Understanding the Risks of Off-Label Use of Ozempic: What You Should Know


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Ozempic, the brand name for semaglutide, is an injectable medication manufactured by the pharmaceutical company Novo Nordisk and used to manage type 2 diabetes. It improves blood sugar levels in people with diabetes and decreases the risk of other health problems associated with diabetes, such as cardiovascular disease and stroke. It also happens to cause weight loss. While the drug is only FDA-approved to manage diabetes, it has become increasingly popular for its off-label use as a weight loss drug.1

What Is Off-label Use of Ozempic?

The off-label use of Ozempic is prescribing the drug for weight loss. Some mechanisms of action that help the body reduce blood sugar levels in people with diabetes also cause people to lose weight.

Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1 RA) that mimics the body’s natural hormones released in the gut when we eat. GLP-1 works to manage diabetes by doing the following:

  1. Stimulating the pancreas to produce more insulin
  2. Stopping your liver from releasing too much sugar into the bloodstream
  3. Slowing down gastric emptying (food leaving your stomach)

Slowing down gastric emptying causes people to feel fuller and, therefore, to have a decreased appetite, resulting in weight loss. In addition, higher levels of GLP-1 affect the part of your brain that tells you you’re full. The version of Semaglutide FDA approved for weight loss goes by the brand name Wegovy. However, the drug is costly and not covered by insurance, whereas Ozempic is covered, which is why Ozempic is frequently prescribed for its off-label purpose. 2

Potential Risks Associated with Off-label Use of Ozempic

Using Ozempic does not come without risks. There are severe health problems associated with this drug. The FDA has issued a boxed warning (previously called a Black Box Warning) for Ozempic due to its potential to cause thyroid tumors and thyroid cancer. A boxed warning is the most serious safety warning issued by the FDA and not something to take lightly.3

Here are some other serious side effects of Ozempic:

  • Pancreatitis (inflammation of the pancreas)
  • Kidney failure
  • Gallbladder disease
  • Changes in vision
  • Hypoglycemia (low blood sugar)
  • Allergic reactions

The most common side effects are stomach issues, which include nausea, vomiting, diarrhea, constipation, and abdominal pain.1

There is also a dark side of Ozempic that goes beyond the physical side effects. There have been several reports of suicidal behavior. The higher doses of semaglutide come with warnings for suicidal behavior and thinking, and the FDA recommends that prescribers monitor their patients for suicidal thoughts and behaviors if they are taking this drug.4

Other safety concerns involve the black market for this medication. There is currently a shortage of the medicine, but buying Ozempic without a prescription is illegal and dangerous. Any prescription drug should be used under a healthcare provider’s supervision to ensure safety.5

Additionally, not everyone experiences weight loss when taking these medications, and some may reach a point where they stop losing weight or even gain weight as their bodies adjust to the drug. This drug is designed for long-term use. To maintain weight loss, you can’t stop taking it, which means enduring any associated side effects. When you stop taking the drug, weight regain happens fairly quickly.

Unfortunately, using Ozempic for weight loss comes from societal pressures and diet culture promoting weight reduction and smaller body sizes. This media contributes to the perpetuation of weight bias, weight stigma, and body shaming. This message can be very triggering and damaging for individuals suffering from eating disorders and for those in recovery from their eating disorders.6

What to Do If You Have Any Questions or Concerns About Off-label Use of Ozempic

If all the celebrity headlines and social media talk about this drug are negatively affecting you, reach out for support. Talk to your healthcare provider if you have any questions about the off-label use of Ozempic. It’s especially important to disclose if you have any history of mental health issues or disordered eating, so your healthcare provider can help you make the best decisions regarding your health and mental well-being.

If you are struggling with body image or disordered eating, reach out to the team at Selah House and find out what treatment options are available. We are here to support and guide you on your journey toward healing. You can reach us at 866-324-8081 or by filling out our contact form.


  1. Ozempic. (2023). What is ozempic? https://www.ozempic.com/why-ozempic/what-is-ozempic.html
  2. UCLA Health. (2023, January 12). Semaglutide for weight loss – what you need to know. https://www.uclahealth.org/news/semaglutide-weight-loss-what-you-need-know#:~:text=For%20that%20reason%2C%20health%20care,signal%20you%20to%20feel%20full.
  3. Delong, C., & Preuss, C. (2023, February 11). Black box warning. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK538521/
  4. U.S. Food and Drug Administration. (2021, June 4). FDA approves new drug treatment for chronic weight management, first since 2014. https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014
  5. Mitchell, E. (2023, May 29). Fears grow over illegal sale of Wegovy and Ozempic. Healthnews. https://healthnews.com/news/fears-grow-over-illegal-sale-of-wegovy-and-ozempic-on-social-media/
  6. Harrison, C. (Host). (2023, April 3.). The truth about those new diet drugs. (No. 316). [Audio podcast episode]. In Food Psych. Food Psych Programs, Inc.

Author Bio:
Kate Delaney Chen, BSN, RN-BC is a healthcare writer and registered nurse with over 17 years of bedside experience. She specializes in Psychiatric Nursing and Nephrology and currently works at a nationally recognized Inpatient Eating Disorders Program.

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