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What it’s like to stay on Ozempic for years

After about two years of taking Ozempic for diabetes or weight loss, people say they still have to stay diligent about diet and exercise.
Photo Illustration: Two Ozempic dispensers replace the hands of a clock
NBC News / Getty Images

Given the immense demand for Ozempic, the blockbuster drug that treats diabetes and is also prescribed off-label for weight loss, it’s not unusual to know someone who is starting or already taking the medication.

Data from Novo Nordisk, which makes Ozempic, suggests that U.S. providers were writing around 60,000 new weekly prescriptions for the drug as of April. But far fewer patients have been on the drug for years, given that it's relatively new, can cause side effects and is expensive without insurance coverage.

Barbie Jackson-Williams, 54, of Des Moines, Iowa, said she started taking Ozempic in early 2021 to lose weight and manage her Type 2 diabetes. She said the medication has helped her make changes that she’d previously found challenging, like subbing out pasta — her old favorite — for lean proteins and cutting out sweetened iced coffees from her diet.

“People are just taking it just to get skinny and that’s not true,” she said. “You have to do the work, and people don’t realize that.”

NBC News identified and talked with seven people who have been on Ozempic for between one and a half and two and a half years. All generally agreed that the medication was not a fast pass to good health. Although Ozempic has helped them either shed pounds, lower their blood sugar levels or both (reasons for taking the medication vary from person to person), maintaining those changes takes effort, they said.

Edward Matias
Matas has been on Ozempic for a year and seven months.NBC News / Courtesy of Edward Matias

“This isn’t a magic bullet or pill,” said Edward Matias, 45, a Connecticut resident who works in IT. “It’s not the fountain of youth. It takes work and commitment. If people are asking for this med because they want to lose weight and think they can eat anything at all, they’re in for a rude awakening.”

Matias said that because of his diabetes, he still has to be careful about eating foods high in sugar or carbohydrates. But his weight has dropped from about 310 pounds to 230 while taking Ozempic, he said. 

Most of those interviewed said that rather than being a cure-all, Ozempic has kick-started lifestyle changes, such as enabling them to exercise in ways they couldn’t before. 

Jackson-Williams said that losing weight has led her to feel more energetic and less inclined to be stationary.

“I want to be active. I want to be doing stuff. I can’t sit and watch TV like I used to,” she said.

Photos of Barbie Jackson-Williams, before (L) and after (R) starting Ozempic
Jackson-Williams lost 180 pounds while taking Ozempic. NBC News / Barbie Jackson-Williams

Ozempic and its sister medication, Wegovy — approved for weight loss for people who are obese or overweight with weight-related medical conditions — are considered long-term or lifelong treatments. But Ozempic has been on the market for less than six years, and Wegovy for two, so doctors and patients are learning in real time what it’s like to use the drugs for extended periods.

Dr. Eduardo Grunvald, an obesity medicine physician at UC San Diego Health, said he’s waiting on the results of trials to see if Ozempic and Wegovy reduce the risk of heart disease, as is the case with Trulicity, another weight-loss medication in the same class.

There’s also a possibility the drugs might lower bone density or raise the risk of thyroid cancer, which has been detected in animal studies involving Ozempic, Grunvald said.

“Are we going to see that pop up with millions and millions of patients on these medications?” he asked. But most likely, he said, the benefits “probably still outweigh the risk.”

Ozempic may enable people to exercise more

To manage his prediabetes, Arnob Alam said he does a 30-minute cardio workout almost every day — an increase from two to three times a week before he started Ozempic — and has started lifting weights.

“You still have to make adjustments to your diet and exercise. But it does prevent overeating because you do get sick if you eat too much,” said Alam, who works for the Defense Department in Washington, D.C.

Jackson-Williams credits her 180-pound weight loss to a combination of taking Ozempic and working out. She previously weighed more than 400 pounds, used an oxygen mask and slept in a recliner because she couldn’t breathe while lying flat. 

“Just walking out from my apartment to my mom’s car, I’d have to sit for 10 minutes just so I could catch my breath,” she said.

Now, Jackson-Williams said, she walks around the track and uses the cross-trainer at the gym. Her blood sugar dropped to prediabetic levels and she no longer needs oxygen support.

“I used to be dead from the waist down. Very dead. But I’m not now,” she said.

But several people said they saw their weight creep up when they stopped exercising or ate more than usual while on Ozempic.

Alam said he takes the drug to help him control his blood sugar and shed extra pounds but has gained back about 17 of the 25 pounds he originally lost after starting the drug. Travel and returning to the office disrupted some of his healthy routines, Alam said, though he still feels more agile. 

Grunvald said many people taking Ozempic or Wegovy have an easy time losing weight in the beginning, but eventually their bodies resist further weight loss. Regardless, he said, it’s healthiest to exercise and eat well in tandem with taking the medication.

“These drugs should be used with lifestyle modification. If you have to watch your diet and exercise with the medications, that’s what they’re meant for,” Grunvald said.

Healthy eating has gotten easier for many on Ozempic

Those who’ve been on Ozempic long-term said the medication reduced their cravings for fatty or sugary foods and all but eliminated the urge for mindless eating.

Kimberly Tabor, who takes Ozempic for her Type 2 diabetes but struggled for years with severe obesity, said she had changed her family’s diet before going on the medication but didn’t notice significant weight loss until after she started Ozempic.

“Working all the time and having a small child, I stopped doing stuff for me. And then I started getting the fast food, the stuff you could microwave or stick in the oven already prepared, because I didn’t feel like I had time,” she said.

Now, she said, she is better able to control snacking and eats smaller portions.

Kimberly Taylor before (L) and after (R) starting Ozempic
Tabor before Ozempic, left, and while taking the medication.NBC News / Kimberly Taylor

Serafina Raskin, general counsel at Found, a weight-loss company that offers online consultations for drugs including Ozempic and Wegovy, said she has found taking Ozempic easier than following the diets she used to rely on. She never had soda or fast food before, she said, but now she eats pasta on weekends — a food she used to avoid.

“It’s really the first time in my life where I feel that I do have some room to kind of not eat perfectly,” said Raskin, who is taking Ozempic off-label to manage her weight. “I don’t really restrict my carbohydrate intake anymore. And I get a signal from my brain that tells me, ‘Oh, you’ve had enough. You don’t need to eat anymore.’” 

Of course, people who have had positive experiences taking Ozempic — and minimal side effects — are the ones most likely to continue it long-term. Those interviewed said they were largely free of the side effects now, but other people have reported vomiting, fatigue, headaches and stomach cramps that forced them to go off the medication

Challenges to maintaining weight loss

Ozempic and Wegovy are both versions of semaglutide, a medication that can lower blood sugar and suppress appetite by mimicking a hormone that signals to the brain that a person is full. Like many drugs, the effects don’t last after patients go off them, so people tend to regain most of the weight they lost if they stop taking the medication.

Grunvald said many patients are under the false impression that they can stop taking Ozempic or Wegovy after they hit their goal weight. Others, he said, see their weight plateau and mistakenly assume they aren’t making progress.

“Many people think that the drug’s not working anymore,” Grunvald said. “It’s working great, because otherwise you would have regained the weight.”

Although much remains to be learned about the long-term effects of Ozempic and Wegovy, similar drugs could offer insight. In a study of people on the weight-loss medication Saxenda, about half of those who lost at least 5% of their body weight after a year kept the weight off after three years of taking the drug in combination with regular exercise and a low-calorie diet. But only 25% of those treated with Saxenda in 2021 stayed on it for more than a year, according to data from Novo Nordisk. 

For those committed to staying on Ozempic long term, high price tags and supply shortages can pose challenges. The Food and Drug Administration has reported limited availability of the three lowest doses of Wegovy and the highest dose of Ozempic. The medications can also cost more than $1,000 a month without insurance.

Wendy Tell before (L) and after (R) starting Ozempic
Tell before Ozempic, left, and after losing 30 pounds on the medication.NBC News / Wendy Tell

Wendy Tell, a retired teacher in Yorktown, Virginia, said she’s not sure she can afford to stay on Ozempic, which she takes primarily for Type 2 diabetes. Even though she’s on Medicare, she said, she currently pays more than $700 for a 90-day supply because of coverage limits in her prescription plan.

Tell said she dreads gaining back the 25 pounds she has lost.

“I’m at a dilemma,” she said. “Am I going to get it again? Because who has that much money?”