Ozempic injections on weight scale with red background

Four Reasons Ozempic Isn’t a Miracle Weight Loss Drug From a Longevity Doctor

Dr. Peter Attia sounds a warning about the wildly popular weight loss drug.

Not since the advent of Viagra has a drug caused such a frenzy. Stories are everywhere about the skyrocketing rise in popularity of Ozempic (also known as semaglutide) and similar medications for weight loss. An alarming side effect known as “Ozempic face” has some reconsidering the hype. And it turns out drinking while on Ozempic may thwart efforts to shed pounds.

Now Peter Attia, a renowned doctor with a focus on longevity, is urging caution when it comes to Ozempic and other GLP-1 agonists. Attia, who recently made an appearance in Chris Hemsworth’s Limitless National Geographic docuseries, works with patients toward the goal of lengthening their lifespan while improving their healthspan.

In an Instagram post, Attia covered some highlights from his newsletter article on the “downside” of GLP-1 agonists, a class of drugs called glucagon-like peptide-1 receptor agonists, which includes Ozempic. While touted as “miracle” drugs by some, Ozempic and related drugs may be anything but. Whether they could be helpful for you largely comes down to your individual body and situation. Here are the four main takeaways from Attia’s article about the pros and cons of Ozempic and its ilk.

(Note: This is specifically concerning the drugs’ use for weight loss. GLP-1 agonists like Ozempic are also used to regulate blood sugar in patients with diabetes. Before you start taking any new prescription drug, you should consult your doctor.)

You need to pay attention to body composition, not just body mass.

It can be easy to get lured into obsessing about your exact weight and body mass index (BMI). While those numbers can be meaningful, it’s also crucial to think more holistically about other health data. In particular, Attia advises, you should target body composition, which is used to describe the percentages of fat, bone, and muscle in the human body. 

“The goal is to increase the body’s overall proportion of lean mass,” Attia writes. “In other words, to improve body composition.”

Even for those with obesity, he says, “not all weight loss is healthy. While shedding excess fat mass (and in particular, visceral fat mass) has a multitude of beneficial effects on health, shedding lean mass – which includes muscle and bone – is associated with poorer health trajectories and reduced lifespan.”

Attia adds that significant weight drops inevitably mean a certain decrease in lean mass (usually about 25 percent of total weight loss), you want to limit lean loss. And Ozempic may prove to be a hindrance in that regard.

Ozempic may not be miraculous for everyone. But it could have benefits for certain people.

Attia is careful not to dismiss Ozempic altogether. He notes that there is still not a whole lot of data to determine the effects of GLP-1 agonists on body composition. But sub-cohort data makes the drugs “look a bit less miraculous.”

Two trials revealed that around 40 percent of semaglutide-induced weight loss was attributed to a decrease in lean mass, which is “substantially higher than ideal.” (The data comes from scans of small sub-cohorts, so more research is needed to be sure.) 

This could mean the drug is winnowing away your muscle, not just fat, which is not good. 

Here’s the critical but: Overweight and obese patients may find that a higher lean mass loss is an “acceptable cost” in weight loss efforts, so long as overall body composition is improving. Which it did in the two trials mentioned. So depending on your weight and struggle to lose excess fat, Ozempic may still prove beneficial.

Those with a normal weight may want to steer clear of the drugs.

If you fall into the category of “healthy-weight individuals,” Attia recommends more skepticism about Ozempic. The drug isn’t only being used by those with obesity for weight loss, and for those people: “Potential benefits of fat loss are minimal and are unlikely to offset the sizable health risks associated with reduced lean mass.”

Who should be most worried about a drop in lean mass? Those who already have low levels of lean mass, “as is common in older populations,” Attia writes.

There really is no such thing as a “miracle” drug.

A pill cannot replace healthy eating and exercise.

There really is no such thing as a “miracle” drug. The quick or easy fix almost always comes with drawbacks. For those who do decide to pursue Ozempic, “increasing weight-bearing exercise and consuming sufficient protein” can counteract lean mass losses, Attia writes.

And eating a balanced diet that includes protein, as well as hitting the gym (safely), are of course cornerstones to living a longer, better life. With or without Ozempic.