Ozempic (also known as semaglutide or Wegovy) has recently made headlines as a ‘miracle’ weight loss drug. Coverage has largely focused on celebrities misusing Ozempic to shed unhealthy amounts of weight, which has given it a (potentially unfair) bad reputation.
By focusing on the tiny minority who are misusing Ozempic, we’re missing the bigger picture. Almost half of all adults (an estimated 40% worldwide) are overweight or obese, with the numbers increasing each year.  A medication which combats this obesity epidemic could transform the lives of millions and relieve strained healthcare systems across the globe. It’s potentially the biggest healthcare breakthrough since chemotherapy, and there’s also evidence to suggest that Ozempic could benefit healthy people too.
In this blog, we’ll look at how Ozempic works, how it affects health, what studies we’d like to see in the future, and why we think it’s worth keeping an eye on as a longevity drug.
How does Ozempic work?
Ozempic is a synthetic version of the hormone GLP-1, however it lasts much longer than the natural version of the hormone, meaning its effects are much more powerful. Natural GLP-1 is released after you eat any food and it stimulates insulin release while preventing glucagon release, resulting in better control of your blood glucose levels.  It also acts on various aspects of the digestive system and the brain, reducing appetite, food cravings and slowing the speed your stomach empties, keeping you fuller for longer. [3, 4] GLP-1 agonist drugs are broken down far more slowly than the naturally occurring hormone, so these effects last much longer. Ozempic has the longest half-life of all GLP-1 agonists, meaning it can be given as a once-weekly injection.
What impacts does Ozempic have on health?
Although Ozempic has become famous for its weight loss effects, it was originally approved for use in 2017 as a treatment for diabetes because of its powerful effect on glucose metabolism.  Since then, multiple large-scale studies have since shown that Ozempic significantly decreases weight and improves metabolic health not just in diabetics, but in all groups of people.  In one study looking at obese adolescents (a notoriously difficult group to treat), all participants took part in a lifestyle intervention (good diet, exercise protocols, etc.) and some subjects were also given Ozempic. Over a year later, the average BMI of the Ozempic group had decreased by 16.1%, whereas the BMI of those given just lifestyle advice had increased by 0.6% (see graph below).  Another trial showed that the BMI of obese or overweight participants given Ozempic decreased by 14.9% after 68 weeks, compared to a 2.4% decrease in the placebo group. 
Ozempic also appears to protect against cardiovascular disease,  with one study finding that on average it delayed the onset of major cardiovascular events by two years.  Animal studies have suggested that Ozempic can prevent neurodegeneration too, and trials in humans are underway to investigate its effects on Alzheimer’s and Parkison’s disease. 
Ozempic as an anti-addiction medication:
While Ozempic acts primarily on digestion and metabolism, the literature suggests it may have wider applications. Following reports that many Ozempic users also stopped drinking, smoking, shopping and nail biting while on the medication, research has found that GLP-1 agonists can interact with the hippocampus, which controls aspects of eating behaviour such as the impulse to continue eating palatable food even once you’re full.  Ozempic may therefore influence the brain’s reward centres and reduce cravings for other substances. Animal studies support this theory, [13, 14] but more studies are still required to confirm this link.
Could Ozempic be the next big longevity drug?
It’s evident that Ozempic has huge benefits for diabetics and those who suffer with weight issues, but there are reasons to believe it might have a powerful positive impact on fit and healthy people too. For one, as we wrote about in our last blog, having better control of blood glucose levels contributes to healthier aging by reducing the risk of cardiovascular disease, neurodegeneration, and cognitive and mood disorders. [15, 16, 17] It’s worth noting that many longevity therapeutics which can improve healthspan, such as metformin and berberine, are primarily diabetic drugs, like Ozempic. The beneficial cardiovascular and neuroprotective effects may also translate to protection against age-related disease at much lower doses.
What studies still need to be done?
Regarding Ozempic’s potential as a longevity drug, the major issue with the current research is that all studies have looked at patients who are diabetic, overweight or obese. In order to assess its potential as a longevity therapeutic, we need to see how much smaller doses affect fit and healthy people. This is an issue that almost all longevity therapeutics face, since studies into already healthy people are rarely funded by public health systems.
Some, most notably Peter Attia, have also questioned how Ozempic impacts muscle mass, noting how some studies have shown that lean mass decreases. However, this is an issue with any type of weight loss and until we have reliable studies looking at Ozempic use in healthy subjects, it's impossible to know if these effects would be replicated at lower doses or in individuals following an appropriate exercise protocol.
Ozempic shouldn’t be vilified just because a small group of celebrities are abusing it. It’s a highly promising drug, possibly the most potent one we have against the global obesity epidemic which is one of the most important health issues of the modern day. It may also offer long-term longevity benefits to cardiovascular health and preventing neurodegenerative diseases as well as combatting addiction, but more research into healthy or normal-weight participants is required to confirm this hypothesis.