Inside the growing trend of Ozempic 'microdosing'.

In the latest Ozempic news, there are reports of people now 'microdosing' weight loss medications in order to lose weight and skip side effects, like nausea, vomiting and constipation. But is it actually safe?

For the uninitiated, Ozempic (semaglutide) is a weekly injectable prescription medication currently subsidised under the Pharmaceutical Benefits Scheme (PBS) for type 2 diabetes in Australia. While there are studies that suggest this medication can be an effective solution for weight management, it's still currently classified as 'off-label use'.

However, in recent times, the drugs have become more widely accessible, with medical experts reporting they can have a place in this area for those who meet specific criteria — that is, patients who are suffering from complications of obesity or being overweight, such as high blood pressure or type 2 diabetes.

The drawback? These drugs can come with some serious side effects — which can become debilitating.

Watch: In this episode, Insight are looking at people who push their bodies to the limit. This is Leah's story. Post continues below.

In a US clinical trial, nearly half (48.6 per cent) of people taking semaglutide reported experiencing adverse effects. Nausea and vomiting were the most frequently experienced (36.6 per cent) followed by diarrhoea (8.6 per cent), fatigue (6.3 per cent) and constipation (5.7 per cent). In another trial, many participants (74.2 per cent) using semaglutide reported gastrointestinal symptoms.

Meaning? Many patients have to stop taking the medication because they cannot tolerate the adverse effects. Others have had to either reduce the dose or remain on the same dose to avoid them.

Another worrying way of side-stepping adverse effects? Playing pharmacist at home.

Why are people microdosing Ozempic?

Browse through Reddit and TikTok, and you'll see hundreds upon hundreds of posts with people sharing their personal dosing schedules and results in order to skip side effects but still lose weight and turn the 'noise' off when it comes to cravings. Many others also tout the effectiveness of 'microdosing' when it comes to stretching their supply, reducing costs and keeping off the weight they lost while taking standard doses of the drugs.

And it's not just about dropping weight. Many others believe that using smaller-than-recommended amounts has a positive impact on a range of health conditions — everything from chronic pain to PCOS and heart disease.

In a 2023 study, it was found that semaglutide reduced major cardiovascular events by 20 per cent. Notably, with people in the overweight or obese weight categories losing at least five per cent of their body weight, other changes beyond weight include lowered cholesterol levels, lowered blood pressure and lowered blood glucose levels, which all reduce the risk of chronic diseases.

In the UK study from 2021, people taking semaglutide had greater improvements in physical capabilities and risk factors for heart disease and diabetes, including reductions in waist circumference, markers of inflammation, blood pressure and blood glucose levels.

In a recent conversation on The Diary Of A CEO podcast, host Steven Bartlett speaks about the impact of microdosing on health conditions with Dr Tyna Moore, a certified naturopathic and chiropractic physician and expert in holistic regenerative medicine.

According to Dr Moore, with 'tiny' doses of Ozempic, we can start to 'heal' some common chronic health conditions.

"Everyone is saying Ozempic is evil," she told Bartlett. "But a lot of people are being overdosed for weight loss and this leads to a very high risk for side effects. but Ozempic, done correctly, has all these other benefits that have nothing to do with weight loss, and they are just mind blowing."

@steven

Ozempic is being called the most effective weight loss dr*g ever, but could it have other miraculous benefits? In today’s episode, I sit down with Ozempic Expert Dr Tyna Moore who is a certified Naturopathic and Chiropractic physician and expert in holistic regenerative medicine. In this conversation, we discuss topics such as: - How Ozempic saved Tyna’s mother’s life. - The link between Ozempic and fertility. - The impact on your gut microbiome?! - The real impact of taking saunas. And so much more! Can’t wait for you to watch 🙏🏾 #podcast #podcastclips #clips #ozempic #ozempicjourney #weightloss #weight #interview #expert #story #trailer #teaser #doctor #dr #diaryofaceo

♬ original sound - Steven Bartlett

So is there actually any truth behind this? Is experimenting with 'microdosing' and using smaller-than-recommended amounts actually safe? And is it something medical experts would recommend doing?

Is Ozempic microdosing safe?

As most medical experts will tell you, there's a lot we still don't know when it comes to 'microdosing' Ozempic. Experts say that currently, there isn't enough data to support the impact of these drugs used on those with lower BMIs, and long-term side effects are unknown. There's also very little data to suggest taking smaller doses has any impact when it comes to losing weight or maintaining weight loss.

Mamamia spoke to Professor Michael Cowley, the Head of the Department of Physiology at Monash University and the founding director of the Monash Obesity & Diabetes Institute.When asked about the safety of people taking smaller doses of weight loss medication to avoid side effects and maintain weight loss, Dr Cowley said: "The issue with weight loss drugs is that the effect is proportionate to the dose. When you first start taking one of these drugs, you start off at a low dose, and as your tolerance improves and as the nausea fades, you increase the dose. If you increase your dose and you get nausea, you drop back to a lower dose. So it's normal to not use the full dose."

As Dr Cowley explained, this is part of what we call "titration regime" — that is, to slowly increase doses over six, eight or even 12 weeks for some patients.

"We also tell patients that if they're not tolerating the dose they're on, to drop back to a lower dose — try for another month and move up again. We know that patients lose weight even on the low doses of these drugs. By 12 weeks, we can see the trajectory of weight loss, and while most patients haven't achieved a full dose by 12 weeks, we know that the weight loss they had at those lower doses predicts the weight they're going to lose on the full dose. So, using a lower dose is not a problem at all."

"I think the issue is, if you think using a lower dose permanently is a solution, then you're not going to get the same weight loss as someone who uses a full dose," he said.

So, what does this mean when it comes to maintaining the effects of weight you've already lost? Can you 'keep off' weight by using lower doses?

According to Dr Cowley, there's very little data to support this. "There are no good studies about what you need to do to keep weight off after you've already lost it. That's because the regulatory authorities in Australia, the Therapeutic Goods Administration (TGA), or in the US the Food and Drug Administration (FDA), don't have guidance on what weight maintenance is. Without clear guidance from the regulators, there's no way to design a study to test it."

That's not to say these studies are never going to happen, Dr Cowley added, it just hasn't happened yet.

"It's only in the last few years that we've had really effective weight loss drugs, and the weight maintenance becomes an important factor for lots of people."

He added that while it's absolutely plausible that a lower dose will help you keep weight off, you essentially need a higher dose to cause weight loss to begin with.

In terms of the effectiveness of smaller doses of Ozempic when it comes to managing various health concerns such as cardiovascular disease, he said we're just not there yet when it comes to research in this area.

"We just don't know what happens. We know that these drugs are beneficial to the heart, even if you don't lose weight. We know these drugs are beneficial to the kidneys, even if you are not obese. So we would assume that they're beneficial even if you haven't lost weight. But we haven't done those studies — and these are probably more important studies because these are things you can't see yourself," he told Mamamia. 

"If you're taking a weight loss drug and you're regaining weight, you know it's not working and that dose you've chosen is no longer effective. Whereas in terms of cardiovascular, heart or kidney mortality, those things require sophisticated measures to let you know what's going on — and patients won't be able to perceive that. We don't know where the dose-response is there."

"It's more concerning if you've taken this medicine for kidney health and you then decide to reduce your dose because it's only with blood tests and urine tests that you will actually understand what's happening to your kidney function."

Meaning? If you're taking one of these drugs for something other than weight loss and you decide to take a lower dose, then you essentially need to aggressively monitor to know if the drug is still doing what it's meant to do. As Dr Cowley shared, that's not an easy thing to do — it takes a lot of sophisticated measures and tests.

Of course, when it comes to 'microdosing' on your own, without guidance from a medical expert, Dr Cowley said this is dangerous and should be avoided at all costs. These are serious medications with serious side effects, and if you're side-stepping the advice of medical experts, you're going to have a bad time.

"Any kind of medication that uses prescription medication has to be discussed with the GP who prescribes it — because it's not fair to make them legally responsible for what you do if you're not doing the correct thing," he said.

"These are prescription-only medicines. If you're buying them illegally through a pharmacy overseas, you know you're breaking the law, so you're already playing in a grey area."

What are your thoughts on 'microdosing' Ozempic? Share with us in the comment section below.

Feature image: Getty/Canva.