Ozempic: What is It and Where It Came From

By: Allison Warren  |  March 31, 2024

By Allison Warren

Ozempic, a new drug circulating its way throughout Hollywood and beyond, is famous for its rapid weight loss capabilities. “There are a million ways to lose weight, why not do it through something that isn’t as boring as working out?” argues Kelly Osbourne. Even Oprah reasons, “the fact that there’s a medically approved prescription for managing weight and staying healthier, in my lifetime, feels like relief, like redemption, like a gift, and not something to hide behind and once again be ridiculed for.” Tracy Morgan finds himself to be very fond of the drug explaining how the drug “cut [his] appetite in half” allowing him to now only eat “half a bag of Doritos.” Elon Musk explained his recent weight loss as a result of “fasting…and Wegovy,” a weight loss drug with the same active ingredient as Ozempic.  

Ozempic is a product made by the pharmaceutical company Novo Nordisk. Novo Nordisk specializes in medications for diabetics and developed a drug called Semaglutide. Semaglutide is the active ingredient in Ozempic, which was designed to treat Type 2 Diabetes. This chronic disease occurs when the body does not make enough insulin or respond to insulin appropriately. 

When one is prescribed Ozempic (Semaglutide) they receive an injectable pen that may come in the forms of 0.5mg, 1mg, or 2mg, as described by the Ozempic website. Their website explains that the drug should be taken “once a week, on the same day every week, exactly as prescribed by your healthcare provider.” When taken properly, along with diet and exercise, it can improve the blood sugar in adults with Type 2 Diabetes and “may also reduce the risk of major cardiovascular events such as heart attack, stroke, or death in adults with Type 2 Diabetes with known heart disease.” Regarding those with Type 1 Diabetes, Ozempic would not be beneficial in its treatment, and for children under the age of eighteen, the drug has not yet proven to be safe and effective. The symptoms experienced when on the drug include nausea, diarrhea, stomach pain, vomiting, and constipation. 

Semaglutide is a manufactured version of the human GLP-1, glucagon-like peptide-1 molecule. GLP-1 is a natural hormone that works to keep the body’s blood sugar balanced. Its work is twofold: it tells the pancreas to release more insulin in response to food intake and reduces the release of glucagon, a hormone that increases blood glucose. When one is on Ozempic to treat their Type 2 Diabetes, they are not taking insulin; instead, they are taking a drug that will help their pancreas produce more insulin when their blood sugar is high. 

Yet, in addition to the impact GLP-1 has on blood glucose, it also impacts weight in two capacities. Firstly, GLP-1 reduces one’s hunger, appetite, and cravings by affecting the hunger centers in one’s brain, namely the hypothalamus. Secondly, this hormone will slow the rate of stomach emptying, prolonging the sensation of fullness and satiation after meals. Between a decreased appetite and a prolonged sense of fullness, one will ultimately arrive at losing weight. 

When taking GLP-1 medications, such as Ozempic, it is important to bear in mind that the medication is “designed to be taken long term” as they are “chronic medications for the treatment of chronic conditions (both diabetes and obesity),” explains Dr. Christopher McGowan, a gastroenterologist specializing in obesity medicine and endo-bariatrics. 

If one were to modify their diet to include good fats, such as avocados or nuts, lean protein sources, such as eggs, and foods high in fermentable fibers, like vegetables and whole grains, they would obtain the macronutrients that stimulate GLP-1 secretions, and reap the benefits of increased fullness from their meals. 

While this treatment appears to be the product of some recent novel research discovery, it actually has been studied for several decades. In June 2023, the Wall Street Journal published an article titled “Monster Diet Drugs Like Ozempic Started With Actual Monsters,” detailing the path to the discovery of Semaglutide. The process began in 1980 at Massachusetts General Hospital when researchers, seeking to discover the gene that encodes for the hormone glucagon, studied anglerfish, a fish with particular organs that make glucagon. The scientists went  to Cape Cod with fishermen to catch the anglerfish and described the fish as “the ugliest fish you could ever imagine.” When determining the genetic sequence of glucagon, the scientists learned that the same genes also encoded for the related hormones known as peptides, leading them to discover GLP-1. As time went on and GLP-1 continued to be studied, researchers found its effects on insulin and blood sugar and the ways in which it may have promoted weight loss by making people feel fuller faster and slowing down the rate at which the stomach is emptied, with the hope that it may be used in the treatment of diabetes. However, GLP-1 was found to disappear from the human body almost as quickly as it was secreted, being digested by enzymes and removed by the kidneys within minutes, giving little hope that it could be developed into a drug. Initially, GLP-1 was given intravenously to diabetics, which worked in lowering blood sugar but gave patients terrible nausea. 

Meanwhile, a scientist named Jean-Pierre was studying insect and animal venom to see its effects on digestive enzymes in mammals, discovering a massive response from Gila monsters. Gila monsters are poisonous lizards native to the Southwest, measuring 20 inches with powerful jaws and black-and-orange beaded skin. An adult will only eat four meals per year, living the majority of their life underground, slowly digesting the energy stored in their tails. A decade later, when a peptide expert named John Eng heard of this research, the two collaborated on their study of the Gila monster. 

Eng successfully isolated a small peptide similar to GLP-1 in humans, naming it Exendin-4. When testing the peptide on diabetic mice, it was discovered that it could reduce blood glucose for hours, unlike GLP-1. This fact proved vital in transforming GLP-1 into a device that could be useful for diabetes treatment. However, other scientists remained skeptical that something derived from a poisonous lizard may be effective in humans. 

After getting his work patented in 1993, a few years later, Eng received the attention of Andrew Young, an executive from Amylin, a small pharmaceutical company, who believed that this technology could be manufactured as a drug based on the results in mice. Interestingly, when testing the drug on humans, it was predicted that it may actually increase weight in patients, as that is the usual effect of increased insulin secretion. However, the effects the drug had on food processing and the way in which it was slowed, were more pronounced, leading their drug to be tested for weight loss. 

In 2005, the FDA approved GLP-1 treatment. It worked as a twice-daily injection, remaining in the bloodstream for hours, helping those with Type 2 Diabetes. With pharmaceutical companies witnessing these results, they were determined to make more effective and longer lasting GLP-1-based drugs. Oddly enough, Novo Nordisk had little interest initially in GLP-1 drugs after the original studies found nausea as a side effect. Yet, once the Gila monster version was on the market, it left Novo eager to develop a competing drug, succeeding in developing a GLP-1 drug that requires only a once-a-week injection. 

Although Ozempic was not officially designed to act as a weight loss drug, research notes that those taking the drug may lose weight. However, it is stated explicitly on the Ozempic website that “Ozempic® is not FDA approved for weight loss or chronic weight management.” When commenting on the drug’s popularity amongst celebrities, the Ozempic website explains that they “cannot control which specific patients receive our prescription-only medicines.” Rather, all they can do is “ensure that we reinforce who our medicines are intended to treat, based on their medical trials and FDA-approved indications, in support of responsible use of these medicines.” Novo Nordisk has not yet conducted studies evaluating the effects on weight after a person discontinued using Ozempic. However, studies have shown, claims Rekha Kumar, M.D., head of Medical Affairs at evidence-based weight care program Found, that when one stops using Ozempic, they are likely to regain most of the weight they lost within several months. 

Novo Nordisk also created the drug Wegovy, which also utilizes semaglutide as the main ingredient. Wegovy is a 2.4mg (a larger dosage than Ozempic) injectable prescription medicine designed to help adults and children aged twelve and above with obesity. The goal is for those taking the drug to lose weight and keep the weight off. The drug should be used in conjunction with a reduced-calorie meal plan and increased physical activity. Unfortunately, Wegovy, unlike Ozempic, is not usually covered by insurance. 

Novo Nordisk sponsored a study in which 1,961 adults with excess weight or obesity, not diabetes, were prescribed either 2.4mg of semaglutide or a placebo once a week for 68 weeks, in addition to lifestyle changes. It was reported that those taking semaglutide lost 14.9% of body weight compared to the 2.4% those taking the placebo lost. 

With Wegovy increasing in popularity, combined with news of Ozempic’s weight loss capabilities being widely shared in the media, those without a Type 2 Diabetes diagnosis have found themselves using Ozempic off-label, interfering with those with an actual Type 2 Diabetes diagnosis from accessing the drug. Another challenge faced with accessing these drugs is their price tags, with medications costing over $1,000 a month without insurance. Therefore, it is strongly urged by medical professionals only to seek out Ozempic if truly suffering from type 2 diabetes and Wegovy if truly suffering from obesity, ensuring that the medications end up in the proper hands.