How Weight Loss Medications Like Ozempic Improve More Than Just the Scale: A Regstered Dietitian Explains
The impact of ozempic and other weight loss medications on chronic diseases like Type 2 Diabetes, heart disease and PCOS (polycystic ovary syndrome).
If you think weight loss medications like Ozempic (semaglutide) are only about changing the number on the scale, it’s time to zoom out. As a registered dietitian working with adults to reduce chronic disease risk, I see these medications as more than just a weight loss tool—they’re part of a broader strategy to protect against serious health conditions like type 2 diabetes, heart disease, and PCOS.
In this blog, I’ll break down how semaglutide and similar drugs work inside the body and why they're proving to be effective in preventing and improving some of the most common chronic diseases in the U.S.
Obesity: A Chronic Disease, Not Just a Lifestyle Problem
Major medical organizations—including the American Medical Association—classify obesity as a chronic disease. That means it’s not simply about overeating or making poor choices. Obesity involves complex hormonal, metabolic, and genetic factors that influence weight and health.
And because obesity increases the risk of over 200 comorbid conditions, treating it as a disease in its own right is critical—not just for weight loss, but for disease prevention.
What Semaglutide and Other Weight Loss Medications Actually Do
Semaglutide (the active ingredient in Ozempic and Wegovy) and other GLP-1 receptor agonists don’t just reduce appetite—they impact the body’s insulin response, blood sugar regulation, and inflammation. That’s why their impact goes far beyond shedding pounds.
These medications are now being studied for their effects on:
Type 2 diabetes
Cardiovascular disease
Polycystic ovary syndrome (PCOS)
Sleep apnea
Fatty liver
Even some cancers
Let’s dive into three key conditions where semaglutide is showing promising benefits.
1. Type 2 Diabetes and Insulin Resistance
Over 38% of U.S. adults have prediabetes, and another 43% already have type 2 diabetes. This trend is projected to worsen, with over 60% expected to have the disease by 2050. And while weight loss can help reverse or manage diabetes, it often takes a 15% or greater reduction in body weight to make that happen.
That level of sustained weight loss is rarely achieved through diet and exercise alone—which is where medications like Ozempic come in.
What the Research Shows:
Semaglutide and tirzepatide (another GLP-1 medication) reduce HbA1c and fasting blood glucose more effectively than other medications or placebo.
In one study, only 1.3% of semaglutide users with prediabetes progressed to full type 2 diabetes over three years—compared to 13% in the placebo group.
Even after stopping the medication, semaglutide users had better outcomes in blood sugar regulation than those who never took it.
These results suggest that weight loss medications are not only helping with weight—they’re actually preventing the development of chronic conditions like diabetes.
2. Heart Disease and Cardiovascular Risk
Cardiovascular disease remains the leading cause of death worldwide, and over 51% of Americans have high blood pressure—often unknowingly. Excess weight, particularly around the midsection, increases inflammation and arterial damage, placing major strain on the heart.
How Semaglutide Helps:
The SELECT trial followed 17,000 adults with obesity and high heart disease risk (but no diabetes). It found that semaglutide users:
Reduced their waist circumference by 7.7 cm (compared to just 1.3 cm in the placebo group).
Lowered their BMI significantly, with 12% reaching a "normal" BMI under 25.
Showed better outcomes for obesity-related heart failure.
This shows that semaglutide doesn't just help with body weight—it improves cardiovascular markers that are often silent but deadly.
3. PCOS (Polycystic Ovary Syndrome)
PCOS is a hormone disorder linked to insulin resistance. It can lead to irregular periods, acne, unwanted hair growth, infertility, and more. Traditional weight loss strategies often don’t work well for people with PCOS—and few treatments offer consistent success.
Promising PCOS Research:
In a 2023 study of semaglutide for patients with PCOS and a BMI over 30, over 80% lost at least 5% of their body weight.
Fasting glucose normalized in 80% of participants.
After 6 months, participants lost an average of 25 pounds, and BMI dropped from 34.4 to 29.4.
80% of those who continued treatment resumed regular menstruation—a significant clinical improvement.
For a condition with limited options, these results are incredibly encouraging.
But What About Food? A Reminder From a Registered Dietitian
As a registered dietitian, I’m not here to promote magic pills or quick fixes. But I also believe that dismissing these medications ignores real science and real patient success.
That said, medications are most effective when paired with a nutrient-rich, balanced diet and regular activity. The data is starting to show that many people on these medications are under-consuming critical nutrients like fiber, iron, calcium, vitamin D, and more.
That’s why in my next post, I’ll share exactly which foods to eat while on Ozempic and how to structure a semaglutide diet to support long-term health and prevent nutrient deficiencies.
Final Thoughts
Obesity is a chronic disease, and Ozempic is a valid, evidence-based tool for treating it—especially when it comes to preventing or improving type 2 diabetes, heart disease, and PCOS. But like any tool, it works best when used as part of a broader plan that includes nutrition, lifestyle, and behavioral support.
If you don’t have access to a registered dietitian, I hope this blog and my video series can help guide you toward practical, realistic ways to eat and live well—especially while using weight loss medications.