Semaglutide and weight loss: notes of caution

Wegovy, Ozempic and other GLP-1 agonists hail a new frontier of medicine for effective weight loss and type 2 diabetes remission. But is it the silver bullet some are hoping for?

As obesity rates soar throughout much of the Western world, news of a highly effective weight loss drug has made waves in scientific circles and the population at large. There are hundreds of millions of views for videos with the hashtag #ozempic and thousands of live adverts running for the drug across social media channels.

The drug –  semaglutide – certainly is impressive. And there’s no doubt this drug is already helping people. However, some important notes of caution aren’t getting the attention they deserve. 

But first, what’s all the fuss about? 

How good is it? 

A 2022 study recruited 204 participants with overweight or obesity. After 2 years, those taking semaglutide lost an average of 15.2% of their body weight, compared with 2.6% in the placebo group which constituted of general healthy eating and exercise advice for weight loss.

This is quite an incredible result. To put that in perspective, if a participant weighed 280 pounds (127 kilograms) at the start of the study, they might have lost 42 lbs (almost 20 kg).

There’s no doubt this is a powerful drug; many patients describe it as ‘quietening the constant food chatter’ in their brain and giving them agency over food choices back. This is the power of appetite suppression, targeting the brain to help people lose weight where that weight loss is medically necessary for good health (not for cosmetic preferences).

However, as with all pharmaceutical interventions, there are some downsides and things to be aware of.