Let’s have a transparent conversation today about Ozempic side effects hair loss, GI motility. And more!

Social media (and the media in general) are booming with conversations about Ozempic^®. 

The rapid weight loss results are evident. 

Because we are a society obsessed with quick fixes combined with weight loss, it only makes sense that Ozempic would pick up this kind of momentum.

My goal today with this article is to explain more about what Ozempic is, and to share a darker side for these glp-1 drugs.

What is Ozempic?

Ozempic is the brand name for the injectable drug semaglutide created by Novo Nordisk.

Semaglutide belongs to a class of medications known as glucagon-like peptide-1 (GLP-1) receptor agonists. And what it does is mimics the GLP-1 hormone that is released in the gastrointestinal tract in response to eating. 

Two main roles of these GLP-1 agonists are:

1. Prompt the body to produce more insulin (which reduces blood glucose, sugar)
2. In higher amounts it also interacts with the parts of the brain that reduce appetite to signal the feeling of fullness

GLP-1 is one of many essential gut hormones that help to control eating behavior, nutritional ab­sorption, di­gestion, and the overall balance of energy coming into and being used by the body.

Type 2 Diabetes

Ozempic was originally approved by the U.S. Food and Drug Administration (FDA) in 2017 for use in adults with type 2 diabetes.

This is important to note because it was never intended to be part of the weight loss drugs group.

Penn State Health News reports,

It’s important for us to communicate this to our patients as there has been a great deal of misinformation on what is an FDA-approved drug for obesity. We have seen patients requesting their provider to start them on Ozempic, and it gets rejected by their insurance plan for coverage because the patient did not have T2DM. Popular culture has contributed to this kind of misunderstanding that Ozempic is a weight loss medication. Both Wegovy and Ozempic are Semaglutide but at a different dose, with Wegovy being approved by the FDA for treatment of obesity. The same is true for Mounjaro and Zepbound. Both are the antidiabetic medication Tirzepatide, but Zepbound is only approved for obesity treatment.

Ozempic works for type 2 diabetes by helping the body produce more insulin when needed. 

 It also reduces the amount of glucose, or sugar, produced by the liver, and slows down how quickly food is digested. 

This all helps to lower blood sugar levels and HbA1c.

Enter: Weight Loss Side Effects

It’s very common that a drug intended for one use then becomes more well-known for other uses.

Ozempic is one of them, but the trend for taking a medication to address one issue but having the “weight management bonus” is not new.

Here are some other examples of this happening:

• Penicillins (for antibiotic use) can cause weight loss
• Stimulants like methylphenidate (for ADHD) can induce weight loss
• Hydralazine for treating high blood pressure can cause weight loss
• Prozac (Fluoxetine), an antidepressant, has been known to also cause weight loss (at 60 mg+)

Sources: HERE and HERE

While most people are not intending to take drugs and medications with the desire to lose weight, like anything else, they can be used and abused for those reasons.

However, I’d argue that after the FDA’s approval of Ozempic in 2017, the intention for many was to use it for weight loss vs. type 2 diabetes.

In 2018, Ozempic launched in the U.S. as an injectable medication.

And then from 2019 – 2020 it expanded and saw massive growth:

• 2019: approved in several other countries, including the European Union, Japan, and Canada
• 2020: Studies indicated these weight loss “benefits,” leading to increased interest in its use for obesity management

In 2021, the FDA approved a higher dose of semaglutide via Wegovy for chronic weight management and weight loss purposes in adults with obesity or overweight with at least one weight-related condition like high blood pressure.

And once this happened there was surge in popularity for weight loss. Celebrities and social media influencers began singing its praises.

Before continuing on, make note that I bolded “Celebrities and social media influencers began singing its praises.”

And think about this: How many of those celebrities and social media influencers were truly obese and seeing an obesity medicine specialist?

Here we are today.

Ozempic Side Effects [Hair Loss, GI Motility + More]

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My intentions for writing this article are not to say that no one should take these medications.

Your health issues for addressing are just that: YOURS.

And if you have health issues that a health care provider has highly recommended Ozempic or any class of drugs like it for, then that’s your prerogative. 

I will never be the one to tell you that the treatment options you choose for any medical condition you’re faced with are right or wrong.

That being said, I don’t think we have talked enough about the side effects of drugs and medications. 

Furthermore, if you aren’t a type 2 diabetic and/or fall into the obese category, but are taking things like Ozempic as a quick fix for weight loss, the lasting issues can far outweigh the instant results you might be seeing.

According to Ozempic, here are the official “most common” side effects:

• Nausea
• Diarrhea
• Stomach (abdominal) pain
• Vomiting
• Constipation

They also make note of serious side effects that can occur:

• Possible thyroid tumors, including cancer
• Inflammation of the pancreas (pancreatitis)
• Changes in vision
• Low blood sugar (hypoglycemia)
• Kidney problems (kidney failure)
• Serious allergic reactions
• Gallbladder problems

Besides these, here are other common things people are experiencing….

Excess Hair Loss

There are many reasons this might be occurring.

One is simply rapid weight loss, which tends to happen due to hormonal changes. Significant weight loss places significant stress on the body. And this stress can disrupt the normal body functions, including the hair growth cycle.

In additional to hormonal changes, rapid weight loss can result in nutritional deficiencies, and a nutrient deficiency can result in hair thinning, temporary hair loss, and take a general toll on hair follicles. 

Additionally, AHLA experts (American Hair Loss Association) hypothesize that the hormonal shifts from semaglutide and similar drugs can trigger not only temporary telogen effluvium but also early onset male and female pattern hair loss, also known as androgenic alopecia.

Androgenic alopecia is a progressive condition that can continue to worsen over time, resulting in permanent hair loss.

NOTE: While one of the potential side effects is ‘possible thyroid tumors, including cancer,’ I have also been hearing of women who started having generalized thyroid problems.

Thyroid issues, like both prolonged hypothyroidism and hyperthyroidism can cause loss of hair.

I believe that for these individuals it’s not from the medication themselves, but the indirect result of rapid weight loss, leading to those nutrient deficiencies.

GI Motility

While excessive hair loss can feel embarrassing, the risk of hair loss is not life-threatening or usually enough to outweigh the perceived positive weight loss implications desired. 

Also, I’m not a hair loss expert.

However, I am a gut expert, and I know the important role gut plays in the use (and misuse) of these weight-loss drugs like Ozempic.

The main issue I see from taking Ozempic are the longer-term negative ramifications of gastrointestinal motility.

Even from an Ozempic legal perspective it has been stated:

However, it is suspected that semaglutides may affect the function of the vagus nerve, which controls the movement of food through the digestive tract. By slowing down the movement of food through the stomach, semaglutides may contribute to the development of gastroparesis and other gastrointestinal adverse events.

And while not everyone will experience these gastrointestinal issues, it’s very important to explore them.

Peristalsis

In a healthy gut, food moves through the GI tract through a process called peristalsis, which is a wave-like movement that helps push food forward. Other things contained in the GI tract help the process as well; chewing, digestive juices, stomach acid, bile, saliva, and enzymes.

That process, peristalsis is also known as stomach (or gastric) motility.

When functioning appropriately, the muscles in the intestinal walls contract and release.

This pushes food (aka ‘bolus’) from the esophagus to the stomach, through the intestines and then out. 

But when stomach motility is not working as it’s supposed to, those muscle contractions don’t work appropriately and the digestive transit is also inherently off.

This means that food doesn’t pass through the intestines properly, causing slow gut motility.

When GI motility functions appropriately, it will, without a doubt, have a positive and significant impact on your overall digestive health.

Learn all about peristalsis and bowel motility.

And while Ozempic doesn’t (directly) talk about peristalsis, many others do.

For example, Dr. Comite states,

“The most common side effects of Ozempic derive from slowing peristalsis (rippling GI waves that push contents through the gut).”

And Matthew Hayes, a nutritional neuro­scientist at the University of Pennsylvania, who has studied GLP-1 and other gut hormones since 2006, explains that these drugs work partly because they slow digestion and modulate glucose levels.

Note: Dr. Nirala Jacobi has identified motility as one of the 4 major underlying causes of SIBO.

Gastroparesis

This lack of gut motility can lead to gastroparesis, which is when the stomach takes too long to empty its contents resulting in slow digestive motility.

Ozempic may be linked to a dangerous medical condition known as gastroparesis.

This slows down or even paralyzes stomach and intestinal muscles, preventing the normal movement of food through the body.

It is one of the most serious potential side effects not disclosed on Ozempic’s label.

This delay can be beneficial if you have type 2 diabetes, but it’s definitely not a good thing for overall digestive health.

In fact, the NIH states,

If a patient is already experiencing bloating, nausea, abdominal pain, and discomfort in the abdomen, it is not recommended to use it due to concern about aggravating these symptoms.

The NIH reported a case of a patient who started taking semaglutide and later developed gastroparesis. 

But there’s more.

And this is directly correlating to peristalsis and the vagus nerve, which I’ve already mentioned above. 

Vagus Nerve

The Vagus Nerve has exploded in conversation as it relates to gut health.

Here are just 4 ways the Vagus Nerve and digestion are connected:

1. The vagus nerve tells the stomach to churn the food within it, as well as to produce stomach acid that’s necessary for digesting that food and a number of other things. That’s why a damaged or under-active vagus nerve often results in low stomach acid levels and low enzyme production. In turn, this means digestion is ineffective. (source)
2. The Cleveland Clinic reports, ” Vagus nerve damage can lead to gastroparesis, food not moving into your intestines.”
3. This research indicates, “A significant, and growing, body of literature supports the actions of gastrointestinal luminal microorganisms to modulate gut-brain signaling via vagal afferents, the so-called microbiota-gut-brain axis. While gut microbiota might normally be expected to activate vagal afferents directly only under conditions where intestinal permeability is compromised (e.g. following inflammation or stress), luminal bacteria may activate vagal afferents indirectly, subsequent to stimulation and release of neuroactive mediators from enteroendocrine cells or gut associated lymphoid tissue (GALT). (source)
4. Furthermore, the research study in #3 also states, “The GI tract receives the majority of the vagal efferent nerve fibers and harbors the most immune cells in the body.”

This is a HUGE component for which we might be overlooking because Ozempic quiets food noise in the brain.

Scientific American reports,

But scientists don’t have a technical definition for so-called food noise, and they are only be­ginning to understand how synthetic GLP-1 acts not just in the digestive system but in the brain. This work is illuminating neurobiological explanations for hunger and satiety, pleasure and reward—as well as why these sensations so critical to survival might get dysregulated, causing compulsive behaviors and addictive patterns. 

[Make note that for the Scientific American article, they share this information from a “good news” standpoint in the evolution of weight loss treatments. Again, depending on your current circumstances, that may or may not be a good thing.]

Loss of Muscle Mass

Another one of the huge potential side effects of Ozempic is the loss of muscle mass.

This one should not be overlooked when it comes to long-term weight loss.

Whenever rapid weight loss occurs, typically muscle mass decreases as well.

A recent study showed that those taking Ozempic, or any form of semaglutide, lost on average 60% fat and 39% muscle mass.

In another study that looked at those taking Zepbound, or the active ingredient tirzepatide, showed that patients lost roughly 25% muscle and 75% fat during treatment.

The article continues,

Weight-loss specialists explain that one-quarter to one-third of the weight lost is muscle, regardless of the tool: diet, bariatric surgery or medications. When calories are being restricted, the body turns to the energy stored in glycogen — the main source of energy that is primarily stored in the liver and muscles — and in fat and muscle to provide the fuel it needs.

While many see the fat loss and cheer, they oftentimes don’t understand the implications on weight loss and muscle. 

And maintaining muscle as we age is critical, not just for bone health and overall healthy aging, but also for weight maintenance.

Final Thoughts on Ozempic

If you’re reading this article and have followed A Gutsy Girl’s work for any length of time, the chance that you already have some sort of digestive health concern is probable. 

So while I absolutely don’t think desiring weight loss is inherently “bad,” I do strongly believe that weight loss through optimal gut health is key.

Just because these newer medications directed towards weight loss have FDA approval doesn’t mean they will be able to address the underlying problems.

As I’ve written about countless times, when we don’t address the root problem of anything the only lasting changes are new problems which ultimately surface. 

For any decision, you should always take a magnifying glass in identifying the risks and benefits. 

If you truly believe (in conjunction with your healthcare provider) that the benefits of taking Ozempic or the like will truly target the root problem then make the decision to move forward.

But if, after a thorough review of available data of these weight loss medications you understand the risks for both immediate and lasting ramifications, then know for certain that there are other ways to proceed on your journey.

Know for certain that with changes in both diet and lifestyle, you can make huge progress.

And your gut will thank you.

If you liked this article on Ozempic Side Effects [Hair Loss, GI Motility + More], you might also enjoy:

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For further reading and listening on Ozempic, you might enjoy:

1. OZEMPIC EXPERT WARNING: 12 Risks You Need To Know
2. The Ozempic Expert: Everything You Need To Know Before Using Ozempic For Weight Loss
3. Ozempic: A Weight Loss Miracle or Metabolic Menace?

Xox,

SKH