What are the effects of long-term Ozempic (semaglutide) use?

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Last updated: February 20, 2025 • View editorial policy

From the Guidelines

Long-term Ozempic (semaglutide) use is generally safe and effective for weight loss and blood sugar control in most patients, with sustained benefits observed in studies lasting up to 2 years, as evidenced by the most recent and highest quality study 1. The positive effects of long-term Ozempic use include:

  • Sustained weight loss, with an average weight loss of 15-20% of body weight
  • Improved blood sugar control in type 2 diabetes
  • Reduced risk of cardiovascular events, as demonstrated by the SUSTAIN-6 trial, which showed a 26% reduction in major adverse cardiovascular events compared to placebo 2 Potential side effects to monitor include:
  • Gastrointestinal issues, such as nausea, vomiting, and diarrhea, which usually improve over time
  • Increased risk of gallbladder-related issues
  • Potential increased risk of pancreatitis
  • Rare cases of retinopathy progression in diabetic patients Long-term use of Ozempic requires ongoing medical supervision, with regular check-ups to monitor blood sugar levels, kidney function, and screen for gallbladder issues. Patients should be educated on recognizing signs of rare but serious side effects like pancreatitis. The long-term efficacy of Ozempic is attributed to its ability to mimic GLP-1, a hormone that regulates appetite and insulin secretion, leading to reduced food intake and improved metabolic function over time, as supported by the most recent guidelines 1. Key considerations for long-term Ozempic use include:
  • Starting with a low dose and gradually increasing as needed and tolerated
  • Monitoring for potential side effects and adjusting treatment accordingly
  • Regularly assessing kidney function and screening for gallbladder issues
  • Educating patients on recognizing signs of rare but serious side effects like pancreatitis Overall, the benefits of long-term Ozempic use, including sustained weight loss, improved blood sugar control, and reduced cardiovascular risk, outweigh the potential risks, making it a valuable treatment option for patients with type 2 diabetes, as recommended by the most recent guidelines 1.

From the FDA Drug Label

The effect of long-term glycemic control with semaglutide on diabetic retinopathy complications has not been studied. The FDA drug label does not answer the question.

From the Research

Effects of Long-Term Ozempic (Semaglutide) Use

  • The long-term use of Ozempic (semaglutide) has been shown to have various effects on patients with type 2 diabetes and obesity, including:
    • Improvement in glycemic control, with reductions in HbA1c levels 3, 4
    • Weight loss, with significant reductions in body weight 4, 5
    • Decreased blood pressure and albuminuria 3
    • Preservation of residual kidney function (RKF) 3
  • The safety and efficacy of semaglutide have been evaluated in several studies, including a 52-week open-label extension of the PIONEER 7 trial, which demonstrated the long-term efficacy and safety of oral semaglutide in patients with type 2 diabetes 4
  • A systematic review and meta-analysis of randomized controlled trials found that once-weekly semaglutide was associated with substantial decreases in long-term relative and absolute body weight in patients with overweight/obesity and without diabetes 5
  • However, the use of semaglutide has also been associated with an increased risk of gastrointestinal adverse events, although these events are typically transient and mild-to-moderate in severity 4, 5

Metabolic Effects

  • Semaglutide has been shown to have beneficial effects on metabolic parameters, including:
    • Reductions in HbA1c levels 3, 4
    • Improvements in insulin sensitivity and beta cell function 6
    • Decreases in body weight and body mass index (BMI) 4, 5
  • A study protocol for a randomized clinical trial (SemaPsychiatry) aims to investigate the long-term effects of add-on treatment with semaglutide on metabolic status in pre-diabetic and diabetic patients with a schizophrenia spectrum disorder 6

Economic Considerations

  • A study comparing out-of-pocket costs among commercially insured individuals with type 2 diabetes and obesity found that sleeve gastrectomy was associated with lower out-of-pocket healthcare costs compared to Ozempic at 2 years after treatment 7

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.