Get the “skinny” on the blockbuster drug helping people shed pounds

Everything we know—and don’t know—about Ozempic for weight loss

I was an obese child and adolescent. And I still have the psychological scars to prove it. (It’s one of the main reasons why I wrote my first book, Feed Your Kids Well.)

So, you can understand why I’ve committed my life’s work to helping others, at any age, achieve—and maintain—a healthy weight.

It’s something I take quite seriously. After all, we’re in the midst of a global obesity epidemic, with no signs of it letting up any time soon.

In fact, according to the latest estimates, 2 percent of children between the ages of two to four are severely obese.1 (Experts define this category of obesity as being well above the 95th percentile for combined height-weight ratios.)

And before you shrug off that 2 percent, consider this…

That “small” statistic means that nearly 17 million children suffer from the ill-effects of severe obesity starting at a very young age. Not to mention, roughly 21 percent of six-to-11-year-olds and 22 percent of 12-to-19-year-olds are obese, too.2

And while those numbers are truly staggering collectively, it makes me wonder why even just one child should be suffering like this?!

After all, it puts them at a much greater risk for developing other serious problems down the road. Including high blood pressure, high cholesterol, Type 2 diabetes, breathing issues (like asthma and sleep apnea), and joint problems.

Plus, we know these problems tend to follow folks into adulthood. Which explains why 42 percent of all American adults are obese—and 74 percent are overweight!3

But do you know the worst part?

Being large has become so normalized in our culture—nearly 50 percent of people don’t even realize they’re overweight. And according to a study in the Archives of Internal Medicine, more than 30 percent of overweight patients and around 55 percent of obese patients have “never been told by a doctor” about their weight issues…

Much less received medical guidance about how to lose weight and improve their health.4

In my view, that’s a severe disservice. Because obesity is a disease.

And the only way we’re going to turn the tide on the obesity epidemic is to start talking about itacknowledging the problem… and presenting solutions—at all ages.

That’s why, this month, I want to provide the “skinny” on the ever-so-popular drug being labeled a weight-loss phenomenon for adults across the country: Ozempic.

The “good” about Ozempic

Research shows—and most of us can attest—it’s incredibly hard to shed excess weight. And when it comes to severe obesity, it’s almost universally irreversible.

So, for adults who never overcame their struggle with childhood obesity—or who simply gained an uncontrollable amount of weight as the years ticked by—this is where Ozempic (semaglutide) can help.

As you probably know by now, Ozempic is a prescription drug designed to treat Type 2 diabetes. And like most pharmaceutical drugs, it comes with some side effects.

But there’s one particular effect folks just can’t get enough of… weight loss.

For this reason, many doctors now prescribe it “off-label” for weight management—myself included.

In fact, I personally started prescribing Ozempic to my patients who have consistently failed to maintain a healthy weight through lifestyle prescriptions—such as following a healthy, balanced diet and committing to regular exercise.

(To be totally transparent, I also prescribe the drugs Wegovy—which contains semaglutide, just at a higher dose—as well as Mounjaro [tirzepatide]—for weight loss. These are all GLP-1 agonist drugs. But I want to focus mainly on Ozempic, as it continues to steal headlines.)

Why? Because I have witnessed it help accomplish the unthinkable…

Ozempic helps “normalize” or “quiet down” appetites. Therefore, other important health metrics—including blood sugar, blood pressure, cholesterol, and more—stabilize and improve with very little effort. (I’ve seen this kind of success in 99.9 percent of the patients I’ve prescribed the drug for!)

And best of all… their self-esteem and self-worth go into overdrive!

I hear things like, “This is the best I have ever felt.” Or, “This is the first time in my life I don’t think about food—it is so freeing!” So, let’s take a step back to look at how semaglutide works in the body.

Firstly, semaglutide stimulates the pancreas to release insulin. This helps push sugar out of your blood and into your tissues. (This is why doctors prescribe Ozempic to patients with Type 2 diabetes.)

Secondly, it slows transit time of the food through your system, so you stay fuller, longer.

And finally, semaglutide works as a bona fide appetite suppressant by mimicking glucagon peptide-1 (GLP-1)—a hormone your body produces naturally in response to eating.5

You see, as GLP-1 rises in your intestines, it signals to your brain that you’re FULL. So, the more GLP-1 in your system… the less hungry you feel… and the less you eat. (That’s why these GLP-1 agonist drugs tend to be so successful for so many.)

Yep, this drug actually makes you eat less. And—violà—before you know it, the pounds start dropping away.

 The “bad” about Ozempic

Of course, as with any drug, there are some other side effects and factors you should consider before taking semaglutide.

For example, you may have heard about “Ozempic face,” where your skin sags and wrinkles severely. But I haven’t seen this problem in any of my patients. (More about how to avoid “Ozempic face” in the box to the right.)

What I have seen are some of the more common side effects, including nausea, vomiting, diarrhea, and constipation. But they all generally go away or become manageable by making a few key changes…

Like drinking more water, eating smaller portions, eating more slowly, and avoiding fatty and greasy foods. (It’s especially important to learn how to stop eating when you feel full while taking this drug.)

Less common, but more serious, side effects of semaglutide and other GLP-1 agonists include:

  • Pancreatitis, an inflammation of the pancreas that causes abdominal pain
  • Gastroparesis, in which movement of food out of the stomach slows or stops
  • Bowel obstruction, which prevents food from passing through the intestines
  • Gallstone attacks and bile duct blockages

In addition to potential side effects, there are four other important factors to consider before starting the drug…

For one, semaglutide is very expensive. And if you take Ozempic “off-label” for weight loss, Medicare or other insurers won’t cover it, since it’s technically designed to help control prediabetes or Type 2 diabetes.

Second, because of the drug’s soaring popularity, there are a lot of dangerous counterfeit products popping up in the supply chain. So, when filling a prescription for Ozempic, stick with major, retail pharmacies, such as CVS or Rite Aid. (Never get the drug from an online retailer without a prescription.)

Third, semaglutide is a weekly medication you must inject into your belly. This might turn some people off. But don’t worry—no big needles are involved. And even the most squeamish of my patients seem to do fine with the “autoinjector”—where you simply press a button to insert the medication.

Fourth—and this one’s a biggie—it’s very likely you’ll have to stay on the drug for life. I realize that may be daunting to some people.

But I also wonder… what difference does it make if you do have to stay on this drug forever? And, more importantly, why is the medical community so crazed about that possibility? After all, many drugs tend to be prescribed with the notion that they are lifetime drugs. I mean, when was the last time a doctor unprescribed a drug to you?

That said, I have had dramatic success with at least reducing the dose or frequency of Ozempic injections. So, as always, it boils down to continuing the conversation and looking at how the drug is impacting your individual health as time ticks on.

Okay, now that you know “the good” and “the bad,” let’s talk about what the future holds…

The “unknown” about Ozempic

Because semaglutide is so new, we don’t know yet about the long-term side effects. I’m talking about what happens to you 10, 20, and 30 years down the road.

But this is true for all new drugs. And while I’m not giving Ozempic a complete pass, the medical community makes it seem like semaglutide is the only drug in the world we have questions about. Which just isn’t true.

For me, this unjustified criticism of semaglutide further highlights the prejudice against not just overweight people… but also against women in particular. (Since more women take this drug than men.) After all, we don’t seem to have a big, national debate about the long-term side effects of that little blue pill, now, do we?

I also think that because these drugs show the ability to combat almost all the metabolic woes plaguing America, Big Pharma is quaking in their boots. Just think about it…

If these drugs—Ozempic, Wegovy, and Mounjaro—could replace your need for high blood pressure meds, high cholesterol meds, Type 2 diabetes meds, anti-anxiety meds… who suffers? (For once, not you and me!)

The big picture

The bottom line? Obesity is a mounting global health threat. And you must remember that it’s IMPOSSIBLE to be obese and healthy.

So, when I discuss prescribing semaglutide as a “weight-loss solution,” it is NOT for aesthetic purposes. It has nothing to do with how you’ll look in a swimsuit during these dog days of summer… or whether you’ll fit some standard ideal of beauty.

It’s 100 percent about your health.

I want you to be healthy and strong and live the best life possible—and I want the same for your children, grandchildren, and great-grandchildren.

Because I know firsthand how hard it is to struggle with weight day in and day out. My personal, decades-long weight-loss journey continues to this day. It takes a lot of hard work and dedication to change your relationship with food… to change how you think about your body image… and to start an exercise regimen.

For me, I’m committed to waking up every day and choosing to make smart dietary choices, move my body, and practice self-care—all of which help boost my self-confidence. And believe you me, it is almost NEVER easy.

Your journey may sound a lot like mine… and maybe you’ve been successful achieving your ideal weight by working hard to maintain a healthy lifestyle.

But if that’s not your story—you might consider some extra help from semaglutide (or another GLP-1 agonist) to get to the top of that hill.

And hear me when I say: That’s OKAY.

Go ahead and give yourself the kickstart you need. Then, gradually, but surely, work to rebalance your diet, dump the sugar and carbs, and start moving your body.

After all, that will always be my FIRST prescription for weight loss that lasts a lifetime. But so what if it falls in line after a little help from a drug?

So, at your next physical, I encourage you to broach the subject of your weight with your doctor. Don’t sugarcoat anything, especially if you feel like giving up on the good fight. Ask your physician to confirm a healthy weight range for you (see the sidebar on page 2)—and whether they feel you might benefit from semaglutide to help achieve and maintain that goal.

The failure of BMI

Most researchers and doctors use a measurement called body mass index (BMI) to categorize your weight. It’s a simple math equation that looks at your weight compared to height. And according to the U.S. Centers for Disease Control and Prevention (CDC):

  • Underweight = BMI below 18.5
  • Healthy weight = BMI between 18.5 – 24.9
  • Overweight = BMI between 25.0 – 29.9
  • Obese = BMI between 30.0 – 40.0
  • Severely obese = BMI above 40

However, this calculation doesn’t always paint the full picture. A more accurate way of assessing obesity is to look at factors like waist circumference and total body fat. Discuss this, in addition to your BMI, at your next healthcare visit.

Should you worry about “Ozempic face”?

The press has had a field day lately warning people about “Ozempic face” or even “Ozempic butt.” So, let’s clear this up…

These physical changes aren’t direct side effects of the medication. Rather they’re the result of losing an extreme amount of weight over a short period of time.6 And this can happen no matter how you lose weight.

Plus, as I mentioned, I haven’t seen any of this extreme sagging in my patients taking semaglutide. Of course, there are a few things I recommend to all my patients taking the drug. And these will help reduce the risk of sagging skin.

For one, as soon as you’re able… get moving. Exercising is one of the best ways to help your skin return to normal after losing weight. It’s especially helpful if you can work in weightlifting and resistance training to build up your muscles, while you’re losing weight. This will fill in some of the space left behind after you lose fat. It also promotes skin elasticity.

You should also make sure to stay hydrated, follow a Mediterranean-style diet, and keep up your healthy supplement regimen. (For a good overview of the supplements you should take daily, refer back to the August 2020 issue of Logical Health Alternatives [“My 2020 ‘Desert Island’ supplement list”]. To access this issue, simply go to my website, www.DrPescatore.com, and log in using the “Subscriber” button at the far right of the blue navigation bar.)

In the end, just make sure you work closely with a doctor you trust when you start taking a weight-loss drug like semaglutide. They will monitor your progress and make sure you don’t lose too much weight too fast.

Is Ozempic safe for seniors?

Ozempic is approved for adults 18 years and older. But age should always be discussed when deciding an appropriate dosage.

That said, Ozempic is safe for most seniors. In fact, I even have a 93-year-old woman in my practice taking Ozempic, and she loves it! Of course, like everyone taking these types of drugs, seniors should work closely with a trusted physician and use extra caution.

In fact, I recommend starting slow if you’re over age 65. That means begin on the lowest dose—and see how your body responds.

In general, I find seniors taking Ozempic have nothing more to worry about except slower transit time of food through the digestive system. This is especially true if you’re already prone to constipation. (Side note: You will need to go off Ozempic two weeks prior to any kind of surgery, including cataract surgery.)


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