Ozempic for Women Over 50? 5 Doctors Weigh In on the New Weight-Loss Injectables

The use of injectable medications like Ozempic for weight loss has become the hottest health trend in decades. Celebrities—including Kim Kardashian, Mindy Kaling, and Elon Musk—are rumored to be using them to stay trim. One expert with celebrity clients told FIRST, “They’re all on it.” But is this approach right for most women over 50?

What is Ozempic?

This medication, known generically as semaglutide, was originally FDA-approved as a diabetes drug (1 milligram dose) for its ability to steady blood sugar. But research showed it had an amazing side perk: helping users lose a dramatic amount of weight, on par with results seen with gastric sleeve surgery. And they found that the higher the dose, the greater the weight loss. Research in The New England Journal of Medicine found adults lost 489% more weight on the drug, compared to those taking a placebo. For someone weighing 220 pounds, that’s the difference of dropping 34 pounds, compared to just 6 pounds. Then the FDA approved semaglutide under a second brand name (and a higher dose of 2.4 mg.) called Wegovy for weight loss. When supply-chain disruptions affected Wegovy’s availability, people began using Ozempic “off-label” for weight.

How does Ozempic work?

These shots, injected into belly fat, are called GLP-1–stimulating drugs because they mimic the glucagon-like peptides (or hormones) that occur naturally to reduce appetite and slow stomach emptying so we feel full longer. Katrina Ubell, M.D., host of the podcast Weight Loss for Busy Physicians, likes what she’s heard from her doctor clients. “Semaglutide took the edge off of cravings enough so women could actually do the work they’ve been trying to do in terms of connecting to their body and understanding their hunger and fullness signals.”

“Research shows these shots are much more effective than making lifestyle changes alone, and I’ve seen that in my practice,” says Melina Jampolis, M.D., who is prescribing semaglutide to her patients. “In 22 years, this is the best diet drug I’ve seen—the one I really feel comfortable prescribing.”

How can I get Ozempic?

These injectables are designed for people with a body mass index (BMI) of greater than 30, or a BMI of 27+, plus a weight-related health issue such as type 2 diabetes, high blood pressure or high cholesterol. Those criteria are meant for insurance-coverage purposes. Anyone can be prescribed the drugs if they’re willing to pay out of pocket. If insurance doesn't cover the drugs, they cost around $1,200 for a one-month supply.

You’ll need a prescription from a medical professional, but shortages still exist—causing problems for diabetics who need the medication. Dr. Jampolis says, “These shots are being abused by the public and celebrities who don’t need them. They are being used incorrectly, without adequate nutritional guidance or behavioral support, by probably 95% of people.”

What side effects does Ozempic have?

All medications come with side effects, and semaglutide is no exception. Experts point out these new shots are safer than older diet drugs like fen-phen or invasive bariatric surgery. Shauna Levy, M.D., medical director of Tulane Hospital’s Bariatric and Weight Loss Center, finds this new class of meds “thrilling” and says, “For me, the consequences of the disease of obesity itself far outweigh the very rare events like gallstones with semaglutide.”

Unbranded doses are also flooding the market, popping up in spas and Botox clinics. These often come from compounding pharmacies that mix their own ingredients to create meds that are not FDA-approved. Some people are even concocting their own shots from “black market” ingredients to sell at “Ozempic parties” held in homes like Tupperware parties.

Is taking Ozempic ‘cheating’?

When Weight Watchers announced it would be offering members access to prescription diet drugs, the response was mixed. “Some people view taking these shots as cheating,” says master nutritionist Christina Jordan, who works with a doctor to prescribe semaglutide at her weight-loss clinic, where about 90% of patients, including Jordan herself, who has lost 38 pounds, are on the shots. She compares them to childbirth, with or without an epidural. “I’ll take the epidural. There’s still work to be done with the drugs. But there’s less struggle.”

What does Ozempic for women over 50 cost?

A one-month supply of semaglutide runs around $1,200 to $1,400, depending on dose. If you have diabetes and are prescribed Ozempic, that price is almost always covered by insurance. But if you’re prescribed the shot for weight loss, it is not covered about 80% of the time. “There’s a weight stigma with pricing,” says Dr. Levy. “Instead of approving these shots as a preventive tool, insurance policies block patients from getting treatment until they develop diabetes.”

As for those risky unbranded versions, prices range anywhere from $99 to $1,200, but Jordan says low-cost shots that claim to be “enhanced” with other vitamins are likely just watered down. “They’re using cheap additions and just a trace of semaglutide.”

How long do I need to take Ozempic?

“I’m always worried about the ‘rebound effect’ of women regaining weight after they stop taking the drug,” says ob-gyn Anna Cabeca, D.O., who has yet to prescribe the shots. Experts like Dr. Levy believe antiobesity meds like semaglutide should be taken for life to treat obesity, much like how high-blood pressure meds are generally taken for life. “When somebody takes thyroid medication, they need to replace a hormone their body is not producing. Semaglutide is doing something very similar,” says Dr. Levy. “The body wanting to gain weight back is part of the disease of obesity and has nothing to do with these medications.” Still, the prospect of “for life” doesn’t fly with most budgets. “These shots serve a sort of ‘Nicorette’ function, improving people’s chances to adhere to a healthy lifestyle,” adds David Prologo, M.D. “But I anticipate that success will be limited by the drug’s cost.”

Bottom line: Proceed with caution with Ozempic over 50

If you choose to use the shots, do so under the care of a trained professional, with a healthy diet and exercise. “It’s a godsend for people in health crisis, but it’s not meant for someone who just has those last 20 pounds to lose,” says Dr. Ubell. And Amy Shah, M.D., says, “While this is a great discovery, it’s not to be used casually. These drugs are not a solution for people who can use lifestyle measures and diet to lose the weight.”

Can you get the results without the shot? One doc thinks so!

“It’s pretty easy to mimic the benefits of this drug without all the risks,” says diet expert Fred Pescatore, M.D. How? By eating in ways that naturally boost the production of GLP-1—the same hormone in semaglutide shots. Delaying breakfast with intermittent fasting is a proven approach. Eating a keto diet is another. British research finds the calcium in cheese paired with the amino acids in meat stimulate GLP-1 release, making you less hungry. In all, research shows folks who boost their GLP-1 melt about 5.5 times more weight than those who don’t.

A version of this article originally appeared in our print magazine, First For Women.

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.