12 Surprising Side Effects of Ozempic

Ozempic, or semaglutide, is a once-weekly injectable drug that is used for the treatment of type 2 diabetes. Some doctors prescribe it "off-label" for weight loss. It's the rising popularity of the latter that's caused a pop-culture sensation over the past year, with users flocking to social media to document their experiences with the drug. But like any medication, Ozempic can cause side effects. Some of them can be surprising, even downright bizarre. 

"An increase in suicidal ideation, depression, and anxiety has been noted in clinical trials with Ozempic," says Dr. Adjoa Smalls-Mantey, a board-certified psychiatrist, certified lifestyle medicine physician, and immunologist in New York City. "The mechanism by which this happens is unknown but it is thought it potentially alters chemicals in the brain leading to these feelings. In addition, physical discomfort, which is well reported, such as nausea and vomiting, especially when initiating treatment, can lead to more feelings of distress."

"Ozempic lowers cravings by its GLP-1 agonist activity, reducing the amount of food people eat, says Smalls-Mantey. "Observations in clinical studies have shown it can reduce alcohol consumption, opiate, cigarette, and other substance use."

College professor Maria E. Rosas recently wrote in Newsweek that after taking Ozempic for two weeks, she developed "a severe, burning pain in my back, shoulders, and arms. I was in excruciating pain." This was followed by "a worse burning pain in my genital area and buttocks…my genitals, anus, and buttocks were severely burned, some areas with charred skin. It was as if I was exposed to sunlight for days."

"Some people are quite surprised by how rapidly weight loss can happen on Ozempic and contribute to flabby skin," says registered dietitian and nutrition consultant Sheri Berger, RDN, CDCES. "In particular, some people have noticed flabby skin in their face, and this is surprising. To prevent such rapid weight loss, consume a balanced diet that includes fruits, vegetables, whole grains, healthy fats, and lean protein. These habits are important to develop to maintain weight loss over time as well."

In addition to flabby skin in the face, some Ozempic users are reporting deflated or saggy-looking skin on their backside caused by rapid weight loss. The condition has earned a nickname on social media: "Ozempic butt."

"Ozempic works by controlling appetite, helping people to feel fuller longer. I've noticed side effects such as nausea, vomiting, loss of appetite, but these can usually be managed with proper medical supervision," says registered dietitian Daniel Murphy of Apex Nutrition. "Ultimately, it's important to work with a healthcare provider to determine if Ozempic is the right medication. There is also no escaping lifestyle and diet management long term."

"Ileus, or temporary intestinal paralysis, is one of the many surprising reported side effects of Ozempic, one that the FDA actually updated Ozempic's label to include a warning about," says Catherine Rall, a registered dietitian with Happy V. "What this means is that the typical muscle contractions that occur within the body which move food in your intestines temporarily stop happening. Food essentially gets stuck, and the feeling of that mimics a bowel obstruction, which can cause serious discomfort and even dehydration. This side effect is rare, but it happens often enough for a warning to be included on the label."

In April, NBC News reported that some people taking weight loss drugs like Ozempic, Wegovy and Mounjaro were experiencing hair loss. ""What is really striking for folks is that there are no scalp symptoms. It doesn't hurt, there's no itching, but you can run your hands through your hair and you have a handful of hair. It can be really disconcerting to see that," said Dr. Susan Massick, a dermatologist at Ohio State University. Experts think this might be caused by a "shock to the system" that results from eating significantly less.

"Ozempic can also be used as an adjunct treatment for patients using psychotropic medications that cause metabolic syndrome, usually antipsychotic medications," says Smalls-Mantey.

"Semaglutide can significantly help people control their blood sugar. But the studies also showed it can cause vision changes, including blurred vision, worsening of diabetic retinopathy and macular complications," says the American Academy of Ophtalomology. This happens because of changes in the body's blood sugar level. "When the body experiences a change in sugar level, it can affect the shape of the eye's lens. This change is what causes blurry vision, a side effect of semaglutide."

Changes in blood sugar can also cause Ozempic users to feel dizzy or lightheaded. Experts say this effect is usually temporary.

A new epidemiological study released this month found that in addition to stomach paralysis and bowel obstruction, Ozempic may cause pancreatitis, or inflammation of the pancreas.