%) of the participants were female. 283 (93.1%) of the participants were white.
It would have been nice to see a more diverse population so the results can be extrapolated to patients of more diverse backgrounds.
I’m sure more than just overweight, Starbucks (don’t go here, they support genocide) drinking, ugg boot wearing (are these still a thing?) people are interested in Ozempic!
What would be interesting to see is, how much of the weight lost was from fat and how much from muscle. You want to preserve muscles and lose fat.
The more muscle you have, the more calories your body burns my just existing. That’d be key factor to assess in future studies.
Ozempic for weight loss, yet another study proving it’s effective! If you are interested in it, discuss it with your health care provider(s)!
Disclaimer: I’m not your doctor. Please consult your doctor, nutritionist or any health care professional before making any changes in your own lifestyle. These blogs are just me sharing my knowledge for you reading entertainment purpose only. None of this is medical advice.
Other Posts You May Like
Ozempic For Weight Loss – 5 Things You MUST KNOW Reviewed By a Practicing Pharmacist
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Resources
- Garvey, W Timothy et al. “Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial.” Nature medicine vol. 28,10 (2022): 2083-2091. doi:10.1038/s41591-022-02026-4
- Lexicomp Online™ [Internet]. Hudson (OH): Lexicomp. c1978 – . Lexidrugs online: semglutide; [cited 2024 March 10
- Wadden, Thomas A et al. “Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy on Body Weight in Adults With Overweight or Obesity: The STEP 3 Randomized Clinical Trial.” JAMA vol. 325,14 (2021): 1403-1413. doi:10.1001/jama.2021.1831. https://jamanetwork.com/journals/jama/fullarticle/2777025
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