Ozempic for Weight Loss: Evidence, Eligibility, Coverage
Ozempic is not FDA approved for weight loss. It is approved for type 2 diabetes, heart risk and kidney disease in type 2 diabetes. Wegovy, with the same ingredient, is approved for weight loss. In STEP 1, people on Wegovy lost 14.9% of body weight on average, vs 2.4% on placebo.
- For weight loss
- Not an approved use
- Active ingredient
- semaglutide
- How it is taken
- weekly injection
- Best result (STEP 1)
- 14.9% weight loss
Ozempic overview
Its half-life lasts about 1 week. Once 7 d pass, half has gone; about 3% remains after five half-lives (35 d).
In SUSTAIN 1, people with type 2 diabetes lost 4.7 kg over 30 weeks, compared with 1.2 kg on placebo.
Monthly prices in US dollars include the list price and self-pay offers, each taken from the maker's price page.
Sources: FDA label (DailyMed), healthsystemtracker.org, prnewswire.com 1 2.
Who qualifies?
| Who sets the rule | Who qualifies |
|---|---|
| FDA label | Adults with type 2 diabetes use it with diet and exercise to lower blood sugar. |
| FDA label | For adults who have heart disease and type 2 diabetes, it reduces the chance of a heart attack, a stroke, or heart-related death. |
| FDA label | When adults have chronic kidney disease and type 2 diabetes, this medicine lowers the chance of kidney failure, worsening kidney disease, and death related to the heart. |
| Typical commercial plan (Aetna policy) | BMI 30 or higher |
| Typical commercial plan (Aetna policy) | BMI 27 or higher with a weight-related condition |
| Typical commercial plan (Aetna policy) | the first step is a diet and activity program that lasts 6 months |
Sources: FDA label (DailyMed), aetna.com.
What the trial results show about weight loss
Ozempic itself was not tested in this group, and the trials shown used brands with the same ingredient.
| Trial | Medicine | Who took part | Length | People | Main result | Comparison |
|---|---|---|---|---|---|---|
| STEP 1 |  Wegovy | Adults with obesity or overweight, without diabetes | 68 weeks | 1,961 | 14.9% weight loss | 2.4% on placebo |
| OASIS 4 | Wegovy | Adults with obesity or overweight, without diabetes | 64 weeks | 307 | 13.6% weight loss | 2.4% on placebo |
Source of the trial data: STEP 1 (FDA label (DailyMed)).
What is different for weight loss?
| What changes | What the label says |
|---|---|
| Acute Pancreatitis | Can cause inflammation of the pancreas. Get care for severe stomach pain that will not go away, and stop it. The pain sometimes spreads to the back. |
| Acute Gallbladder Disease | Gallstones and gallbladder inflammation can happen. Report upper-right belly pain, fever, or yellow skin or eyes. |
Source: FDA label on DailyMed.
These warnings come from the label: FDA label on DailyMed.
How coverage works for weight loss
When a GLP-1 is used for weight loss alone, Medicare Part D does not cover the cost.
Prior authorization is the standard in all places where Medicaid covers GLP-1s for weight loss
Sources: humana.com, KFF.
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- Does Medicare Cover Ozempic? Part D Rules and the GLP-1 Bridge
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- Cheapest Way to Get Ozempic
- Does Medicaid Cover Ozempic? Criteria, Copay, How to Appeal
Weight loss
| Medicine | For weight loss | How it is taken | Trial result |
|---|---|---|---|
| Wegovy | FDA approved | weekly injection or daily tablet | 14.9% weight loss |
 Zepbound | FDA approved | weekly injection | 20.9% weight loss |
 Foundayo | FDA approved | daily tablet | 11.1% weight loss |
 Saxenda | FDA approved | daily injection | 7.4% weight loss |
| Ozempic | Not an approved use | weekly injection | Not listed |
 Rybelsus | Not an approved use | daily tablet | Not listed |
 Mounjaro | Not an approved use | weekly injection | Not listed |
 Trulicity | Not an approved use | weekly injection | Not listed |
 Victoza | Not an approved use | daily injection | Not listed |
| Byetta | Not an approved use | twice-daily injection | Not listed |
Sources: FDA label (DailyMed).
Questions to ask your prescriber
- Does my plan include a separate weight rule of its own, and does my weight meet the label's weight rule?
- Which listed weight-related conditions in my record count?
- What weight loss should I expect during the first year?
- If I stop taking it, what happens?
Read the full prescribing information for Ozempic at DailyMed.