I'm a Doctor Who Prescribes Ozempic and These Are the 4 Patients I Will Never Give It To

Ozempic has been a life-changing weight-loss solution for many individuals struggling with obesity. A prescription drug that was once intended to treat adults with type-2 diabetes by controlling blood sugar levels is now mimicking the natural hormone GLP-1 to manage weight loss by suppressing one's appetite. It stands to reason that in order to manage these powerful functions, Ozempic is a very potent prescription drug—one not to be taken lightly.

GLP-1 drugs aren't a shortcut to weight loss, but rather serious medications that can be effective with the right doctor-patient relationship, common goals, and overall metabolic wellness. That's why we turned to the professionals. When it comes to prescribing drugs, your physician factors in safety concerns, possible interactions, patient history, and even family risk. Many drugs come with serious side effects, and some can be unsuccessful or even toxic, based on one's metabolic profile.

For this reason, it's essential to discuss treatments with your medical professional, who will be extremely informative and cautious when discussing options and game plans. We chatted with a doctor to learn the four patients she will never prescribe Ozempic to.

Dr. Bronwyn Holmes, MD, member of Eden's Medical Advisory Board, assesses the patient's history, family risk assessment, metabolic labs, body mass evaluation, the patient's goals, expectations, lifestyle, and also their ability to sustain their weight loss in the long term.

"I am very careful about when I prescribe Ozempic. When I decide not to prescribe Ozempic (semaglutide)," says Dr. Holmes. "I make that choice because the personal risks can outweigh the benefits for some people. GLP-1 medications can be powerful and effective for blood sugar control and metabolic weight loss. GLP-1 medications are not appropriate or safe for everyone."

These are the four conditions or concerns that will prevent Dr. Holmes from prescribing Ozempic, based on clinical concerns or contraindications that would raise the patient's risk, outweighing any success from taking the drug.

This grouping involves patients with a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN2). Both forms of cancer are rare, with MTC being the rarest of thyroid cancers.

MTC begins inside the thyroid gland and occurs when C cells, which produce the hormone calcitonin, start to grow uncontrollably. MEN2 leads to tumors in the digestive tract, thyroid and parathyroid glands, mouth, lips, eyes, and adrenal glands.

"The risk is enough that I would avoid semaglutide completely if I have a family history of MTC or MEN2," Dr. Holmes tells us.

Anyone with a recent or unresolved history of pancreatitis—inflammation of the pancreas—is another group of individuals Dr. Holmes would not prescribe semaglutide to.

"Semaglutide can cause pancreatitis. I watch patients who have a history of pancreatitis closely. If the patient has had repeated bouts of unknown cause of pancreatitis, the risk of worsening pancreatitis is high," Dr. Holmes says.

According to Dr. Holmes, the appetite-suppressing effects of semaglutide can be quite dangerous for individuals who have suffered from eating disorders.

"The appetite‑suppressing effects of semaglutide may reinforce behaviors or trigger a relapse in atypical anorexia, where the body weight does not reveal the hidden problem," Dr. Holmes tells us. "I have seen patients start to manipulate the dose or skip meals because the medication blunts the internal hunger cues. Weight management is not the goal. Re‑traumatizing the system is the result."

When you embark on a weight-loss journey—especially when taking GLP-1s—losing lean muscle mass is a common concern, as it happens naturally as the weight on the scale moves down.

"In older adults with low muscle mass, excessive or rapid weight loss caused by these medications can lead to a decline in functional health and increase the risk of falls, cognitive decline, and adverse outcomes," Dr. Holmes says.

If you're curious about what else to steer clear of, check out these 5 GLP-1 Medication Mistakes You Need to Avoid, According to an Obesity Expert.