How Ozempic became North America's go-to weight-loss drug

In recent years, a dramatic shift in North America's approach to weight management has emerged, driven by the rising popularity of a once little-known diabetes medication: Ozempic. Originally approved for the treatment of type 2 diabetes, Ozempic, a brand name for semaglutide, is now at the center of a cultural, medical, and economic transformation in the United States and Canada. Its off-label use for weight loss has surged, becoming a widespread phenomenon among celebrities, social media influencers, and the general public alike.

Clinics are seeing rising demand, prescriptions have skyrocketed, and conversations about body image and health have shifted. Here’s how Ozempic became a weight-loss trend, its effects on the healthcare industry, the science behind its function, its regulatory challenges, ethical concerns, and the broader impact on North American society.


What is Ozempic and how does it work

Ozempic is the brand name for a once-weekly injectable medication containing semaglutide, a GLP-1 receptor agonist (glucagon-like peptide-1). It was developed by Novo Nordisk and initially approved by the US Food and Drug Administration (FDA) in 2017 and by Health Canada shortly thereafter, primarily for managing blood sugar levels in individuals with type 2 diabetes.

Semaglutide works by mimicking GLP-1, a naturally occurring hormone that stimulates insulin production, suppresses glucagon, and slows gastric emptying, leading to increased feelings of fullness. This mechanism of action makes it highly effective not only for managing diabetes but also for appetite regulation and weight loss.


#OzempicJourney: How a diabetes drug became a social media weight loss fad

Despite being initially approved for diabetes, Ozempic gained attention for an unintended effect: significant weight loss. Clinical trials demonstrated that patients lost an average of 10%–15% of their body weight over time. This led to widespread off-label prescribing of Ozempic for people without diabetes seeking to lose weight.

By late 2023 and into 2024, this trend accelerated. Celebrities and public figures began endorsing or hinting at their use of the drug, often showcasing dramatic transformations. Social media platforms such as TikTok and Instagram saw a flood of user testimonials under hashtags like #OzempicJourney and #GLP1weightloss, normalizing its use.


Wegovy: The FDA-approved cousin for weight loss

In response to growing demand and clinical evidence, the FDA approved a higher-dose version of semaglutide under the brand name Wegovy in 2021 for chronic weight management in adults with obesity or overweight with at least one weight-related condition. Health Canada followed with approval in 2022.

While Wegovy is technically the preferred medication for weight loss, its high cost and limited availability have kept Ozempic in wide off-label circulation.


Supply shortages across North America

The spike in off-label usage contributed to recurring shortages of Ozempic across both the US and Canada. In 2023 and early 2024, pharmacies across several states and provinces reported difficulty in maintaining stock. Health Canada and the US FDA both issued advisories urging that supply be prioritized for diabetic patients.

Novo Nordisk has since ramped up production and expanded manufacturing capacity, but supply issues remain intermittent due to unprecedented demand.


Ozempic health risks and side effects

While Ozempic has proven effective for weight loss, it is not without risk. Common side effects include:

• Nausea
• Vomiting
• Diarrhea
• Constipation
• Fatigue

More serious complications, though rare, have been reported, including:

• Pancreatitis
• Gallbladder disease
• Kidney problems
• Risk of thyroid C-cell tumors (as indicated in animal studies)

The long-term safety profile of semaglutide in non-diabetic populations is still under review, with health agencies advising caution and medical supervision.


Regulatory oversight and prescribing guidelines

In both countries, Ozempic and Wegovy are prescription-only medications, but telehealth services and online pharmacies have made access easier, raising regulatory concerns.

• Health Canada has reminded physicians to restrict prescribing only to approved indications unless supported by clinical justification.
• The FDA has issued guidelines about off-label use but does not prohibit it, leaving prescribing decisions to healthcare providers.

Some provinces and US states are beginning to monitor Ozempic prescriptions more closely to prevent misuse and ensure continuity for diabetic patients.


Cultural impact and media representation

Ozempic has entered the cultural mainstream. It has been referenced in television shows, comedy specials, and award show speeches. In the US, media outlets such as The New York Times, CNN, and TIME Magazine have run in-depth features on the phenomenon, often referring to the medication as part of a new wave of "pharma-fueled thinness".

In Canada, public discussions have been more subdued, but prominent figures and media outlets have acknowledged the growing popularity, especially in urban centers like Toronto, Vancouver, and Montreal.