A weight-loss drug that is taking the world by storm is “not a miracle, nor a shortcut” for everyone, according to an obese woman who has been taking Ozempic for a year and a half but only managed to shed around three kilos of her 103kg starting point.

The 43-year-old, who asked to remain anonymous, had a different experience from another woman who shared with Times of Malta her “success story” of losing a life-changing 20kg within months of using the “magic diet drug”.

“Ozempic definitely helps reduce appetite and stop weight gain, but you cannot lose weight without changing your diet. It’s not magic,” Mary insisted.

“You still need to make the usual long-term changes to your diet and exercise to lose weight both while taking it and after coming off it.”

Mary maintained she was the longest user of Ozempic for weight loss in Malta, having been on it since October 2022. 

But she has kept this a secret all along, feeling her family and friends, who had “strong opinions” about the potential side effects of the drug, would worry too much.

During this time, Mary did not suffer any major side effects but lost hardly any weight overall, dropping seven kilos in the beginning but slowly regaining it.

She now only weighs three kilos less than when she started and is weaning herself off the drug, in consultation with her doctor, moving to a lower dose because the long-term effects are unknown. 

Ozempic, also known as Semaglutide, is an injectable prescription medicine used along with a healthy diet and exercise to improve blood sugar in adults with type 2 diabetes and to reduce the risk of heart attack and stroke.

Specialists have urged caution as its popularity for weight loss shoots up. While it can be taken by people with a body mass index (BMI) of 27 upwards (30 is considered obesity), especially with evidence of insulin resistance and other health conditions related to weight, such as high blood pressure, high cholesterol or obstructive sleep apnoea, there are no studies on the drug’s impact if taken by people who are not within these brackets.

While licensed for type 2 diabetes, Ozempic could be used for overweight people, improving health outcomes, longevity medicine specialist Philip Borg had told Times of Malta, explaining that conditions related to being overweight and obese included the risk of cardiovascular disease, stroke and cancer.

Drugs like Ozempic, Wegovy and Mounjaro have a role in reducing weight – always, however, in combination with lifestyle changes, Borg had insisted, and with the correct patient selection. 

Mary did not have diabetes, or any other health condition, and took it purely to lose weight in consultation with a weight-loss doctor. 

“At 103kg, I was the heaviest I had been in years and feeling really stressed about gaining a lot of extra weight,” Mary said. Then there was the pain in her knees and elevated blood pressure.

After several diet and lifestyle changes, she looked into the option of bariatric surgery. But Mary’s doctor suggested she first try Ozempic.

She was hesitant at first, worried about the possible side effects and having to use an injection pen on herself every week. 

Ozempic lowers blood sugar levels by mimicking a hormone involved in blood sugar regulation. It also slows down food’s movement through the stomach, leading to a reduction in appetite.

Mary’s appetite did decrease drastically when she first started taking it: “I could not even eat a pineapple cube without feeling full, and this was on the lowest dose.”

She lost weight immediately but she plateaued soon after and started to slowly regain it. 

Although Mary has a sedentary office job, she has an active lifestyle thanks to her two young kids. 

While they eat healthily, she admitted she did not look after herself all that well, plagued by what she considers to be ‘food noise’ – “the constant thinking of food in the background and wanting to pick at it even when not really hungry”. This led to making bad decisions or overeating when stressed and tired, she said.

And since her social life involves a lot of eating and drinking, she finds it hard to limit calories.

She didn’t drop those habits after starting Ozempic but ate around half of what she was consuming before. “I would still order a burger and drink wine, but I would become full after a smaller amount. I would eat half the burger and one glass of wine as opposed to three.”

She believes she might have lost more weight had she been stricter and cut out sugar and carbs completely. 

“I believe Ozempic can help dieters lose weight because it stops them thinking about food all the time and reduces the appetite. It also reduces the tolerance of sugar because you do not feel good after eating,” she explained. 

“But at the end of the day, it is definitely not a miracle.”

She insists on the need to make long-term changes to diet and exercise regimes to see a significant difference.

She is now ending her journey with the drug primarily due to her concern about the lack of studies on long-term use and side effects. The more common include nausea, with some patients unable to tolerate the drug and having to stop, as well as headaches, diarrhoea, abdominal pain and fatigue. Serious side effects include gallstones and an increased risk of thyroid cancer.

“My doctor has explained to me that the risk of a big weight gain is higher if a patient comes off it suddenly, so I am tapering off it over six months.”

She has no regrets though. “While I feel sad not to be a big success story with a huge weight loss, I at least feel happy I have not continued to gain more weight. “I have also had a more peaceful state of mind when it comes to food, which really has been great,” she said.