This article is written by registered dietitian, Julia Henry, who specializes in GI conditions and PCOS at Bamboo Nutrition LLC.

In recent months, medications such as Ozempic and its cousin, Wegovy, have become very popular on social media for their ability to help many people lose weight. In fact, these two medications are the same medication, generically called Semaglutide, with Ozempic being prescribed for managing diabetes and Wegovy being prescribed for weight loss. I have gotten a lot of questions about these medications from my clients with PCOS (Polycystic Ovarian Syndrome). This makes sense, as the most common recommendation for PCOS is weight loss, and insulin resistance and blood sugar management are very common with this condition. Below you will find information intended to allow people to be able to make an informed decision about whether or not these medications are right for them.

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Ozempic was approved by the FDA in 2017 for treatment of diabetes. Research thus far has found that this medication has been shown to increase insulin production, decrease the amount of sugar released by the liver and slow gastric emptying, which can release sugar into the bloodstream more slowly. It has also been shown to reduce weight in many people, which is a huge reason it has become so popular.

But what does the research say about using these medications for PCOS?

So far, studies have shown that it can be more effective than metformin in reducing blood sugar and insulin, and improving regularity of periods as well as improving fertility. I mention metformin because this is a commonly prescribed medication for those with PCOS dealing with blood sugar issues. These medications, however, have not been shown to increase risk of hypoglycemia the way other diabetes medications can. Other general benefits appear to be decreased risk of cardiovascular disease, stroke and kidney disease, as well as improvements in blood pressure and cholesterol.

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As with any medication, however, there are also important drawbacks to consider. Side effects are one, and may include nausea, vomiting, diarrhea, heartburn, gas, headaches and blurred vision. They may also decrease the effectiveness of birth control methods, requiring additional birth control measures to be taken. There is also concern for thyroid cancer and pancreatitis. As a dietitian, one side effect that comes up a lot in my work with clients is the decrease in appetite. This can make it challenging to eat enough to meet someone’s needs and, in severe cases, could lead to malnutrition. For those looking to improve their relationship with food and/or practice intuitive eating, this can present challenges in being able to connect with one’s body and eat according to its cues. This is especially dangerous in those with eating disorders, whose body cues are often distorted from undernutrition. I do not recommend taking these medications if one has an eating disorder or a history of eating disorder.

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The longest these medications have been studied is 60 weeks.

The most common reason I hear from people who are interested in taking these GLP-1 medications is that they are helpful for weight loss. While this may be true, studies show that weight loss plateaus after about 60 weeks, and that when one stops taking the medication, the weight lost is regained. This is true for any weight loss method, and research also indicates that weight cycling itself has negative effects on our health. Weight cycling is the weight loss and regain that occurs over time during repeated attempts at weight loss. Essentially, the more we try to lose weight, the more we are likely to weigh in the long run. While there is nothing wrong with living in a larger body, if one’s goal is to weigh less overall or to improve health outcomes, intentional weight loss attempts do not appear to help people reach those goals. The harm that this causes, and the frustration and shame that can come with it, are reasons why I have found it more beneficial to focus on self-care and lifestyle behaviors instead of weight loss.

“In my professional opinion, this is just the newest way that our culture and healthcare system’s obsession with weight actually harms people instead of helping them. ”

— Julia Henry

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Finally, due to the popularity of Ozempic and Wegovy, there are often shortages of these medications, including right now according to the FDA. For my clients who have had diabetes, this made it very difficult for them to manage their blood sugar and had an impact on their health. Additionally, insurance does not always cover these meds, or may stop covering them, which can lead people to be frustrated when they have to stop them and they gain all the weight back. In my professional opinion, this is just the newest way that our culture and healthcare system’s obsession with weight actually harms people instead of helping them. There is no evidence of any method of weight loss that works in the long term and, often, the risks can far outweigh the benefits when it comes to medications for weight loss. For those clients who are interested in trying these medications, I like to encourage them to focus on the benefits to their blood sugar and other actual health markers rather than focusing on the effects on their weight. This can keep the focus on wellbeing rather than body image, which is much more likely to help us take care of ourselves.

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