The Downsides of Ozempic: What You Need to Know

Ozempic (semaglutide) has made headlines as a game-changing drug for managing type 2 diabetes and, more recently, for promoting significant weight loss. But while the benefits of Ozempic have been widely publicised, the risks and downsides are often overlooked in the excitement.

Like all medications, Ozempic has side effects and limitations. It’s not a miracle cure, and for many people, the potential downsides can be serious or even life-changing. This article explores the known and emerging issues surrounding Ozempic, backed by peer-reviewed studies and official health sources.

What Is Ozempic?

Ozempic is a GLP-1 receptor agonist manufactured by Novo Nordisk. Originally approved in 2017 by the US Food and Drug Administration (FDA) and later by the European Medicines Agency (EMA), it is used to improve blood sugar control in adults with type 2 diabetes. It mimics the hormone glucagon-like peptide-1 (GLP-1), which stimulates insulin production, reduces appetite, and slows gastric emptying.

In recent years, Ozempic and its sister drug Wegovy (also semaglutide, but at higher doses) have been prescribed off-label for weight loss, rapidly growing in popularity due to celebrity endorsements and viral TikTok trends.

1. Gastrointestinal Side Effects Are Common

The most frequently reported downsides of Ozempic are gastrointestinal issues. According to clinical trials and real-world data, up to 44% of patients experience nausea, while vomiting and diarrhoea are also widely reported.

Common Side Effects:

• Nausea
• Vomiting
• Diarrhoea
• Constipation
• Abdominal pain
• Indigestion

These symptoms often occur in the first few weeks but can persist. In some cases, they lead to dehydration, weight loss beyond healthy limits, and discontinuation of the drug.

Evidence: Frequent issues like nausea, vomiting, diarrhoea, constipation, and abdominal pain are widely reported—particularly during dose escalation. You can find an in-depth breakdown in the article “Dangers of Taking Ozempic for Weight Loss | What You Need to Know”

2. Risk of Gallbladder Disease

Semaglutide has been linked to an increased risk of gallbladder-related conditions, particularly gallstones and cholecystitis (inflammation of the gallbladder). This is likely due to the rapid weight loss that can accompany its use, which is a known risk factor for gallstone formation.

Evidence: Rapid weight loss increases the chance of gallstones or gallbladder inflammation, and there are occasional reports of pancreatitis. See the University of Queensland’s article “Considering taking a weight‑loss drug like Ozempic? Here are some potential risks and benefits”

3. Potential Link to Pancreatitis and Pancreatic Cancer

Though rare, there have been concerns about a possible link between GLP-1 medications like Ozempic and acute pancreatitis or pancreatic cancer. These concerns are based on animal studies and post-marketing surveillance reports.

The FDA and EMA have not found conclusive evidence to support a strong link, but both agencies continue to monitor safety data.

Evidence: Rapid weight loss increases the chance of gallstones or gallbladder inflammation, and there are occasional reports of pancreatitis. See the University of Queensland’s article “Considering taking a weight‑loss drug like Ozempic? Here are some potential risks and benefits”

4. Thyroid Tumour Risk (Rodent Data)

Semaglutide carries a black box warning in the US for the potential risk of medullary thyroid carcinoma (MTC). This is based on rodent studies, where semaglutide caused thyroid C-cell tumours. It is not yet confirmed whether this risk translates to humans, but it remains a concern.

People with a personal or family history of MTC or multiple endocrine neoplasia syndrome type 2 (MEN 2) are advised not to take Ozempic.

5. Muscle Loss and Frailty

Weight loss on Ozempic is not always healthy. While body fat decreases, evidence is emerging that significant lean muscle mass is also lost. This is especially problematic for older adults, as loss of muscle can lead to frailty, weakness, and increased risk of falls or injury.

Evidence: A study presented at the Endocrine Society’s 2023 annual meeting found that up to 40% of weight lost on semaglutide was from lean body mass.

This highlights the need for resistance exercise and dietary support while on GLP-1 therapy—but these steps are often overlooked in casual weight-loss use.

6. Psychological Effects and Eating Disorders

There are growing concerns about the psychological impact of using Ozempic, particularly among individuals without type 2 diabetes who take the drug purely for cosmetic weight loss.

Disordered eating patterns may develop or worsen, and some people report feelings of food aversion or detachment from eating altogether. This can contribute to malnutrition, anxiety, or even depressive symptoms.

Evidence: Ozempic misuse can exacerbate eating disorders or anxiety. WithinHealth shares a thoughtful perspective in “Dangers of Taking Ozempic…”  , and Healthline explores more in “Ozempic and Eating Disorders: Why Experts Are Raising Concerns” 

7. High Cost and Limited Access

Ozempic is expensive, and NHS prescribing is currently limited to people with type 2 diabetes. Off-label use for weight loss is not currently covered, meaning many people are purchasing it privately or through online services.

This raises concerns about:

• Inequitable access
• Overprescription without proper supervision
• Long-term cost sustainability if taken for years

Moreover, shortages have been reported worldwide, leaving diabetic patients without access to their prescribed medication.

8. Long-Term Dependence

Ozempic does not “cure” obesity or diabetes. Its effects only continue for as long as it is taken. Once discontinued, weight tends to return - often rapidly.

This raises the question: is Ozempic a lifelong drug for many users? And if so, what are the risks of long-term use?

Is it worth the risks?

Ozempic is undoubtedly a powerful tool for managing type 2 diabetes and promoting weight loss. But it is not without its downsides. From common side effects like nausea and vomiting to more serious concerns such as gallbladder disease, muscle loss, and psychological effects, Ozempic carries risks that users and prescribers must carefully consider.

Its growing popularity as a weight-loss solution - particularly among people without diabetes - has outpaced the science and, arguably, the safeguards needed to protect public health.

If you’re considering Ozempic:

• Speak to your GP or specialist
• Be aware of the full side-effect profile
• Ensure you’re monitored regularly
• Combine it with a healthy diet and exercise

Ozempic may be part of the answer - but it is not the whole solution!

References

1. Wilding JPH et al. Lancet Diabetes Endocrinol. 2022.
2. Faillie JL et al. JAMA Intern Med. 2016.
3. Butler AE et al. Diabetes Care. 2020.
4. Rubino D et al. Diabetes Obes Metab. 2022.
5. FDA Label for Ozempic. Accessed 2024.
6. Nature Medicine Editorial. 2023.