Dear Doctors: I’m trying to lose the 18 pounds I have gained since the pandemic. It has been hard enough that I’m wondering about Ozempic. How does that work? I’m also hearing about people doing Ozempic microdosing. Do you know what that is and why you would do it?
Dear Reader: Ozempic is a drug that helps manage blood glucose levels in people living with Type 2 diabetes. It works by mimicking a hormone called glucagon-like peptide-1, or GLP-1, which stimulates the body’s production of insulin. This hormone also puts the brakes on both appetite and digestion, which is how Ozempic became popular as an aid for weight loss. Because this is an off-label use, insurance may not cover the weekly injections, which can be costly. And like many medications, Ozempic can cause side effects. These include feeling nauseated, vomiting, diarrhea, upset stomach, headache, dizziness and a complete loss of appetite. Also of concern is the loss of lean muscle mass that can occur during weight loss on the drug.
The cost and possible side effects of Ozempic appear to have led to yet another off-label use. That’s the microdosing you are asking about. For those who are not familiar, microdosing is the act of taking a fraction of the recommended dose of a drug. The practice dates back to the early 1990s, when it was used to safely study how a newly developed drug is absorbed, used and eliminated by the body. Microdosing later became popular in conjunction with psychedelics. Now, thanks to the reach of social media, microdosing Ozempic in order to reap its benefits is becoming increasingly popular.
The thinking is that a smaller amount of the drug can still trigger its effects, but on a more modest scale. For many people adopting the practice, the goal is to curb hunger just enough to make a weight-loss regimen easier to sustain. Smaller doses also lessen the cost of the drug, and may help avoid side effects. The practice involves using just a portion of the weekly dose.
Needless to say, because this is an experimental and unauthorized approach, there are no microdosing guidelines. There is also no reliable information about the safety of this practice, or the possible effects, either good or bad.
Interestingly, some people who have taken to microdosing Ozempic are in search of the unexpected side benefits that have emerged. Clinical trials of GLP-1 drugs have found they can lower inflammation, decrease the risk of cardiovascular and kidney disease and may help cut cravings for alcohol and tobacco. Newer research is looking at how the anti-inflammatory effects of these drugs might be helpful to people living with neurodegenerative diseases, such as Alzheimer’s and Parkinson’s.
If you are considering using a GLP-1 drug to aid in your weight-loss goal, it is important to talk it over with your health care provider. They will fully explain the benefits, as well as the possible side effects. If you move forward with this approach and side effects do occur, your physician can help you manage them.
(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
