What You Can Expect From the Weight Loss Drug Ozempic Week By Week

Emily Laurence
·7 min read
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Obesity doctors break down exactly what this drug will do week by week in terms of side effects and weight loss.

Scrolling social media and seeing celebs promote weight loss teas and supplements is nothing new, but the promise of a shortcut to weight loss has reached a whole new level with Ozempic, the prescription drug many can’t stop talking about. Some might even wonder if it's exactly what they need for confidence ahead of the spring vacation they booked.

Dr. Jamy Ard, MD, a professor of epidemiology and prevention at Wake Forest School of Medicine and an obesity specialist, says that there is a lot of confusion about Ozempic that he wants to straighten out to ensure people have all the facts. First, he says it’s important to know exactly what Ozempic is. “The generic form of Ozempic is semaglutide, and this drug has been approved to help manage Type 2 diabetes,” he explains. Dr. Ard says that the same pharmaceutical company that makes Ozempic also makes another drug called Wegovy. “This is the exact same medication, but it’s approved for weight loss,” he says.

This was, he says, a business decision; the pharmaceutical company wanted to offer a targeted solution for type 2 diabetes and another one for weight loss. For this reason, Dr. Ard says that, typically, Wegovy is prescribed for weight loss, although Ozempic may be prescribed if Wegovy is not available.

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Got all that? Here’s what else he wants people to know. First, these drugs are not intended for someone who wants to lose 20 pounds before their cruise or wedding. They are intended for people with obesity, where weight loss is a direct health risk. “Ozempic and Wegovy are not meant for short-term use,” he says. “They are meant for chronic, long-term use. The same way someone with cancer wouldn’t stop taking their cancer medications, someone with obesity wouldn’t stop taking their obesity medication.” What happens if you do? He says you’ll gain the weight right back. (Not even celebs are immune. Influencer Remi Bader recently made headlines after this happened to her.)

With all of this in mind, if you do feel that Ozempic or Wegovy is a good fit for you, you may still be curious about what to expect when you start taking it. Here, doctors specializing in obesity explain exactly this—detailing the drug’s effects week by week.

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What To Expect From Taking Ozempic or Wegovy Week by Week

Week 1

Ozempic and Wegovy are obtained through prescription only, so the first step is meeting with your doctor to find out if one of them is, in fact, a fit for you. NYU Langone obesity medicine specialist Dr. Holly Lofton, MD, echoes Dr. Ard and emphasizes that neither drug is intended to achieve short-term weight loss goals. “We try to restrict [these drugs] to people who have a body mass index of 27 or higher, because that’s what [they're] intended for,” she says. “This is who the scientific studies were done on.”

With Ozempic, Dr. Lofton says that patients are typically started at a low dose of .25 milligrams. This is injected under the skin, typically on the stomach, thigh or upper arm. Dr. Lofton explains that though there have recently been many articles in the news about the horrendous side effects of Ozempic, most people tolerate it quite well. “There is a 20 percent chance of experiencing nausea, which is the most common side effect, but 80 percent of people don’t experience this,” she says. Dr. Ard adds to this, saying that the dosage is increased gradually over time, to lessen these effects.

When someone first starts taking Ozempic (or Wegovy), Dr. Ard says that they may notice that they feel fuller and are aware of their fullness in a way that they haven’t been before. “I’ll hear from patients that they used to be president of the Clean Plate Club but now they are surprised to be leaving food on their plate and not feeling the desire to finish it all,” he says. This, he explains, is because the drug changes one’s brain chemistry to slightly decrease the amount of reward one gets from eating.

Both doctors emphasize that taking a drug for obesity is done in tandem with making diet and lifestyle changes, so someone may be starting to change the way they eat and their exercise habits this first week as well.

Weeks 2 - 4

Both Ozempic and Wegovy are administered weekly, so the start of week two means it’s time for your second dose. If you experienced nausea after receiving your first dose, Dr. Lofton says it’s more likely that you will experience it when you get your next one too. “The nausea can happen at any time, not necessarily right after you are administered the drug; it could happen two days after,” she says.

If you are experiencing nausea, Dr. Lofton says your healthcare provider will work with you to figure out why and find a solution. For example, she says a diet high in fried food and cheese is more likely to cause nausea. Or, there may be another medication or supplement that can be prescribed.

In terms of weight loss, Dr. Lofton says most people don’t start to see it yet; this will come later as the dosage is increased.

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Week 5

Week five is a milestone because both doctors say that this is typically when the dosage is increased from .25 milligrams to .5 milligrams. Once a patient starts taking .5 milligrams, Dr. Lofton says they are likely to start experiencing weight loss. “Many people continue with this dosage and continue to lose weight for months,” she says. According to clinical studies, people taking Ozempic or Wegovy can expect to lose between 5 and 15 percent of their body fat in roughly one year.

Week 6 and beyond

While many people will maintain a .5 milligram dosage, Dr. Lofton says that some doctors will gradually increase patients to a dosage of 2 milligrams over time.

Since these weight loss drugs affect brain chemistry, Dr. Ard says it changes the eating behaviors of those who are prone to emotional eating. “If you are an emotional or stress eater and are taking Ozempic, you may not get the same feeling of calm or comfort that you’re used to getting with food. In these cases, it can be helpful to work with a health coach who can help establish some healthier habits of what to do when you’re feeling sad, anxious or bored,” Dr. Ard says.

Both doctors reiterate that Ozempic and Wegovy are meant to be taken long-term. Once a medication is stopped, you can expect to gain the weight you lost back—even after lifestyle changes have been made, unfortunately. For people with obesity, these weight loss drugs can be beneficial, but they shouldn’t be taken to lose what Dr. Ard calls “vanity weight,” aka weight that is not negatively affecting one’s health.

While it’s human nature to look for a shortcut, nothing can replace the basic health pillars of eating healthy and exercising regularly—no matter what any celebrity shares on social media.

Next up, see a list of 100 different diet plans linked to weight loss.

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