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Ozempic ‘microdosing’ is the new weight-loss trend: Should you try it?
A new trend gaining popularity among people trying to lose weight is microdosing the diabetes medication Ozempic.
With approximately 70% of American adults meeting the criteria for being obese or overweight, more people are turning to weight loss medications to help them shed pounds.
Ozempic is approved for type 2 diabetes, while its counterpart, Wegovy, is approved for treating obesity. Both are made by Novo Nordisk.
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Eli Lilly also offers a diabetes medication, Mounjaro, as well as a version for weight loss, Zepbound.
“Ozempic is the only version among the weekly injectables — Ozempic, Wegovy, Zepbound and Mounjaro — that has the option to ‘hack’ the pen for a smaller dose,” Dr. Alexandra Sowa, an obesity medicine specialist and founder of SoWell in New York, told Fox News Digital.
She is also the author of the book “The Ozempic Revolution” that is set to be released on Jan. 7.
Fox News Digital spoke to the experts to get the skinny on this latest trend.
What is microdosing?
Microdosing Ozempic refers to using smaller amounts compared to the standard therapeutic doses that are traditionally prescribed for managing type 2 diabetes and aiding weight loss, experts say.
This practice is not approved by the U.S. Food and Drug Administration (FDA).
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“Health care clinicians do not typically recommend this approach, as the standard dosing regimen is based on clinical trials determining the most effective and safe amount for these conditions,” noted Dr. Fatima Cody Stanford, obesity medicine physician at Massachusetts General Hospital and Harvard Medical School.
There are no established guidelines for microdosing – although there are reports on social media of using 10 to 100 times lower than standard prescriptions, added Dr. Christopher McGowan, a gastroenterologist and obesity specialist who runs True You Weight Loss in Cary, North Carolina.
“Health care clinicians do not typically recommend this approach.”
Some people get confused by the terminology, the doctors noted.
“I think there’s a little bit of a misconception, as some people say ‘I’m microdosing’ when they’re just on the starting doses or don’t go all the way up in the escalation titration dosing of the medication,” Sowa said.
Benefits of microdosing
The primary reason for microdosing is to reduce costs, according to McGowan.
For example, he said, a patient might think that if a full prescription costs over $250 per week, they may be able to achieve some benefit with just $25 worth of the medication.
The average monthly retail price of Ozempic ranges from $1,000 or more without insurance, per GoodRx.
People may also pursue microdosing to reduce the incidence or severity of side effects such as nausea, vomiting or stomach discomfort, according to Stanford.
“Some individuals might start with microdoses to gradually acclimate their body to the medication, potentially easing into the full therapeutic dose over time,” she said.
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Any potential benefit of the medication, however, will likely wane proportionally with lower doses, experts noted.
Individuals may also microdose due to supply challenges, according to Dr. Amy Rothberg, clinical professor of medicine in the Division of Metabolism, Endocrinology & Diabetes at the University of Michigan.
“Some feel they may derive a benefit from microdosing by being able to extend their supply and may perceive an effect,” Rothberg, who is also the medical director of Rewind, a lifestyle program for type 2 diabetes patients, told Fox News Digital. “As we know, the placebo effect may have a strong impact.”
Potential risks of the practice
The most likely risk of microdosing is a lack of effectiveness, McGowan noted.
“Microdosing Ozempic or other [weight-loss] medications is entirely off-label and unproven, with no supporting clinical studies,” he cautioned.
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Stanford also warned that smaller doses may not provide adequate blood sugar management, leading to uncontrolled diabetes and associated complications.
It can also lead to suboptimal weight loss and unpredictable results, as well as the potential for misuse, she added.
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People who microdose often use a “compounded” version of the medication, which the FDA does not regulate.
“This introduces risks such as contamination, inconsistent formulations and uncertainty about the actual strength of the product being injected,” McGowan stated.
Additionally, these compounded versions are usually dispensed in vials, which requires a syringe to draw it up, in contrast to the FDA-approved versions that are simpler to use.
Using the compounded versions through vials runs the risk of drawing up too much medication — so instead of microdosing, it’s possible to macrodose, Sowa warned.
Medical supervision is key
Some providers are still comfortable offering microdosing for select patients with one caveat — that people should always consult a health care clinician before altering their medication regimen.
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“As long as it is being dispensed and monitored by a physician, I don’t see how anybody is going to overdose, especially when we are giving such small amounts,” Dr. Suzanne A. Trott, a double board-certified plastic and general surgeon in Beverly Hills, told Fox News Digital.
“I have seen a lot of patients who are given metformin for weight loss — I don’t see how this is any different,” said Trott, who runs her own microdosing clinic.
Trott pointed out that there are many “off-label” practices offered to patients.
“Botox and fillers are not even FDA-approved for most of the places we use them,” she noted.
“Some individuals might start with microdoses to gradually acclimate their body to the medication.”
Experts agree that sustained weight loss will not occur with medication alone.
“I think people find that it’s easier to take a drug, but neglect concomitant behavioral changes,” Rothberg said.
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In the absence of changes to diet and physical activity patterns, the long-term benefits will disappear once the drug is stopped, she noted.
Trott also recommends maintaining consistent exercise, strength training, hydration and high protein intake to maintain muscle mass.
Fox News Digital reached out to Novo Nordisk, the maker of Ozempic, for comment.
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Botox for burping? Doctors use injections to treat ‘no-burp syndrome’
Burping is often considered a “faux pas,” as it can be embarrassing and off-putting, especially in social situations.
But for some, the inability to belch can be an issue that can cause discomfort. There is even a medical name for the condition: retrograde cricopharyngeal dysfunction (R-CPD), also known as “no burp syndrome.”
The cricopharyngeus is the main muscle of the upper esophageal sphincter, the top gate of the food pipe. With no burp syndrome, this muscle does not relax, which interferes with the burping process, according to Neil Chheda, MD, associate professor and vice chair in the department of otolaryngology and chief of the division of laryngology at UF Health in Gainesville, Florida.
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“Both men and women can be affected, and risk factors for developing this condition are not known,” Chheda told Fox News Digital.
It may not seem like an inability to burp is a big deal, but it can bring severe challenges, the doctor said.
“Those who can’t burp may report quality of life issues, such as bloating, a gurgling noise, and discomfort with certain foods and drinks, such as carbonated beverages,” Chheda said.
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Priya Krishna, MD, an otolaryngologist in the department of head and neck surgery at Loma Linda University in California, agreed that no burp syndrome can cause “significant psychological distress” in the affected person.
“It actually severely impacts the life of an individual, making social situations embarrassing because the gurgling can be loud and the flatulence excessive,” she told Fox News Digital.
“Those who can’t burp may report quality of life issues, such as bloating, a gurgling noise, and discomfort with certain foods and drinks.”
If over-the-counter options, prescription medications and lifestyle tweaks don’t solve the burping issues, patients can turn to Botox for a potential remedy, medical experts say.
Whether it’s injected into the face for a cosmetic procedure or elsewhere in the body for a functional reason, Botox works by preventing a motor nerve from releasing the chemical transmitter that signals a muscle to contract, explained Dr. Chheda with UF Health.
“When Botox is injected into the cricopharyngeus, the muscle can’t contract, and thereby relaxes and permits the venting of the esophagus.”
As a result, this can help a patient burp.
Dr. Krishna of Loma Linda University told Fox News Digital that a Botox injection can be a very safe procedure as long as it is injected into the correct and intended muscle.
“That means having a surgeon familiar with the anatomy — as all otolaryngologists are — injecting the cricopharyngeus muscle,” she said.
The remedy was discovered by Robert Bastian, MD, an otolaryngologist (ear, nose and throat doctor) and director of Bastian Voice Institute in Downers Grove, Illinois.
“I have subspecialized in laryngology (the ‘T’ of ENT), which means voice, swallowing, upper airway, sensory neuropathic cough and inability to burp, or R-CPD,” he told Fox News Digital. “So I describe myself as a ‘laryngologist.’”
Bastian said he pioneered the procedure that involves injecting Botox into the cricopharyngeal muscle, which enables it to loosen and permits burping.
What to expect from the procedure
There are two methods of using Botox to induce burping, according to Bastian.
The first is a brief procedure under general anesthesia in an outpatient operating room.
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“A simple ‘scope’ procedure allows one to see the sphincter, at the junction between the low throat and opening of esophagus,” the doctor told Fox News Digital. “A tiny needle is then inserted into the muscle to inject Botox.”
Because of the anesthesia, someone must drive the patient home after the procedure.
The second method is to inject the muscle while the patient is sitting in a chair in a doctor’s office.
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“A needle is passed into the muscle from the side of the neck. Surface landmarks and three-dimensional visualization are used by the surgeon, and an EMG device monitors and verifies muscle placement,” Bastian described.
The patient can drive to and from the procedure since only local anesthesia is used.
Bastian said it has been rewarding to pioneer the Botox method.
“It has been a great privilege to be the one to ‘discover’ and codify the diagnosis and help spread the information to other doctors … and above all, it has been an honor to work with lovely patients who have suffered so much and for so long with this terrible disorder,” he told Fox News Digital.
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A patient of Bastian spoke about the effectiveness of the procedure, saying it has allowed them to burp, that “any gurgling is gone,” and that “bloating has diminished almost entirely,” the doctor shared.
The patient also noted that getting the procedure has “drastically” improved their day-to-day life.
Fox News Digital reached out to the manufacturer of Botox and the U.S. Food and Drug Administration (FDA) requesting comment.
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