Ozempic seems to be very popular. Someone told me it’s wonderful. Someone told me I should avoid it. What do you think?

By Aharon Elkayam, M.S.

Aharon’s new series, “Health FAQs,” answers common questions about popular and practical health topics — giving you honest answers rooted in science, and committed to natural, sustainable solutions that work in tune with how your body is designed to function.

Ozempic and similar weight-loss drugs are all the rage worldwide, promoted as a breakthrough solution to obesity. They suppress appetite and produce significant weight loss, which understandably makes them attractive to people who have struggled for years.

It seems like people have finally found a “silver bullet” for our obesity problems, in a shot.

But before using one, it’s important to understand what these medications actually do — and what they don’t.

The most important thing to understand is that Ozempic does not heal the root causes of obesity.

It doesn’t help you eat a healthier diet. It doesn’t repair a damaged relationship with food. It doesn’t build muscle or encourage exercise.

It primarily works by interfering with normal appetite and digestion so that you eat less.

Sounds great, right? For some people, in the short term, it certainly can be. But eventually you have to face reality: forcing the body to consume less food isn’t the same thing as restoring health.

How does Ozempic work?

Ozempic contains semaglutide, a drug that mimics a hormone called GLP-1. It sends strong fullness signals to the brain, reduces hunger, and slows the movement of food out of the stomach. In other words, it suppresses your desire to eat.

This can be effective for cutting calories, but hunger isn’t merely an inconvenience or a character flaw. Think of it this way: if you felt lonely, would you want to numb that ache with a pill instead of reaching out to a friend? Maybe for a little while — but not for the rest of your life.

Hunger works the same way. Like loneliness, which pushes you toward connection with people who care about you, hunger pushes you toward the foods that keep you alive and nourished. When a drug powerfully overrides that system for a long period, it shouldn’t surprise anyone that problems follow.

People on these drugs sometimes become so uninterested in food that they struggle to eat balanced meals or get enough nutrients. Some feel full after a few bites. Others become nauseated at the thought of eating.

What are the side effects?

Beyond the underlying problem with using these drugs as a health strategy, it’s also worth knowing that, like all medications, they come with side effects — which is probably why you know someone who started one and then had to stop.

The most commonly reported issues with GLP-1 drugs like Ozempic include nausea, vomiting, constipation, diarrhea, abdominal pain, reflux, and a persistent feeling of fullness. Not exactly the same side-effect profile as starting the Mediterranean diet.

These effects aren’t random — they trace directly back to the drug’s mechanism, since Ozempic deliberately slows digestion and alters appetite. More serious complications can include dehydration, kidney injury, gallbladder disease, pancreatitis, and excessive slowing of stomach emptying.

Does the weight loss include muscle?

When people lose weight quickly while eating very little, the body doesn’t burn only fat — it can also break down muscle and other lean tissue. This isn’t a minor concern with GLP-1 drugs.

In a body-composition substudy of the pivotal STEP 1 trial, patients on semaglutide lost about 15% of their body weight — and roughly 40% of that loss was lean mass rather than fat. That’s a notably larger lean-mass share than typically seen with diet-alone weight loss, where the rule of thumb is usually closer to a quarter.

Some more recent studies have found smaller lean-mass losses, especially when patients get enough protein and stay active, but the pattern shows up consistently enough that endocrinologists now flag it as a real risk, particularly for women and older adults.

Muscle is essential for far more than appearance. It supports metabolism, protects the bones and joints, helps regulate blood sugar, and allows people to remain active and independent as they age.

This is particularly concerning for older adults, who may already be losing muscle naturally. A person may celebrate a lower number on the scale while unknowingly becoming weaker.

Manufacturers and weight-loss clinics tend to emphasize total pounds lost. A more meaningful question is how much fat was lost, how much muscle was preserved, and whether the person actually became healthier and stronger.

What happens when you stop taking it?

For many users, hunger returns, and weight begins to come back.

This shouldn’t be surprising. The medication didn’t necessarily change the diet, food environment, emotional triggers, or lifestyle that existed before treatment — it temporarily suppressed the biological drive to eat. Once that suppression is removed, the original pressures often remain.

What the research is saying is that for most people, GLP-1 drugs work only as long as they keep taking them. That turns what’s often marketed as a short-term fix into a long-term, possibly lifelong, commitment.

That raises real practical questions: What happens if insurance stops paying? What happens if side effects worsen? What happens if the medication becomes unavailable?

Is maintaining a healthy weight impossible without an injection?

And underneath all of that: what happens when the health problems caused by a poor diet catch up with you regardless?

The take-home: a treatment that works only as long as it’s continuously taken shouldn’t be confused with a cure. It may be a reasonable short-term tool in extreme situations, but it isn’t a cure.

But isn’t obesity a medical condition?

Obesity is associated with serious health risks, but that doesn’t mean the first or best response should always be pharmaceutical.

Much of modern obesity is driven by an abnormal food environment — often called the “Standard American Diet,” or SAD. People are surrounded by heavily processed products engineered to be intensely rewarding, easy to consume, and hard to stop eating.

These foods are calorie-dense while being low in fiber, water, and natural bulk. They can overwhelm the body’s normal appetite-regulation mechanisms.

Many people simply haven’t been taught how to eat well or how to change their habits. Ozempic lets them keep eating the same foods while using medication to suppress their desire to eat them.

It’s also worth saying plainly: the companies selling these drugs profit when people stay on them for life, not when people learn to need them less. That’s just how the incentives are built.

Most of us know, deep down, that eating badly while suppressing the resulting hunger with a drug isn’t sustainable. We wouldn’t take this approach to personal finances or raising children — in neither case would you reach for a pill to manage the stress instead of addressing what’s actually going on. You’d get the finances, or the kid, on the right track.

What happens when someone takes Ozempic and still eats badly?

For most people, Ozempic just means eating smaller portions of fast food, sweets, processed meat, and refined snacks — and, unsurprisingly, they lose weight, because total calorie intake has fallen.

But weight loss alone does not equal good health.

Ozempic can’t provide fiber. It can’t nourish the gut microbiome. It can’t replace vegetables, fruit, beans, intact whole grains, and other nutrient-dense whole foods. And it can’t undo the effects of a diet high in saturated fat, sodium, and ultra-processed ingredients on heart health simply by shrinking portion sizes.

Eating less junk food may help you lose weight, but it isn’t the same as learning to eat a healthy diet.

What is the better approach?

The long-term goal should be to restore normal appetite regulation rather than chemically silence it.

A diet built around whole, minimally processed plant foods lets people eat satisfying portions while naturally consuming fewer calories. Foods rich in fiber and water create fullness without the extreme calorie density found in oils, cheese, sweets, and processed snacks.

A complete approach should also include regular movement, resistance exercise, adequate sleep, stress reduction, and support for emotional eating when it’s part of the picture.

People are capable of making this change. Assuming they cannot—and that obesity is simply a genetic or medical condition requiring a chemical crutch, rather than a problem that can often be addressed through education and a return to the whole foods our ancestors ate—sells them short.

Ozempic may make people thinner while they take it. But it does not make them healthy, strong, well-nourished, and capable of maintaining that health without a lifelong dependence on appetite-suppressing medication.

Aharon Elkayam, M.S., is a practitioner trained in Traditional Chinese Medicine and functional medicine, with clinical internships in the U.S., Taipei, and Beijing. He has spent over a decade in clinical practice as an acupuncturist, herbalist, and functional medicine practitioner, with more than 10,000 patient visits, and now focuses on guiding people in improving their diet as a health coach. He can be reached at [email protected] or visit his website at aharonelkayam.com.

Health FAQs:

Ozempic seems to be very popular. Someone told me it’s wonderful. Someone told me I should avoid it. What do you think?

By Aharon Elkayam, M.S.

Aharon’s new series, “Health FAQs,” answers common questions about popular and practical health topics — giving you honest answers rooted in science, and committed to natural, sustainable solutions that work in tune with how your body is designed to function.

Ozempic and similar weight-loss drugs are all the rage worldwide, promoted as a breakthrough solution to obesity. They suppress appetite and produce significant weight loss, which understandably makes them attractive to people who have struggled for years.

It seems like people have finally found a “silver bullet” for our obesity problems, in a shot.

But before using one, it’s important to understand what these medications actually do — and what they don’t.

The most important thing to understand is that Ozempic does not heal the root causes of obesity.

It doesn’t help you eat a healthier diet. It doesn’t repair a damaged relationship with food. It doesn’t build muscle or encourage exercise.

It primarily works by interfering with normal appetite and digestion so that you eat less.

Sounds great, right? For some people, in the short term, it certainly can be. But eventually you have to face reality: forcing the body to consume less food isn’t the same thing as restoring health.

How does Ozempic work?

Ozempic contains semaglutide, a drug that mimics a hormone called GLP-1. It sends strong fullness signals to the brain, reduces hunger, and slows the movement of food out of the stomach. In other words, it suppresses your desire to eat.

This can be effective for cutting calories, but hunger isn’t merely an inconvenience or a character flaw. Think of it this way: if you felt lonely, would you want to numb that ache with a pill instead of reaching out to a friend? Maybe for a little while — but not for the rest of your life.

Hunger works the same way. Like loneliness, which pushes you toward connection with people who care about you, hunger pushes you toward the foods that keep you alive and nourished. When a drug powerfully overrides that system for a long period, it shouldn’t surprise anyone that problems follow.

People on these drugs sometimes become so uninterested in food that they struggle to eat balanced meals or get enough nutrients. Some feel full after a few bites. Others become nauseated at the thought of eating.

What are the side effects?

Beyond the underlying problem with using these drugs as a health strategy, it’s also worth knowing that, like all medications, they come with side effects — which is probably why you know someone who started one and then had to stop.

The most commonly reported issues with GLP-1 drugs like Ozempic include nausea, vomiting, constipation, diarrhea, abdominal pain, reflux, and a persistent feeling of fullness. Not exactly the same side-effect profile as starting the Mediterranean diet.

These effects aren’t random — they trace directly back to the drug’s mechanism, since Ozempic deliberately slows digestion and alters appetite. More serious complications can include dehydration, kidney injury, gallbladder disease, pancreatitis, and excessive slowing of stomach emptying.

Does the weight loss include muscle?

When people lose weight quickly while eating very little, the body doesn’t burn only fat — it can also break down muscle and other lean tissue. This isn’t a minor concern with GLP-1 drugs.

In a body-composition substudy of the pivotal STEP 1 trial, patients on semaglutide lost about 15% of their body weight — and roughly 40% of that loss was lean mass rather than fat. That’s a notably larger lean-mass share than typically seen with diet-alone weight loss, where the rule of thumb is usually closer to a quarter.

Some more recent studies have found smaller lean-mass losses, especially when patients get enough protein and stay active, but the pattern shows up consistently enough that endocrinologists now flag it as a real risk, particularly for women and older adults.

Muscle is essential for far more than appearance. It supports metabolism, protects the bones and joints, helps regulate blood sugar, and allows people to remain active and independent as they age.

This is particularly concerning for older adults, who may already be losing muscle naturally. A person may celebrate a lower number on the scale while unknowingly becoming weaker.

Manufacturers and weight-loss clinics tend to emphasize total pounds lost. A more meaningful question is how much fat was lost, how much muscle was preserved, and whether the person actually became healthier and stronger.

What happens when you stop taking it?

For many users, hunger returns, and weight begins to come back.

This shouldn’t be surprising. The medication didn’t necessarily change the diet, food environment, emotional triggers, or lifestyle that existed before treatment — it temporarily suppressed the biological drive to eat. Once that suppression is removed, the original pressures often remain.

What the research is saying is that for most people, GLP-1 drugs work only as long as they keep taking them. That turns what’s often marketed as a short-term fix into a long-term, possibly lifelong, commitment.

That raises real practical questions: What happens if insurance stops paying? What happens if side effects worsen? What happens if the medication becomes unavailable?

Is maintaining a healthy weight impossible without an injection?

And underneath all of that: what happens when the health problems caused by a poor diet catch up with you regardless?

The take-home: a treatment that works only as long as it’s continuously taken shouldn’t be confused with a cure. It may be a reasonable short-term tool in extreme situations, but it isn’t a cure.

But isn’t obesity a medical condition?

Obesity is associated with serious health risks, but that doesn’t mean the first or best response should always be pharmaceutical.

Much of modern obesity is driven by an abnormal food environment — often called the “Standard American Diet,” or SAD. People are surrounded by heavily processed products engineered to be intensely rewarding, easy to consume, and hard to stop eating.

These foods are calorie-dense while being low in fiber, water, and natural bulk. They can overwhelm the body’s normal appetite-regulation mechanisms.

Many people simply haven’t been taught how to eat well or how to change their habits. Ozempic lets them keep eating the same foods while using medication to suppress their desire to eat them.

It’s also worth saying plainly: the companies selling these drugs profit when people stay on them for life, not when people learn to need them less. That’s just how the incentives are built.

Most of us know, deep down, that eating badly while suppressing the resulting hunger with a drug isn’t sustainable. We wouldn’t take this approach to personal finances or raising children — in neither case would you reach for a pill to manage the stress instead of addressing what’s actually going on. You’d get the finances, or the kid, on the right track.

What happens when someone takes Ozempic and still eats badly?

For most people, Ozempic just means eating smaller portions of fast food, sweets, processed meat, and refined snacks — and, unsurprisingly, they lose weight, because total calorie intake has fallen.

But weight loss alone does not equal good health.

Ozempic can’t provide fiber. It can’t nourish the gut microbiome. It can’t replace vegetables, fruit, beans, intact whole grains, and other nutrient-dense whole foods. And it can’t undo the effects of a diet high in saturated fat, sodium, and ultra-processed ingredients on heart health simply by shrinking portion sizes.

Eating less junk food may help you lose weight, but it isn’t the same as learning to eat a healthy diet.

What is the better approach?

The long-term goal should be to restore normal appetite regulation rather than chemically silence it.

A diet built around whole, minimally processed plant foods lets people eat satisfying portions while naturally consuming fewer calories. Foods rich in fiber and water create fullness without the extreme calorie density found in oils, cheese, sweets, and processed snacks.

A complete approach should also include regular movement, resistance exercise, adequate sleep, stress reduction, and support for emotional eating when it’s part of the picture.

People are capable of making this change. Assuming they cannot—and that obesity is simply a genetic or medical condition requiring a chemical crutch, rather than a problem that can often be addressed through education and a return to the whole foods our ancestors ate—sells them short.

Ozempic may make people thinner while they take it. But it does not make them healthy, strong, well-nourished, and capable of maintaining that health without a lifelong dependence on appetite-suppressing medication.

Aharon Elkayam, M.S., is a practitioner trained in Traditional Chinese Medicine and functional medicine, with clinical internships in the U.S., Taipei, and Beijing. He has spent over a decade in clinical practice as an acupuncturist, herbalist, and functional medicine practitioner, with more than 10,000 patient visits, and now focuses on guiding people in improving their diet as a health coach. He can be reached at [email protected] or visit his website at aharonelkayam.com.