There’s An Ozempic Shortage. Here's What Happens When You Stop Taking It.

Ozempic isn’t a new drug, but the buzz around it is hard to ignore. That buzz is causing a shortage, which can have serious consequences for people with Type 2 diabetes.

Celebrities seeking to lose weight is just one factor driving a worldwide shortage of Ozempic, a drug originally approved to treat Type 2 diabetes that can also result in significant weight loss.

#Ozempic and #OzempicChallenge have over 400 million views combined on TikTok, as people gush about losing weight with the drug. This fall, Andy Cohen called out celebrities using Ozempic for weight loss, tweeting, “Everyone is suddenly showing up 25 pounds lighter. What happens when they stop taking #Ozempic ?????”

It’s an important question. Content creator and model Remi Bader, who was taking the drug because she was prediabetic and had insulin resistance, stopped taking it in 2020 and said it worsened her binge eating. People magazine reported that she gained double the weight back after she ceased taking the drug.

BuzzFeed News caught up with medical professionals and the company that manufactures it to get the inside info on why Ozempic has become a weight-loss hit and what happens when there’s none left.

That answer depends on why you’re taking it, said Archana Sadhu, MD, an endocrinologist and director of the diabetes program at Houston Methodist.

For people who are trying to lose weight, whether or not they need to, Ozempic will flush out of your body and you’ll go back to where you were, Sadhu said. There’s no withdrawal and you don’t need to taper off the drug, although you may feel hungry again and regain the weight.

But if you’re taking the drug to manage Type 2 diabetes, the consequences could be life-threatening. Blood sugar will soar almost immediately and could even lead to heart attacks, strokes, kidney damage, and even death, said Sadhu, who is fielding panicked phone calls from people with Type 2 diabetes who are running out or have run out.

What is Ozempic?

Ozempic is a brand name for semaglutide, an injectable medication that the FDA first approved in 2017 for the treatment and management of Type 2 diabetes and heart complications in people with the condition. It was immediately adopted by the medical community to control blood sugar levels, which it does very well. “It’s much more potent than existing drugs,” Sadhu said.

In clinical trials, Ozempic turned out to have a side effect: weight loss. It suddenly became attractive to people without Type 2 diabetes who wanted to shed pounds.

The drug was originally used “off label” as a weight-loss aid but, soon enough (June 2021), the FDA also approved it under the brand name Wegovy for weight loss in people who were overweight or obese, which includes two-thirds of Americans. There’s also a wide overlap between overweight/obesity and Type 2 diabetes.

But, Sadhu noted, there are strict criteria for using drugs such as Ozempic and others in the same drug class for obesity. “You have to have a body mass index of 27 and certain chronic conditions like heart disease and fatty liver disease or a body mass index of 30 and above,” Sadhu said. To put that in perspective, someone who is 5’5'' tall would need to weigh about 160 pounds to have a BMI of 27 and 180 pounds to have a BMI of 30.

“For someone who has a BMI of 24 and wants to be 22, the risks don’t outweigh the benefits,” Sadhu said.

How do Ozempic and Wegovy work?

Ozempic is one of a class of medications known as GLP-1 receptor agonists. These drugs work in multiple ways.

“One is to go to the brain appetite center to suppress appetite,” Sadhu said. They also delay food emptying from the stomach which makes you feel fuller longer. Most importantly for Type 2, Ozempic is an artificial version of a gut hormone called incretin which helps the pancreas release the right amount of insulin when blood sugar levels are high.

Most people take the shot once a week at dosages ranging between 0.25 milligrams and 2 milligrams per week, said Dr. Andrew Kraftson, director of the post-bariatric endocrinology clinic and weight navigation program at the University of Michigan, Ann Arbor.

Wegovy versus Ozempic

The only difference between Wegovy and Ozempic is their maximum dosage levels (Wegovy is higher) and what they’re approved for, explained Dr. Jamy Ard, codirector of the weight management center at the Atrium Health Wake Forest Baptist Medical Center.

Both drugs are semaglutide, but Ozempic is approved to treat Type 2 diabetes, while Wegovy is approved to treat obesity, Ard said. Ozempic’s top weekly dosage is 2 milligrams weekly, while Wegovy’s is 2.4 milligrams.

“Although Wegovy and Ozempic both contain semaglutide, they are different products with different indications, dosages, titration schedules, and delivery devices,” a spokesperson for the pharmaceutical Novo Nordisk, which manufactures both drugs, wrote in an email. “The products are not interchangeable and should not be used outside of their approved indications.”

Experts told us these differences in the medications were negligible.

Why has Ozempic become so popular, and why is there a shortage of it?

The surge of interest and resulting shortage in Ozempic has been fueled by a combination of factors.

The company said it anticipated that the demand for Ozempic would grow, just not at the pace they’re seeing. According to the company’s numbers, usage of the drug grew 69% globally year to date, while usage rates of its weight management medications, which includes Wegovy, grew 75%.

The experts said the largest factor driving the popularity of Ozempic is how effective Wegovy is and the resulting demand for semaglutide medications. Society’s anti-fat bias and the influence of the weight loss industry on medical professionals, also play a role.

“The average weight loss drug on the market prior to Wegovy caused 7% to 10% of body weight loss, whereas Wegovy is now topping 15% to 17% body weight loss,” Ard explained.

An even more effective drug, Mounjaro (the brand name for tirzepatide, which is in a similar class of medications), was approved by the FDA in May 2022, Ard added. At higher doses, Mounjaro can result in losing as much as 20% of your body weight, which is similar to results from bariatric surgery, Sadhu said. But this, too, is headed for shortages.

When a medication causes weight loss, there tends to be a word-of-mouth effect, said Dr. Daniel Bessesen, a professor of medicine in the division of endocrinology, metabolism, and diabetes at the University of Colorado’s School of Medicine.

When people hear or see that someone has lost weight, they may ask their doctor for the same medication, Bessesen said, adding that many older weight loss meds haven’t had this impact because they’re not as effective.

A shortage from the start

Soon after Wegovy was released, it was clear that the demand was outstripping supply, Kraftson said. There was also a supply issue regarding the device used to inject Wegovy, Ard added.

Once the Wegovy shortage began, doctors compensated the best they could. People also quickly realized Ozempic and Wegovy were the same drug under different brand names.

“Since physicians, and now patients, know that Ozempic is the same medication as Wegovy, the workaround [for clinicians] has been to prescribe Ozempic while waiting for the Wegovy backorder to resolve,” Kraftson said.

As more people and clinicians turned to Ozempic as a replacement for Wegovy, it wasn’t long before a shortage of the former ensued, the experts explained.

The insurance factor

You can’t really explain the Ozempic shortage without discussing the insurance angle.

Many health plans don’t cover weight-loss medications, but they do tend to cover diabetes medications, and Ozempic, unlike Wegovy, falls into this category.

Doctors can prescribe Ozempic for obesity off label — for uses other than its official designation — allowing people to get coverage for a medication they otherwise couldn’t, Ard said. When companies do require evidence someone needs diabetes treatment, doctors can usually provide blood tests that show someone has poorly regulated blood glucose levels or prediabetes, Bessesen added.

The off-label prescription use of medications is very common in many areas of medicine. But since health issues related to weight impact so many individuals, and given the publicity surrounding the issue, this case has been generating a lot more attention than normal, Kraftson explained.

But why do insurance companies cover diabetes medications and not weight management medications?

Part of the reason insurance companies offer less coverage for weight management medications is because they tend to be very expensive, Bessesen explained. He said by far the most widely prescribed weight management drug, phentermine, entered the market around the late 1950s and has maintained its usage status despite only tending to result in 3% to 5% loss of body weight – primarily for one reason: its low cost.

“Phentermine costs around $10 to $20 a month, whereas semaglutide medications cost more like $1,200 a month,” he said.

Ozempic versus other weight loss drugs

Adding to this issue is that older-generation weight management drugs were generally not very effective or had risky side issues, encouraging the idea that these medications don’t work well and aren’t worth the risk of an insurance plan covering it, Bessesen described. Yet these concerns are no longer warranted, according to the experts.

There is an abundance of evidence supporting the efficacy and safety of newer anti-obesity medications like Wegovy, Bessesen said. “But from the perspective of an insurance company, these drugs are extremely expensive. Around 42% of all adults in the US have obesity, and most people need to use these drugs indefinitely.”

With these factors in mind, the idea of insurance companies trying to provide coverage for everyone who qualifies to take weight loss medications seems near impossible, Bessesen concluded.

How are shortages affecting patients?

When asked whether their patients are affected by Wegovy and Ozempic shortages, the experts were mixed.

Dealing with the ramifications of these shortages is a daily hassle, Ard said. “I probably have several emails in my inbox right now with questions like, ‘Where can I find it?’, ‘Do you know which pharmacies still have any?’, ‘How can I get a refill because it’s on backorder?’”

Bessesen felt the shortages weren’t as big of an issue based on his experience. “The shortage seems to be pharmacy-dependent, and to an extent, payment method–dependent,” he said. “But it’s clear that the production capacity compared to the demand for these medications has been exceeded.”

For people with Type 2 diabetes, Sadhu said doctors are having to switch to older, less effective drugs to control blood sugar.

How long will it take to resolve the Ozempic and Wegovy shortages?

When asked when the Ozempic shortage will be resolved, a Novo Nordisk spokesperson told us that 1- and 2-milligram doses of Ozempic are now available for patients across the US — but, due to high demand and global supply chain constraints, the company is still experiencing intermittent supply disruptions on the Ozempic pen that delivers 0.25- and 0.5-milligram doses.

Ozempic continues to be manufactured and shipped, the company spokesperson wrote, but patients in some areas of the country will experience delays. They added that the company is making both short- and long-term investments to solve these temporary challenges.

The spokesperson mentioned that while they recognize that some healthcare providers may be prescribing Ozempic for patients whose goal is to lose weight, it is up to each provider’s discretion to choose the best treatment approach for their patients.

Novo Nordisk said it doesn’t encourage off-label use of its medicines, and is committed to fully complying with all applicable US laws and regulations.

Ozempic continues to be manufactured and shipped, the company spokesperson wrote, but patients in some areas of the country will experience delays. They added that the company is making both short- and long-term investments to solve these temporary challenges.

What do the experts think about celebrities and TikTokers promoting Ozempic for weight loss?

When a Twitter user asked Elon Musk in October 2022 what his secret was to looking so “fit, ripped, and healthy,” he replied, “Fasting … And Wegovy.”

(Novo Nordisk said it does not currently work with any celebrities to promote Wegovy.)

Ard said he’d be remiss not to mention that part of the demand for Wegovy and Ozempic is being driven by celebrities, and social media influencers using the drug. “As an obesity medicine specialist,” he said, “I really cringe at this thought.”

When these drugs are used for cosmetic, not medical, purposes, it can drive usage rates that create or worsen disparities in medication access, Ard said. In other words, people who don’t really need these medications, but can afford to pay a lot for them, can cause supply issues for people who do need the medication but can’t afford to pay for it outright.

Sadhu is imploring people without diabetes to forgo the drug temporarily in favor of those who are desperately sick.

As for the safety of basing weight-loss treatment decisions off social and celebrity advice, it’s fine to hear about people’s methods of losing weight, but you should treat obesity as you would any other medical condition, Ard said.

“You wouldn’t find me seeking advice on how to treat heart disease or cancer from a celebrity or influencer with no medical training,” Ard said. “You really shouldn’t turn to these sources for advice on how to lose weight healthfully.”

When people hear about celebrities using weight management medications, the story that people absorb is that this is a cosmetic drug, Bessesen added. “This kind of thinking furthers the engrained idea many people, and society in general, have, that weight is simply a cosmetic, lifestyle issue.”

People may think following a good diet or exercise routine can cure health issues related to weight, but this simply isn’t true. “Weight is regulated by a complex biological system, and in most cases people don’t choose what they weigh. The body really has its own idea of what it wants to weigh, and will work to maintain or return to that weight,” Bessesen said. This means that once you stop taking weight loss medications, you’ll probably regain all the weight you lost.

Bessesen explained that he sees obesity as a biological weight regulation problem and wishes more people — including clinicians — would view it this way.

How to get help

The experts suggested that for people looking to treat obesity or get rid of excess weight, a good first step is to talk with their family doctor.

Bear in mind that even with medication, or bariatric surgery for that matter, diet and exercise still play an outsize role in weight management. “The effect of these medications goes away immediately when you stop them,” Sadhu said. “You have to be building long-term healthy lifestyle habits.”

If you feel like you’re not getting the support or level of advice you need from your doctor, look for a provider who specializes in treating obesity, Ard said. Many family doctors don’t get special training in how to treat the condition.

If you’re having trouble finding an expert, you can search for specialists in your area using a portal provided by the Obesity Medicine Association.