What Ozempic is licensed for
In the UK, Ozempic is licensed for adults with type 2 diabetes that isn't controlled well enough, alongside diet and exercise (Ozempic SmPC, MHRA, 2026).
In the US, the label also covers lowering the risk of heart attack, stroke and heart-related death in adults with type 2 diabetes and heart disease, and lowering the risk of kidney decline in adults with type 2 diabetes and chronic kidney disease (Ozempic label, FDA, 2026). It has no weight-management approval in either country (Ozempic label, FDA, 2026).
In the US, "Ozempic tablets" now also exist: a daily semaglutide tablet for type 2 diabetes. The label says they can't be swapped milligram for milligram with Rybelsus tablets (Rybelsus label, FDA, 2026).
Ozempic and weight loss in the UK
In 2023, the MHRA said Ozempic "is not authorised for weight loss, but it is used off-label for that purpose" (MHRA, 2023). During the 2023 shortage, a national patient safety alert said off-label use for obesity was "strongly discouraged" so that supplies could go to people with type 2 diabetes (DHSC and MHRA letter, 2023).
The MHRA has also seized fake Ozempic pens (MHRA, 2023). It says to get medicines only from a registered pharmacy with a valid prescription (MHRA, 2026).
How the dose steps up
Ozempic starts at 0.25 mg once a week for 4 weeks. That first dose is not a maintenance dose. Then it goes to 0.5 mg. If more blood-sugar control is needed, it can go to 1 mg after at least 4 weeks, then to 2 mg after at least 4 more weeks. The maximum is 2 mg a week (Ozempic SmPC, MHRA, 2026) (Ozempic label, FDA, 2026).
| Weekly dose | Earliest start | What the label calls it |
|---|---|---|
| 0.25 mg | Weeks 1 to 4 | Starting dose only |
| 0.5 mg | Week 5 | Maintenance dose |
| 1 mg | After at least 4 weeks on 0.5 mg | Maintenance dose |
| 2 mg | After at least 4 weeks on 1 mg | Maintenance dose. The maximum |
From the UK label (Ozempic SmPC, MHRA, 2026) and the US label (Ozempic label, FDA, 2026). Your prescriber decides your dose.
What about weight results?
Ozempic's trials were run in people with type 2 diabetes and measured blood sugar, so we don't quote them as weight-loss results here. The weight trials of semaglutide used the Wegovy dose of 2.4 mg. In STEP 1, average weight change at 68 weeks was −14.9% on semaglutide 2.4 mg and −2.4% on placebo (STEP 1, NEJM, 2021).
See Wegovy week by week for how that changed month by month.
Common side effects
The NHS lists these common side effects of semaglutide: feeling sick, being sick, constipation, diarrhoea, feeling tired, itchy or red skin where you inject, and hair loss (NHS, 2026). The US label lists the ones reported by at least 5% of people on Ozempic: nausea, vomiting, diarrhoea, stomach pain and constipation (Ozempic label, FDA, 2026).
Low blood sugar, acute pancreatitis, worsening diabetic eye disease and sudden loss of vision are among the serious side effects on the NHS page, with advice on when to get help (NHS, 2026).
What to track beyond weight
Weight is one number, and it moves for lots of reasons. The trials also measured waist size. In STEP 1, the average waist shrank by 13.5 cm on semaglutide 2.4 mg and 4.1 cm on placebo (STEP 1, NEJM, 2021). In SURMOUNT-1 it shrank by 14.0 to 18.5 cm on tirzepatide, depending on dose (SURMOUNT-1, NEJM, 2022).
A short record makes appointments easier. You can tell your prescriber what happened, not what you remember.
- Weight, at the same time of day, read as a weekly trend rather than a daily verdict.
- Waist, measured the same way each time: midway between your lowest rib and the top of your hip bone, after breathing out naturally (NICE NG246, 2025).
- Photos from the same four angles, in the same light and clothes.
- Each injection: the date, the dose, where you injected and any reaction.
- Side effects, appetite and how you feel, on the day they happen.
- Protein and strength training, because part of the weight lost is lean mass (why it matters).
Before your next injection.
- Write down your dose and injection day
- Log side effects when they happen
- Weigh in on the same day each week
- Measure your waist the same way
- Take photos in the same light
- Take questions to your prescriber
Where these facts come from.
- Ozempic (semaglutide) Summary of Product Characteristics. Updated Jul 2026. emc.
- Wegovy FlexTouch (semaglutide) Summary of Product Characteristics. Revised 09/2026. emc.
- MHRA warns of unsafe fake weight loss pens. 26 Oct 2023.
- OZEMPIC (semaglutide) injection, US prescribing information, Novo Nordisk. Revised 5/2026. DailyMed.
- RYBELSUS and OZEMPIC tablets (semaglutide), US prescribing information, Novo Nordisk. Revised 1/2026. DailyMed.
- Ozempic (semaglutide) supply: letter to healthcare professionals quoting National Patient Safety Alert NatPSA/2023/008/DHSC. 25 Jul 2023.
- Counterfeit weight loss pens worth £2 million seized by MHRA and West Midlands Police. 15 Oct 2026.
- Wilding JPH et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med 2021;384:989-1002.
- Semaglutide. NHS medicines information. Last reviewed 15 May 2026.
- Jastreboff AM et al. Tirzepatide once weekly for the treatment of obesity. N Engl J Med 2022;387:205-216.
- Overweight and obesity management. NICE guideline NG246: identifying and assessing overweight, obesity and central adiposity. Published 14 Jan 2025.
Checked 25 Oct 2026. Trial figures are average results in the trial, not predictions. Labels change; your prescriber and the leaflet in your pack have the current version.
Pip Body Scan is a personal progress record. It is not a medical device and does not give medical advice, diagnose conditions or recommend doses. Speak to your prescriber or another qualified healthcare professional about symptoms, side effects or changes to your treatment.