Pick up the paper, scroll through Instagram, or even take a journey via public transit—chances are, you’ll see something about Ozempic or Wegovy. Also known by its generic name, semaglutide, the GLP-1 agonist was originally prescribed to patients managing diabetes or obesity. However, its remarkable craving-curbing benefits have resulted in significant interest and patient use beyond those who qualify for an on-label prescription.
Like any trend, Ozempic has been the subject of a lot of rumors lately, including whispers about supposed celebrities on the drug and alarming accusations that long-term, taking it could be as damaging as opioids. So what’s the truth? Here, with the help of experts, we get the skinny on Ozempic, breaking down rumors, debunking myths, and sharing the real scoop on this popular drug.
Is there actually an Ozempic shortage right now? What is causing the shortage?
Both Ozempic and Wegovy have been declared on shortage by the products’ manufacturer, Novo Nordisk, according to the company’s own website and the American Society of Health-System Pharmacists. This is especially affecting Wegovy. “Currently, there’s a shortage of the starting doses of Wegovy, which includes all doses up to 1.7 milligrams,” explains Dr. Rekha Kumar, chief medical officer at medically assisted weight-loss program Found and board-certified endocrinologist in New York City.
Not only is this due to the demand for the medication itself exceeding the supply available, but it’s also courtesy of manufacturing delays. “The problem with Wegovy and Ozempic is, there is the manufacturing of the medication component and the manufacturing of the delivery device,” says Joe Baczewski, RN, founder of LIVation in Madison, Connecticut. The lack of injectable pens used to administer these medications is creating a further supply-demand mismatch, resulting in a shortage.
However, there could be some questionable behavior to blame for the shortage, especially if you’re a patient who is getting these drugs covered by your insurance provider. “Consider following the money,” shares Dr. Jessie Cheung, a board-certified dermatologist and regenerative medicine specialist in Chicago. “I hear from my physician friends that if a patient is paying with cash at the pharmacy, these meds are in stock, but if a patient is going through insurance, these meds may not be available.”
After there is no longer a shortage of Ozempic or Wegovy, will you still be able to get semaglutide from compounding pharmacies?
This rumor has been swirling around and putting some people in a panic, causing concern that they won’t be able to get their medication at a more affordable price. After all, those who are getting compounded semaglutide are paying out of pocket for their drugs, often at a much lower cost than those who pay out of pocket for the branded medication—some people are paying thousands of dollars a month to get the real thing. According to Dr. Cheung, the shortage is a loophole—if a semaglutide product appears on the FDA’s drug shortage list under section 506E at the time of compounding and dispensing, it can be procured at a compounding pharmacy. Once a medication is off the shortage list, it can’t be compounded anymore—that is, if it’s a direct copy of an approved medication like Ozempic or Wegovy.
It’s for this reason that Baczewski doesn’t believe there’s any reason to worry. “It’s the pharmaceutical companies’ proprietary blends that are patented, as are the dosing pens,” he says. “If they don’t share what’s in it, they can’t claim the blends are exclusive to big pharma.” (Furthermore, the active itself, semaglutide, isn’t a proprietary molecule, like those found in some injectable drugs like Humira or Stelara.) Baczewski also notes that compounding pharmacies can skirt this issue because their products are preservative-free, which is what makes it so essential for compounded semaglutide to remain refrigerated until use, while products like Ozempic and Wegovy can last for nearly two months without being refrigerated after taking the first dose.
Is it safe to get a prescription for Ozempic or semaglutide via telehealth platforms?
This depends entirely on what telehealth platform you’re using to get your medication. Some people—with great ease—have procured very affordable prescriptions for GLP-1 agonists but are not getting any care from their telehealth providers. Those people have also not received any kind of diagnosis making them a candidate for the medication or precluding them from taking it. “It is not safe to use a telehealth platform that liberally dispenses these medications without medical oversight,” warns Dr. Kumar. “Due to the fact that there are contraindications to the medication, there can be serious side effects—if those contraindications aren’t thoroughly evaluated and discussed with each patient, there could be increased risk of complications.” Beyond discussing potential contraindications or risks (more on these later), a provider should be running basic blood work tests on you, to assess your kidney and liver function as well as blood sugar levels, prior to prescription.
Found, the organization for which Dr. Kumar works, is one example of a telehealth platform that provides oversight and consistent guidance. She notes that it is safe to use a telehealth provider so long as you are being fully evaluated by a physician, your health history is examined, and you’re being prescribed FDA-approved medication under on-label guidelines, including specific BMIs and preexisting medical conditions. “If you are looking into a telehealth platform that doesn’t have these parameters, then I would be concerned,” she says.
Your telehealth platform should also provide ongoing support, to ensure you are reacting well to the medication and are working toward a goal. “Some patients do fine with self-directed care, but most patients do better with accountability and having to check in with a care team, to discuss what is working and what isn’t,” says Baczewski, who also feels telehealth can fall short if a patient is experiencing any side effects from the medication. He gives the example of a semaglutide patient experiencing headaches, nausea, and muscle twitching. “This directly indicates electrolyte imbalance and dehydration that can be resolved with IV infusion administration,” he says. “That cannot be done via telehealth—that is hands-on care.”
Lastly, you should know what you’re getting when it comes to your medication. “Your telehealth provider should be a step above the online sellers that offer ‘research-use’ products that may not be fit for human use,” advises Dr. Cheung. More specifically, this is referring to compounded semaglutide—and not all compounded semaglutide is the same.
Is compounded semaglutide safe?
One of the most hotly debated topics in the world of Ozempic is the safety of compounded semaglutide, which is made by a compounding pharmacy by blending the generic, active molecule (semaglutide) found in the prescription medications with other ingredients. The FDA has warned against the specific use of semaglutide salts, semaglutide sodium, and semaglutide acetate. According to a statement on the FDA’s official website, “the agency is not aware of any basis for compounding using the salt forms that would meet the FD&C [Federal Food, Drug and Cosmetic Act] requirements for types of active ingredients that can be compounded.”
Compounded medications are quite literally mixed up by a pharmacist and are thus not name-brand products or manufactured by a pharmaceutical company. That means you are potentially putting yourself at risk. “Branded GLP-1 medications are all FDA approved, whereas compounded semaglutide is unregulated and has not gone through the FDA approval process, and therefore can not be deemed safe,” says Dr. Kumar. This is a common school of thought among many providers we’ve spoken with while researching Ozempic. However, some have changed their minds over time, due to the prolific shortage, while others are of the opinion that compounded semaglutide is safe—so long as you are getting it from a reputable compounding pharmacy.
To start, Baczewski notes that the safety starts with the location from which your compounding pharmacy sources the semaglutide. There are supply chains of semaglutide all over the world; Baczewski recommends seeking out a compounding pharmacy with 503B designation that uses semaglutide made in North America or Europe, to ensure you’re getting the good stuff. “A pharmacy with 503B designation is held to a very high standard set by the FDA to safely produce medications,” he explains. Dr. Cheung also recommends seeking out a pharmacy accredited by the Pharmacy Compounding Accreditation Board (PCAB), which is a nonprofit organization that standardizes safety, quality, and compliance within compounding pharmacies. It is considered the most prestigious accreditation for compounding pharmacies.
If you have questions about the quality and sourcing of your compounded semaglutide, your provider should be not only able to answer but also happy to share the name of the compounding pharmacy making your product. You can also ask the pharmacy questions, including any testing it may perform on its compounded semaglutide to determine purity and concentration. And perhaps above all, is your medication cold? “Semaglutide is a sensitive protein peptide that needs to remain cold during transport and stay cold until administration,” says Baczewksi.
What are the ingredients mixed with semaglutide?
The most common additives in compounded semaglutide are B vitamins and l-carnitine. “B12 can improve energy and increase red blood cell production, but it is primarily compounded to help the side effect of nausea,” says Baczewski. If you want added fat-burning benefits, consider l-carnitine. “While it won’t help you lose weight, it will help you turn the fat into energy,” explains Dr. Cheung. Adds Bacezwski, “Carnitine encourages the body to break down fat ahead of lean mass or muscle—one can arguably have better breakdown of fat and visceral fat when using an amino acid like l-carnitine.” This is his preferred additive.
Does Ozempic cause cancer?
This is the single biggest rumor regarding Ozempic and semaglutide. The experts interviewed for this article all say that no, Ozempic is not known to cause cancer. “Thyroid cancer was seen in clinical studies in rats on Ozempic and other meds in this category but not in humans,” says Dr. Cheung. The studies showed that it specifically caused the proliferation of medullary thyroid tumors; if you have a family history of this specific type of cancer, you should not be treated with a GLP-1 agonist.
Interestingly enough, despite all the gossip about the risks of taking Ozempic, there’s a chance that these medications could actually prevent cancer. “There was a small study that suggested that these meds may reduce cancer risk in humans, as semaglutide restored the function of natural cancer-killing cells,” Dr. Cheung explains. Ultimately, more research needs to be done on this topic; many clinical studies of these drugs and what they can do are currently underway.
Are there any health risks or side effects when using Ozempic?
Ultimately, Ozempic, Wegovy, and semaglutide of any form are drugs, and something new that you’re introducing to your system. There are health risks and side effects to all medications, even those found over the counter, like plain old acetaminophen. Dr. Cheung says she wouldn’t prescribe these drugs to anyone with a history of thyroid cancer (for the aforementioned reasons) or multiple endocrine neoplasia, due to potential complications; aside from that, she believes it’s not a risky medication.
Again, these medications are still not without risk. In the case of GLP-1 drugs, “some of the greater risks include pancreatitis, severe abdominal pain radiating to the back, and gallstones,” explains Dr. Kumar. That spreading stomach pain could be a sign of pancreatitis; an inflamed pancreas must be addressed immediately, as this condition can be fatal. “For gallbladder issues, you would experience right upper quadrant pain in your belly after eating,” Dr. Kumar says. (For what it’s worth, issues with your gallbladder, including gallstones, can be caused by weight loss, especially rapid weight loss, so the medication itself may not be directly to blame.) Other signs of these concerns include fever, chills, nausea, and a yellow tinge to your skin and eyes, says Dr. Cheung. If you’re experiencing any of these symptoms, see your provider ASAP to determine the cause and whether you should continue taking your medication.
If you’re feeling occasionally nauseous or tired and have frequent headaches or diarrhea, it may not be a sign of something serious (though it’s worth getting checked out by your provider). It may actually just be a lack of improper hydration. “Your liver and kidneys filter oxidants and by-products from the fat-burning process that need to be flushed out of the system,” says Baczewski. “Most of these issues are easily preventable with careful monitoring of hydration status.” Your provider should be happy to help you do this—and let this be a reminder that you should be chugging those eight glasses of H2O daily.
Does Ozempic cause gastroparesis?
GLP-1 agonists like Ozempic work twofold: by telling your brain you’re fuller faster and by slowing down how quickly your stomach processes the food you’ve eaten. “This delay in gastric emptying should last until the medication wears off and motility returns to baseline,” says Dr. Cheung.
A recent series of lawsuits claims that Ozempic causes gastroparesis, which is a diagnosis of slow or no movement in the digestive system. The truth is that this condition is a common effect of long-standing diabetes. “This is because the nerves that allow the stomach to empty normally are impacted by diabetes and don’t work as well,” explains Dr. Kumar. “Most people who take GLP-1s have diabetes, which is why there’s a tremendous overlap in patients who take GLP-1s and those who have gastroparesis.” According to Baczewski, other factors can exacerbate gastroparesis, including poor diet and alcohol and tobacco consumption. So too can certain medications, including some narcotics and antidepressants.
If you’re experiencing gastroparesis, keep in mind that the symptoms can be similar to how it feels when you’re eating too much or eating unhealthy foods on Ozempic, including a sensation of fullness, burping, and heartburn—but if you’re regularly throwing up, that’s a sign of something more serious and you should be seeking out advice from your provider, who will likely recommend you stop taking the drug. Adds Dr. Cheung, “in the cases that were recently reported, the patients continued with their medications for months, despite having side effects of nausea and vomiting.”
Can Ozempic cause muscle loss and bone-density issues?
Losing weight via any means can cause both muscle and bone loss. “Anytime there’s less weight or less mass, there will be a reduction in bone-mineral density and muscle,” explains Dr. Kumar, who recommends counteracting these effects by keeping impact on the bones and muscles through resistance and strength training.
Your diet also plays an important role. “Any major changes to your food intake can result in malnutrition, so it’s important to ensure that you are ingesting enough protein, micronutrients, and healthy fats to prevent muscle breakdown or bone loss,” says Dr. Cheung. Baczewski makes personalized supplement recommendations to his patients depending on their specific needs. “We help prevent muscle loss with carnitine,” he says. “Many of our patients in New England [who may be more likely to have a vitamin D deficiency] are placed on vitamin D with vitamin K, to help with bone density and health.”
If you stop taking Ozempic, will you gain back all the weight you lost?
This is a common fear of many people using this medication for the purposes of weight loss. There is a theory in obesity medicine known as “set-point theory,” which posits that each human body has its own predetermined weight, which is affected by factors like heredity and environment. Without the intervention of strength training (increased muscle mass accelerates metabolism), medications that help support weight loss, or bariatric surgery as well as reducing stress and improving nutrition with the help of nutritional counseling, you may stay at a higher setpoint. “Stopping the medicines doesn’t cause weight gain, [but it allows] your body to revert to where its natural high weight setpoint wants to be,” says Dr. Kumar.
Many people discussing post-Ozempic weight gain cite the example of influencer Remi Bader, who shared that she gained “double the weight back” after discontinuing Ozempic, noting specifically that she had issues with binge eating. Before taking this medication, she had discussed suffering from binge eating disorder, an eating disorder recognized by the DSM-V that can be severe and life threatening. Ozempic is very useful for quieting the “food noise” responsible for many cravings, but if you’re not on the medication, you should be working with a specialist to help you make lifestyle changes that can help you overcome those cravings or respond to them in a healthier way. Says Dr, Cheung, “obesity is a chronic disease—if you haven’t changed your relationship with food or worked on activating your metabolism, the weight may come back.”
