Ozempic before and after: 5 women get real about weight loss, side effects and cost

Weight loss with a medication can lead to a big transformation.

People have been showing off their before-and-after when taking Ozempic and other weight-loss drugs, especially their slimmer bodies thanks to a curbed appetite and eating less.

Ozempic isn’t approved for weight loss but that’s a famous side effect, so some doctors have been prescribing it off-label for that purpose. People with obesity seeking to lose weight can also turn to Wegovy, which contains semaglutide — the same active ingredient as in Ozempic — and is approved for weight loss.

Almost 137 million Americans, or more than half of all U.S. adults, are considered eligible to take semaglutide, according to research published in 2024 in JAMA Cardiology.

The vast majority of them — 129 million — qualify to take it for weight loss based on their BMI and weight-related complications like high blood pressure. That’s more people than are eligible to take statins.

“These numbers really are staggering,” NBC medical contributor Dr. Natalie Azar said on TODAY. “It’s studies like this that we hope will definitely move the needle on (insurance) coverage.”

Less than a fifth of large companies in the U.S. offer health insurance plans that cover weight-loss drugs like Wegovy, a 2024 survey found.

Semaglutide is expensive when not covered by insurance: The list price for a month’s supply is about $900 for Ozempic and $1,300 for Wegovy. Novo Nordisk says it supports a health care system that ensures patient access and affordability.

“We recognize that some people in the U.S. find it hard to pay for their healthcare, including our FDA-approved products containing semaglutide, which is why we continue to work to obtain broader coverage and greater access,” the company says in a statement to TODAY.com.

In November 2024, the Biden administration proposed a new rule that would require Medicare and Medicaid to cover weight-loss drugs for people with obesity.

People have to keep taking semaglutide for the drug to keep working — otherwise, they’ll regain much of the weight, studies have shown.

The medication comes with side effects. The most common include nausea, diarrhea, vomiting, stomach pain and constipation, according to Novo Nordisk, the company that makes both Ozempic and Wegovy. But patients may also experience serious side effects such as pancreatitis, gallbladder problems and kidney failure, it warns.

Here are patients’ experiences with Ozempic and Wegovy, and their before-and-after photos.

‘It makes food less important’

Pepper Schwartz doesn’t have Type 2 diabetes, but says she began using Ozempic off-label in 2022 after her doctor and follow-up medical tests deemed it appropriate for her situation, and her personal physician prescribed it.

She lost about 30 pounds, but has regained 5 pounds back and her weight has stayed steady at that number.

“I would like to lose that 5-pound gain and a little more, however, that seems elusive. Truth to tell, I have to own that I have not been as disciplined as when I first started taking Ozempic,” Schwartz, 79, who lives in Snoqualmie, Washington, tells TODAY.com.

“It has changed my eating habits, though, I think permanently. … Smaller portions seem ordinary and portions I used to eat look overwhelming.”

She thinks about weight loss with the medication in terms of improving her health, rather than being able to fit into a smaller size dress, Schwartz previously told TODAY.com.

Schwartz, a sex and relationship expert, says her weight problems began in her late 30s when she simply began overeating. The main effect of Ozempic is she’s not hungry as much: “It makes food less important,” she notes.

Schwartz says she has not had any side effects. She plans to keep taking the drug hoping to lose a few more pounds, but if that doesn’t happen over time, she says she’ll probably discontinue it.

Still requires exercise and a healthy diet

Jamel Corona says she turned to Wegovy in 2021 after she couldn’t lose weight on her own, despite a healthy lifestyle.

She lost about 60 pounds and discovered an unexpected side effect: She used to enjoy drinking socially, but lost interest in alcohol after starting the medication.

Corona described the weight-loss process as gradual and still requiring food discipline and regular exercise to work. Social media makes it sound like rapid weight loss with no effort, but that wasn’t the case for Corona. She works out five days a week and eats “super healthy.”

In 2024, Corona began scaling back on the medication because she felt she wasn’t eating enough calories to be able to work out, she explained on TikTok. She now injects it every two to three weeks, rather than weekly.

“I’ve gained about 10 pounds, which I’m totally OK with. No clothing size change or anything,” the 38-year-old Chicago accountant, tells TODAY.com.

“I can go about three weeks without the medication before I start to notice my appetite increasing. It’s just been discipline. Knowing how much I should be eating.”

Doctors caution against skipping doses of GLP-1 weight-loss drugs like Wegovy because patients who discontinue the medication for a few weeks and then restart it are more likely to have side effects.

Struggling with side effects

Jeannine DellaVecchia, 41, says she was prescribed Ozempic to treat symptoms related to insulin resistance caused by congenital adrenal hyperplasia and polycystic ovary syndrome.

Weight loss wasn’t a priority although she was intrigued that the drug might also help her slim down. It did just that, with DellaVecchia losing 30 pounds between August 2022 and February 2023. She stopped taking the drug because she couldn’t tolerate the side effects, she says.

The hospital worker in Philadelphia, Pennsylvania, says she would sometimes force herself to eat when she was taking Ozempic because of the side effects.

She would have “absolutely no appetite,” was “completely nauseous” and “vomiting all the time,” DellaVecchia told TODAY.com in 2023.

“You don’t feel like eating… it just wasn’t good for me,” she said.

She never returned to Ozempic or tried another weight-loss drug.

DellaVecchia says she’s been able to maintain the weight loss she achieved with a keto diet — “no carbs.”

No longer hungry all the time

Holly Figueroa O’Reilly says she tried “every known diet” and two bariatric surgeries that didn’t work long-term before she lost 105 pounds with Ozempic.

She began taking the medication in 2023 after her health care provider prescribed it over concern she was becoming prediabetic.

Her A1C came down, and she reached her goal weight of 145 pounds. She also lifts heavy weights and eats a high-protein diet.

“(Ozempic) allowed me some space to develop a healthier relationship with food because I don’t ever remember a time when I wasn’t hungry all the time,” O’Reilly, 52, a chocolatier who lives in Seattle, told TODAY.com.

“I’ve just really changed how I look at food as a form of sustenance.”

She estimates she eats a quarter of what she was consuming before, to the point where she’s careful about scheduling time to eat and making sure she gets enough protein.

When it comes to side effects, O’Reilly says she experienced nausea and some diarrhea at first, which went away after about four weeks.

‘You have to do the work’

Barbie Jackson-Williams, 55, of Des Moines, Iowa, says she has lost 180 pounds thanks to Ozempic and working out.

She once weighed more than 400 pounds and started taking Ozempic in early 2021 to slim down and manage her Type 2 diabetes. Since then, Jackson-Williams told NBC News she’s making better food choices, her blood sugar has dropped to prediabetic levels, and she’s much more active and fit.

“People are just taking it just to get skinny and that’s not true,” she said. “You have to do the work, and people don’t realize that.”

How much weight can you lose in a month on Ozempic?

One study found people who received weekly semaglutide injections lost an average of about 15 pounds after three months and about 27 pounds after six months, which translates into about a 5-pound weight loss per month.

Four years after starting semaglutide, patients maintained an average weight loss of 10% of their body weight, a peer-reviewed 2024 study funded by Novo Nordisk found.

What foods should you avoid while taking Ozempic?

To reduce nausea while on semaglutide, registered dietitian Emily Rubin recommends skipping hot, fried or greasy food; and avoiding eating or cooking strong-smelling food. Other foods to avoid on Ozempic include fruits and vegetables that contain significant roughage such as pineapple, and gas-forming vegetables like broccoli.

Don’t eat too quickly and don’t have a large drink with meals, says Rubin, who works at Thomas Jefferson University Hospital in Philadelphia, Pennsylvania.

Can Ozempic kickstart weight loss?

Semaglutide “works by making people not hungry,” Dr. Leigh Perreault, an endocrinologist at UCHealth in Denver, Colorado, previously told TODAY.com.

It mimics a hormone known as GLP-1, which the body releases into the intestine when people eat food and tells the brain you’ve had a meal.

People have reduced appetite, and when they do eat, they feel full sooner, Dr. Louis Aronne, an obesity medicine physician and director of the Comprehensive Weight Control Center at Weill Cornell Medicine and NewYork-Presbyterian, previously told TODAY.com.

The medication also slows down stomach emptying, which slows down the absorption of calories and may contribute to the feeling of fullness, he added.

Semaglutide for weight loss should be used in addition to a reduced calorie diet and increased physical activity, the FDA says.

This article was originally published on TODAY.com

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