But what if you’re not looking to lose a lot of weight? What if you just want to lose 5 or 10 extra pounds and haven’t found success through diet and exercise alone? Can you take a GLP-1 with the goal of sizing down slightly?
There’s no blanket answer here, experts say. Whether it’s appropriate to prescribe a GLP-1 for modest weight loss depends on multiple factors and varies by patient. Here’s what to know about taking Ozempic to shed a small amount of weight.
What are GLP-1s?
GLP-1 receptor agonists, including Ozempic, Wegovy and Saxenda, promote weight loss by mimicking the effects of GLP-1 (short for glucagon-like-peptide-1), an incretin hormone produced in the gut in response to food intake. GLP-1 has several important functions related to regulating blood sugar and controlling appetite, including:
- Stimulating insulin secretion to reduce blood sugar levels
- Counteracting the effects of glucagon, which raises blood sugar levels
- Slowing gastric emptying (the rate at which your stomach empties after meals) to prevent blood-sugar spikes. If your stomach empties slower, you feel fuller longer.
- Binding to receptors in the brain that activate signals to decrease appetite, thereby suppressing hunger
Who are GLP-1s intended for?
The FDA has approved these medications to treat Type 2 diabetes and obesity. They’re commonly prescribed for people who either have these conditions or are at risk of developing them. Additionally, these drugs are often recommended for people who are overweight and have related health issues, such as high blood pressure or elevated cholesterol levels.
Clinical definitions of obesity, as well as being overweight, are based on body mass index (BMI). Obesity is defined as a BMI of 30 or higher, while overweight is a BMI of 25 to 29. But experts say that qualifying for a GLP-1 medication might be more complex than hitting a specific number on a chart. According to the Centers for Disease Control and Prevention (CDC), BMI is intended to estimate body fat, which is linked to myriad health risks — but it’s not a perfect measure.
“The CDC underscores that elements like age, gender, ethnicity and muscle mass can impact the correlation between BMI and body fat,” says Dr. Tina Wu, Sunrise’s Medical Lead. “Furthermore, BMI doesn't differentiate between surplus fat, muscle and bone mass, nor does it indicate how fat is distributed among individuals.” Therefore, “other assessments might offer heightened accuracy, such as waist circumference, muscle density, fat distribution and bone density.”
People who are only slightly overweight or aren’t clinically overweight could still be prescribed a GLP-1 drug under specific circumstances. “When confronted with weight-related comorbidities and challenges in achieving weight loss solely through diet and exercise,” says Dr. Wu, “prescription weight-loss medications may be considered appropriate under the guidance of a medical professional.”
Moreover, “when considering GLP-1 agonists for weight loss, it's essential to take into account the extent of weight loss required,” Dr. Wu says. “People with varying weight loss goals could benefit from different GLP-1 agonists.”
How much weight do people lose on GLP-1s?
Regarding dramatic weight loss, Dr. Wu shared that “rapid” weight loss means more than 1 to 1.5 kilograms per week (about 2 to 3.5 pounds). A loss of more than 5% of body weight within three to six months can be considered “significant.” (Terms for different degrees of weight loss, such as “mild,” “moderate,” “modest” and “significant,” are appropriate to use, but they’re not standardized and therefore subject to interpretation.)
Studies have shown varied weight-loss results across different medications. People taking liraglutide (the generic name for Saxenda) lose, on average, between 7% and 12% of their starting body weight in the span of 56 weeks. For semaglutide (the generic name for both Wegovy and Ozempic), the average loss is 5% to 7% over 40 weeks, and for tirzepatide (generic for Mounjaro), it’s 22.5% over 27 weeks. (Most of the current data on GLP-1 usage is based on patients who have obesity or diabetes, because those are the conditions the drugs are approved to treat.)
Some patients will lose a modest amount of weight while on GLP-1s, but this can still have a measurable impact on important health outcomes. Research has found that people with obesity can improve their metabolic function and lower their diabetes risk by losing 5% of their body weight.
What’s more, Dr. Wu says that a few pounds is the right starting goal, regardless of a patient’s current condition or end goal. By approaching progress in smaller increments, patients can “experience initial successes, gain confidence, and adapt to new and dietary lifestyle habits that support weight management,” Dr. Wu says. This sets them up for better long-term outcomes.
“Healthcare professionals tend to favor personalized approaches to assess how each patient’s body reacts to specific medications,” Dr. Wu added. She explains that “defining what constitutes a substantial or minor weight loss when using GLP-1 agonists varies according to the person.”
If weight management has been a persistent issue or if you’ve recently put on weight and are having trouble losing it, a healthcare provider can evaluate your personal health history and work with you to address whether losing weight can improve your health and wellness.