Are Weight Loss Shots the New Diet?

It started as a side effect—and turned into a global phenomenon. In the development of a drug to treat type 2 diabetes, researchers discovered something unexpected: the active ingredient not only regulated blood sugar but also significantly reduced body weight. Suddenly, a new blockbuster industry was born. The surge began in 2018 with the U.S. debut of Ozempic, a GLP-1 receptor agonist by Novo Nordisk. Though not initially approved for weight loss, it quickly gained traction off-label as patients reported dramatic drops in weight. Novo Nordisk capitalized on this demand with Wegovy in 2021, a higher-dose version of semaglutide approved specifically for chronic weight management. Then came Eli Lilly’s Mounjaro in 2022, a dual GIP/GLP-1 receptor agonist with even more potent effects—originally approved for diabetes but soon followed by Zepbound in 2023, its FDA-approved counterpart for weight loss. These rapid-fire developments have redefined the obesity treatment landscape, shifting the narrative from diet and discipline to medical science and metabolic recalibration.

Clearly, these medications have been a breakthrough for many people managing serious health conditions tied to obesity. But as they become more mainstream—especially among those using them to slim down for events or appearances—they raise a different kind of question: are we truly evolving in our approach to weight loss, or is this just another diet trend in new packaging?

How Semaglutides Work

Semaglutides, the active compounds in drugs like Ozempic and Wegovy, are part of a class called GLP-1 receptor agonists. They mimic the natural hormone glucagon-like peptide-1 (GLP-1), which is released in the gut in response to food. GLP-1 has several effects: it slows gastric emptying (making you feel full longer), stimulates insulin secretion (to lower blood sugar), and most notably, reduces appetite by acting on areas of the brain that regulate hunger and reward.

Silencing the “Food Noise”

By suppressing appetite and silencing cravings, these drugs are doing more than just shrinking waistlines—they’re muting what many users call “food noise.” The result? A phenomenon known as food indifference, where the emotional and psychological pull of eating simply fades. A common reaction is, “I don’t think about food anymore. It’s like a switch flipped.” As one user on the Ozempic subreddit put it:

I thought people wondering about how Ozempic works might be interested, because I was trying to wrap my head around what it might feel like before I took my first injection, and for me, this is how it normally goes: I think, “The food is available, the food is in reach, and now I want to engage with it.” But now, suddenly, over the course of a day, there’s just no urge to engage with it. Instead, there’s just this new innate feeling that eating it won’t make me feel good, or rewarded, or satisfied. It’s more like all the obsession is negated; and that’s sort of huge for me, because all I want is to nourish my body so it’s healthy, and not worry about the rest.

This phenomenon of “food indifference” is profound. A burger and fries that once equaled 900 calories might now be only partially eaten, reducing that intake to 300 calories or less. This has led to widespread and rapid weight loss, sometimes up to 15% of total body weight in just a few months. In more recent formulas, this number has proven even higher, with results showing 20% to 25% weight loss.

Turns out, semaglutide treatments also show promise in silencing other cravings as well. Recent studies suggest that semaglutides may help reduce cravings for substances like alcohol, nicotine, and even opioids. This is because, according to the underlying behavioral science, In short, they may dampen the brain’s reward response, not just to food, but to other compulsive behaviors.

Recent Trends in the Semaglutide Market

The Semaglutide Market, valued at USD 28.43 Billion in 2024, is anticipated to reach USD 93.60 Billion by 2035, growing at a CAGR of 10.47%.

Since the FDA approved higher-dose semaglutide for weight loss in 2021, these drugs have become a cultural and commercial phenomenon. Now, companies are racing to develop oral versions to capitalize on the momentum. Novo Nordisk and Eli Lilly are leading the charge—though the former just experienced a major leadership shake-up in the wake of competitive pressure to have even more potent of a weight loss drug. As Peter Loftus at the WSJ recently commented, that while Ozempic was the gorilla of GLP-1s, that what Eli Lilly is doing is the King Kong of GLP-1s.

Now, pharmaceutical companies are pushing the science even further—developing new versions of semaglutide compounds designed to bind to fat tissue. The goal: extend the drug’s half-life and create a “fat depot” where the medication can be slowly released over time. This could reduce dosing frequency and improve tolerability. Some early-stage research also hints that targeting fat directly could enhance the metabolic benefits, potentially increasing fat breakdown (lipolysis) and improving insulin sensitivity where it’s needed most.

Until now, GLP-1 drugs like Ozempic and Wegovy have only been available as weekly injections—but that’s about to change. A pill form of semaglutide is on the horizon, promising the same appetite-suppressing and metabolic benefits in a more convenient, needle-free format. Early trials show that the oral version may be just as effective at promoting weight loss and managing blood sugar, with fewer barriers to access for those hesitant about injections. If approved, this could mark a major shift—making GLP-1 therapy easier to start, stick to, and scale across broader populations. In other words, the weight-loss revolution is about to get even more mainstream.

The Phenomenon of “Minor Weight Loss” Use

While Ozempic and other GLP-1 medications like Wegovy and Mounjaro were originally developed for people with obesity or type 2 diabetes, there’s a rising trend of individuals using them for relatively minor weight loss—sometimes as little as 10–15 pounds. This “vanity dosing” has sparked controversy in the medical community, as it diverts supply from higher-risk patients and raises ethical questions about using a powerful medication to achieve what some consider cosmetic results. Critics argue that this approach can normalize medical intervention for marginal weight concerns, while supporters claim it’s a valid tool for jump-starting healthier habits. Regardless, the off-label use for non-obese individuals underscores a cultural fixation on thinness—and a desire for rapid, effortless results in a weight-conscious world.

That leads to the question – are semaglutides appropriate for Freshman 15 (which let’s face it can be more like 20 or 30?) Or the weight gain that can happen after a life event? Or just for people who can never manage to lose those last 20 to 30 pounds? As many of us know, those can be the hardest.

This article has a hot take on the rise of semaglutides for “minor” weight loss and the potential downsides:

The Rise of Ozempic “Shaming” and Cautionary Tales

At the 2025 Golden Globes, Ozempic and similar weight-loss drugs became the unofficial stars of the night—not just through jokes from the host, but in the buzz surrounding several noticeably thinner celebrities. As red carpet photos hit the internet, speculation exploded, with many social media users quick to accuse stars of using GLP-1 drugs like Ozempic or Mounjaro for vanity. This public scrutiny has fed into a growing phenomenon known as “Ozempic shaming,” where even those who may be using the medication for legitimate health reasons are mocked or judged. The conversation has shifted from celebration of weight loss to suspicion and ridicule, highlighting the double bind women and public figures face: gain weight and be criticized, lose weight and be accused of cheating or chasing unrealistic beauty standards.

Although the drugs have not been around enough for long-term testing of side effects, there have been some reports that nondiabetic users have a greater propensity to experience serious side effects, including gastrointestinal issues:

Is This the Cure—or Just Another Diet Cycle?

The vision of the smaller body and the movements it has resulted in can be seen of the evolution of diets across the 20 and 21st century. Take the Grapefruit Diet from the 1930s, for example—a plan that promised quick weight loss by eating grapefruit before each meal to reduce appetite. It rested on the idea that your body would eventually adapt to eating less, and your mind would stop obsessing over food. But most people regained the weight when they resumed “normal” eating.

In the 1920s, tobacco companies openly marketed cigarettes as appetite suppressants, especially to women. Slogans like “Reach for a Lucky instead of a sweet” positioned smoking as a tool to stay slim. The logic? Nicotine is a stimulant that dulls hunger. For decades, cigarette ads linked thinness with glamour, control, and desirability—ignoring the mounting evidence of addiction, cancer, and other deadly health risks. The cigarette diet may seem shocking now, but it reflects how deeply the pursuit of thinness has been marketed, often at the expense of health and truth.

I discuss the diet cycle and the history of fad diets in this video (start it at the five min mark):

And in this blog, my experience with all the diets:

Kind of always knew you’d end up my ex-diet

Diets have come a long way from grapefruits and cigarettes. In the 90s and aughts, diets included variations on high-protein, low-carb lifestyles, with the Atkins, Keto, and South Beach Diets. Then "clean eating" was born with Paleo, Whole30, and "plant-based" diets. Then the biohacking bros got on the scene with intermittent fasting.

With diets, the long-term result favor rebound. In a study done by the NIH, however, that revealed that a meta-analysis of 29 long-term weight loss studies, more than half of the lost weight was regained within two years, and by five years more than 80% of lost weight was regained.

The diet industry is by no means dead. The approximate value of the industry is $73 billion. And of course, diets are often combined with semaglutides for even quicker results.

The major differentiator that appears to be emerging is, diets can make "food noise" way worse - because of the feeling of deprivation. So that's a major plus for semaglutides. But there are more questions.

The 64,000 Question - Do Semaglutide Treatments Last, Or Are They Just Like Diets?

Celebrity fitness trainer and wellness advocate Jillian Michaels, best known for her tough-love coaching style on The Biggest Loser, has never been shy about speaking her mind—and that includes her take on the rising wave of GLP-1 drugs like Ozempic and Wegovy. While acknowledging their effectiveness in fighting obesity, Michaels raises pressing questions about their long-term sustainability and potential side effects.. While Ozempic has been proven to combat obesity, Michaels posed the question of, “For how long?”

“We know you will plateau on this drug. Could be six to eight weeks, a year and a half, could be two years, we know you’re going to plateau; it’s going to stop working. We know if you get off of the drug, all of the meta-analyses show us that you’re going to gain the weight back, and then some,” she said.

She added: “So in my best case scenario for this, where does it go? And the worst-case scenario is stomach paralysis, intestinal blockage, pancreatitis, kidney problems, thyroid cancer.”

Michaels emphasized this ultimately comes down to a “hunger problem, culturally, psychologically, and physically,” as Ozempic facilitates weight loss by curbing hunger, so people eat less.

“That’s what we need to look at. Why are we not satiated? We need to look at the quality of our food, which is absolute crap. You drink 1,000 calories of soda, it’s not going to release GLP-1, which is the satiety hormone that these drugs are mimicking,” she said. “Nobody’s having this conversation.”

Do You Have to Stay On Semaglutides Forever?

One of the most popular internet searches is, "Do you have to stay on [insert weight loss injection] forever?" Well, kind of. According to Columbia Center for Metabolic and Weight Loss Surgery, treatment with GLP-1 drugs like Ozempic often requires a lifelong commitment, as discontinuation typically leads to significant weight regain. The medications can cause a range of side effects, including nausea, acid reflux, abdominal cramping, constipation, and delayed gastric emptying—many of which may deter continued use. Perhaps most concerning is that the long-term effects of taking these drugs over years—or even decades—are still largely unknown.

Two important studies stemming from the largest and most prolonged clinical trial of semaglutide’s impact on weight in more than 17,000 non-diabetic adults with overweight and obesity reveal that participants lost an average of 10% of their body weight and more than 7 centimeters from their waistline over four years. In this study, however, the patients remained on the semaglutide from 2018 to when the study concluded in 2023.

Well, maybe. In an earlier study of 327 patients in 2022 showed that people regained two-thirds of the weight they had lost within 120 weeks of stopping semaglutide injections. The study concludes:

One year after withdrawal of once-weekly subcutaneous semaglutide 2.4 mg and lifestyle intervention, participants regained two-thirds of their prior weight loss, with similar changes in cardiometabolic variables. Findings confirm the chronicity of obesity and suggest ongoing treatment is required to maintain improvements in weight and health.

Here is the study in full:

Health Advocates Have More Concerns

According to this article from University of California Health, there are numerous reasons that people may want to be cautious before using semaglutides for weight loss:

Wegovy and Ozempic are not for everyone. Ozempic is approved for people with Type 2 diabetes. And Wegovy is approved for people with obesity or those who are overweight and have health problems related to excess weight.
If you lose weight with new drugs, you likely will need to keep taking the medications forever to keep the weight off. People who stop taking Wegovy and Ozempic often gain weight back relatively quickly.
The drugs are expensive, and in general, insurance plans don’t cover them for weight loss (although they often do for people with diabetes).
The popularity of the new drugs has led to some shortages.
The drugs can cause unpleasant gastrointestinal side effects.
A small percentage of people who take the drugs can suffer from a diabetes eye complication called retinopathy. Along with consulting with your primary care provider or endocrinologist, you should also see your eye doctor.
The drugs tend to suppress a person’s appetite but to lose weight, you’ll still need to reduce your intake of desserts, sugar-sweetened beverages and fatty foods. And, of course, exercise is important to keep your body healthy.
Some people have complained about looking older due to “Wegovy or Ozempic face.” While many people taking weight loss drugs are pleased to shed some pounds, some say they’re dropping weight in the wrong place: their face. Some have complained of looking old and gaunt due to fat loss in the face.

Still more questions

So diets don't work. Semaglutide injections seem to work. But we still don't know the long-term side effects. And you may have to microdose forever. Many people are not using the drug for a chronic condition. The counterargument, assuming financial means is not a factor, is so what? Many people have to stay on blood pressure or antidepressants for life. But again, we won't know the long term effects until much later, if any.

In some ways, we may be trading one form of circularity for another. Only time—and the science—will tell.

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