Meaning: An abbreviation for “calories in, calories out,” CICO refers to the idea that burning more calories than you consume is essential for weight loss. GLP-1 medications suppress appetite, so the CICO principle plays at least some role in resulting weight loss. Someone who’s lost weight might credit their change in body size to a combination of Wegovy plus the CICO approach.
Where you’ll see/hear it: Reddit, and other online forums where people discuss diet and weight loss. CICO is all over Reddit threads about Ozempic and other GLP-1s. There’s also an official CICO subReddit for tips and info on calorie-counting, and support for CICO weight-loss efforts.
Expert’s two cents: The CICO concept has been around a long time, Tietz says. “It’s the first and simplest way to think about weight loss. But there’s more to it than just that.”
Meaning: An intrusive internal monologue about cravings, hunger and eating decisions. You have food noise if your next meal or snack is always on your mind. Food noise reportedly dissipates (or even vanishes entirely) when you take GLP-1s. The concept is different from hunger, a purely physical sensation. By contrast, food noise can persist even when you’ve just eaten and should feel satiated.
Where you’ll see/hear it: The term is big on social media, has garnered press coverage in the past few months, and is even coming up during weight-loss appointments and therapy sessions.
Expert’s two cents: Food noise quiets down with GLP-1 usage, Tietz says, because the drugs “slow down gastric emptying, which leads to feeling fuller longer and a decreased interest in food.” Food noise isn’t a medical or scientific term, and Tietz doesn’t think it’s widespread enough that patients should expect weight-loss doctors to be familiar. “Some doctors might know it, while others might ask for clarification.” Saying that you’ve experienced reduced food cravings since starting a GLP-1 would get the same point across, Tietz says.
Meaning: A slang term for berberine, a chemical compound derived from plants and sold as a supplement in the US. Berberine, which boasts antimicrobial attributes, has been a staple in Chinese medicine for addressing gastrointestinal problems. It’s potentially beneficial for enhancing gut health, according to the New York Times, and studies have explored its efficacy in treating diverse ailments including insulin resistance. Limited research on the potential weight-loss effects of berberine exists, but it’s scant and the findings are inconclusive.
Where you’ll see/hear it: TikTok, among other social platforms and news sites.
Expert’s two cents: “Berberine has primarily gained attention because there’s some evidence, not great evidence, that patients can lose weight on it and it can lower blood sugar,” says Tietz. “But it’s definitely not equivalent to Ozempic — that’s the big thing. There’s nothing in the actual chemical that would elicit the same effects on the body as GLP-1s. We don’t understand how berberine works, exactly. We have a much better understanding of how GLP-1s work.”
If you decide to give berberine a whirl, Tietz says to ask a doctor or pharmacist about possible interactions with other medications you take. Case reports indicate that berberine could affect the way certain medications are metabolized in the body. We don’t know which enzyme berberine interacts with, but the likely candidates are very common enzymes, Tietz says. Also, berberine crosses the placenta and enters breast milk, so it should be avoided during pregnancy and lactation.
Meaning: Sulfurous burps reported by some people taking GLP-1s. While the FDA lists “eructation” (the technical term for burping) as a possible side effect of semaglutide and tirzepatide, it doesn’t mention any rancid odor. In clinical trials for semaglutide, 9% of patients reported belching.
Where you’ll see/hear it: Patients are complaining to their doctors about burping, per The Atlantic.
Expert’s two cents: Tietz hasn’t found this to be a super common complaint, but notes that GLP-1s do have gastrointestinal side effects. “The sulfur smell in a burp is from the presence of hydrogen sulfide gas,” Tietz says, “so it means that GLP-1s might change how food is broken down in the stomach, and create more of that gas than usual. But that’s speculation. We don’t know for sure if that’s happening.”
Tietz says it’s also possible that certain dietary choices would increase the likelihood of having this side effect. Regardless, if you develop sulfur burps while taking a GLP-1, and find the issue bothersome, Tietz says to tell your provider.
Meaning: One of several similar phrases describing the impact of GLP-1 usage on physical appearance. The term might refer to a posterior with saggy skin, or an overall flat or deflated look, that develops when people take these meds. While the phrase has become associated with Ozempic, many doctors have pointed out that this side effect isn’t specific to GLP-1s. The real culprit in Ozempic butt is rapid weight loss.
Where you’ll see/hear it: Anywhere an Ozempic convo might take place.
Expert’s two cents: If you get Ozempic butt after losing weight, you could get it from any weight-loss regimen — whether or not medication is involved. “This comes down to changes in fat tissue,” Tietz says. “Everyone’s different. Some people might see changes in their butt, while others would see it in their face.”
Meaning: Vivid dreams reported by people taking GLP-1s. So far, these reports are anecdotal. The FDA doesn’t list abnormal dreams as a potential side effect of GLP-1s. In a Wall Street Journal story, one weight-loss doctor said she suspects “the dreams are related to how the drugs work promoting production of a gut hormone that has receptors in the brain” … and also that “drugs might also increase a user’s energy expenditure during sleep, which could contribute to vivid dreams.”
Where you’ll see/hear it: On social platforms, where people are posting descriptions of their trippy reveries.
Expert’s two cents: While the proposed explanation from the WSJ-quoted doctor is just speculation, Tietz says it makes sense to him, because we know that GLP-1 receptors are present in the brain. But he also notes that so many things can affect dreams, such as stress and mood, so it might be hard to untangle possible causal factors, especially when we’re drawing on anecdotal evidence.
Meaning: Gauntness and/or facial sagging associated with GLP-1 usage. As with Ozempic butt, these observed changes in fullness and skin elasticity are caused by rapid weight loss, not by the drugs themselves.
Where you’ll see/hear it: Everywhere. Ozempic face was the first slang term of its kind to take off. A cosmetic dermatologist reportedly coined the phrase.
Expert’s two cents: See: “Ozempic butt.”