What you need to know about Ozempic

A few weeks ago, we looked at the new class of weight loss drugs on the market such as Ozempic.

While these new drugs have received plenty of attention, what has not been so clearly explained, is that diet and exercise remain very important when taking these drugs.

Let’s take a deep dive into why diet and exercise are so important when taking Ozempic and the ONE food guideline that really helps control our blood sugar levels when eating our carbs.

1. What is Ozempic?

Ozempic (generic name semaglutide) is a medication approved by the FDA primarily for the treatment of type 2 diabetes.

It mimics a hormone that regulates appetite and insulin secretion, thereby helping to control blood sugar levels. As an added benefit, many patients on Ozempic also experience weight loss.

While it is true that unwanted weight gain is ultimately caused by eating too much and moving too little, what is now becoming better understood is the role of insulin and how it affects these behaviours.

If insulin is not working well, weight control and specifically weight loss, will become increasingly difficult and this is where drugs like Ozempic can help.

2. Signs You May Need Ozempic

If you're struggling with type 2 diabetes and find it hard to control your blood sugar levels through diet and exercise alone, your doctor might suggest Ozempic. Additionally, if weight loss is a target in your diabetes management plan, Ozempic could be beneficial.

Abnormally high insulin levels deposit fat around the abdominal area. High waist measurements of more than 100cm means hormonal issues may be driving this weight gain.

If you know that you generally do not overeat poor quality food, and exercise regularly, yet still carry a significant amount of weight, and the scales refuse to budge no matter how little you eat, it can also be a strong indicator of hormonal dysfunction.

Also, if you are constantly craving sweet food and feeling hungry, despite consuming an adequate number of calories, you may have an issue with glucose regulation driven by insulin resistance as this is a strong driver of appetite and sweet cravings.

3. Observations in People Taking Ozempic

Some people on Ozempic report reduced appetites and improved blood sugar control. However, like any medication, it also has potential side effects ranging from nausea to more serious events like pancreatitis.

In the case of Ozempic, specifically, there seems to be people who respond and people who do not.

Those who have lost 20-30kg over 12-18 months have done so on a relatively low dose, just 0.25-0.5mg, which has been enough to curb appetite, support insulin action and fat loss when diet and exercise are too a focal point.

This means that if 0.25mg is not working, the answer is not always to increase the dose, rather take a closer look at your diet and exercise regime.

Remember Ozempic and other weight loss medications are a tool to facilitate diet and exercise compliance, not a way to eat poor quality food and still lose weight.

4. Why is Diet so Important When Using Ozempic?

Even with Ozempic, a balanced diet is crucial. It helps amplify the drug's benefits, ensuring your body gets the right nutrients while avoiding high sugar levels that counteract the medication's effects.

Using Ozempic does not increase fat metabolism or result in weight loss unless you have a hormonal issue such as insulin resistance; or dramatically reduce your calorie intake.

Even if you take Ozempic, at a high dose, and you continue to eat more than you need or eat too high a proportion of processed, carbohydrate rich food and don’t do the right type and amount of exercise, you will not see continual, sustained weight loss no matter how much Ozempic you take.

It is a tool to support appetite and hormonal control, and as such facilitate diet and exercise compliance, not a way to eat whatever you like and still lose weight.

I have some clients who have used one of these new drugs and achieved significant weight loss over 6-12 months, then I have others who have not succeeded, because of their underlying food choices and low activity levels.

While you may get an initial weight loss result from a reduction in appetite, and eating less, if you do not weight train, ultimately your metabolic rate will be lowered over time as a result of muscle mass loss, and you will regain the weight lost over time.

Long term you need to focus on becoming better at burning your fuel, and resistance training is a crucial part of this.

At a minimum you should be getting an average of 0.5kg weight loss each week using these medications, if not you need to take a closer look at your food and exercise choices.

5. Key Nutrients to Consider

🍗 Protein is satiating and helps maintain muscle mass. This is especially important when losing weight to ensure that what is lost is predominantly fat. Aim for at least 100g of protein each day, or 25-30g at each of your 3-4 meals.

🍆 Fiber is so important for maintaining blood sugar levels, as well as provide minerals like potassium and magnesium for heart health. Ensure your diet is rich in vegetables, fruits and whole grains.

🥜 Anti-inflammatory fats from avocados, nuts, seeds, and olive oil can support your health when taken in moderation, even when on Ozempic.

🥗 Foods rich in polyphenols provide tons of antioxidants that help reduce inflammation and enhance recover after exercise. These include brightly coloured fruits (berries) and vegetables (red cabbage, beetroot, bell peppers, dark leafy greens).

6. What About Calories?

Calorie intake still matters when on Ozempic. The medication may help reduce appetite, but a caloric deficit is necessary for weight loss.

As a rough guide, if you are experiencing the full effects of the medication in decreasing your appetite, you may consume just 1000 calories for a period of time.

As your metabolism and hormonal control improves, this may move towards a 1200-1400 calorie a day intake. To support weight loss, keep your dinner small, and do not overdo the treats and snacks.

7. Where Do Carbs Fit In?

Carbohydrates are energy-providing and gut loving fiber but should be taken in moderation. Focus on complex carbs with a low glycaemic index to help manage blood sugar levels effectively.

People taking these medications will have underlying issues with glucose regulation, so to help keep insulin levels as tightly controlled as possible, the average person will need just 20-30g serves of carbohydrate, 3-4 times each day, or between 80-120g in total.

Focus on vegetable sources of carbs and whole grains such as oats, whole grain bread (no more than 2 slices), whole grain crackers and quinoa.

8. The Number One Food Guideline When Eating Carbs

To support hormonal control and blood glucose regulation, always eat a carbohydrate rich food with a protein rich food.

There are two reasons for this:

✅ choosing a portion controlled (20-30g) amount of carbohydrate at each meal will ensure that your muscle is fuelled

✅ the protein component will help to slow the rate at which the carbohydrate is digested, helping to keep insulin levels controlled and support appetite regulation, plus protein helps reduce muscle loss while in a calorie deficit.

9. Most Common Reasons Ozempic Does Not Work

Ozempic may not work effectively if it's not accompanied by lifestyle changes.

Skipping doses, poor dietary choices, or inadequate physical activity can all reduce the drug's effectiveness.

Initially, weight loss tends to be quicker, simply as there is more weight to lose, and initial losses of carbohydrate stores and fluid equate to relatively big losses on the scales.

Once this initial weight is gone, fat stores, which may have been there for some time, need to be mobilised for metabolism and this takes time.

After the initial couple of months, weight losses of 1-2kg each month are acceptable, and this suggests the medication is still doing its job along with lifestyle changes.

If your losses fall below this, it may be time to take a closer look at some variables you may be able to adjust to get things moving again.

10. How to Prevent Weight Regain After Stopping the Medication

A long-term approach to lifestyle change is crucial. Continue to eat a balanced diet and stay active to maintain weight loss post-medication.

Incorporating weight training into your routine is KEY as it helps preserve and build muscle mass which increases your resting metabolic rate, helping to control weight regain after stopping the medication.

Aim for 3 resistance training sessions each week and keep up your daily step target.

Remember to always consult with your healthcare provider before starting any new medication or altering your diet or exercise routine.

Ready to Change the Things You Can Change?

If you are considering taking Ozempic, make sure you talk about the pros and cons with your doctor.

Work with a dietitian to ensure you are on track with your calories, protein and food choices.

You are in control of your diet and exercise, this is something you can change.

Reflection

Whether you have 5 or 30kg to lose, you are beautiful 🌸 

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