Metformin & Ozempic For Weight Loss 2024: Is It Safe To Combine Them?

Nia Stevens, BS
Victor Nguyen, PharmD
Metformin and Ozempic are diabetes drugs prescribed off-label for weight loss. Learn what the research says about taking them together.
metformin and ozempic for weight loss
Ozempic and metformin may produce better weight loss results together. Photo: Ba Le Ho

If you struggle with obesity or type 2 diabetes, you’ve probably heard about drugs such as metformin and ozempic for weight loss. While metformin has been around for a while, Ozempic and similar drugs are relatively new on the scene. Neither medication is specifically approved for weight loss, but both have documented positive effects for the individuals who take them and suffer from obesity.

The benefits and risks of each prescription medication are fairly well established, but can taking these diabetes medications together cause drug interactions? Can patients striving for a healthy weight take these two medications together?

Keep reading to learn how these two drugs impact weight management.

Can You Take Metformin And Ozempic Together For Weight Loss?

Yes, metformin and Ozempic can be taken together for weight loss. Both drugs are approved for the treatment of type 2 diabetes, but weight loss is a side-effect of the drugs, even in individuals who don’t have diabetes.

Can You Combine Ozempic And Metformin For Weight loss?

Yes, Ozempic and metformin may be taken together[1] for weight loss. Both drugs are commonly used in the treatment of type 2 diabetes, and obesity is a frequent comorbidity and precursor to type 2 diabetes. However, Ozempic and metformin are not specifically approved for weight loss.

If you have or are at risk of developing type 2 diabetes, weight loss can significantly improve insulin sensitivity and lessen cardiometabolic risk factors.[2] With the careful supervision of a healthcare provider, metformin and Ozempic together for weight loss can be a winning strategy to improve your overall health.

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Metformin And Ozempic For Weight Loss

metformin and ozempic for weight loss
Metformin and Ozempic are two medications that are used in the management of weight. Photo: New Africa/Shutterstock

Metformin and Ozempic can both be prescribed for weight loss, but they work differently.


Metformin is an oral medication that is primarily used to treat insulin resistance in diabetic patients. Though not officially approved for weight management, some physicians may prescribe metformin for weight loss off-label[3] in people who struggle to manage obesity, polycystic ovary syndrome (PCOS), and pre-diabetic insulin resistance. It works in the following ways:

  1. Decreases liver glucose production.
  2. Increases insulin sensitivity.
  3. Decreases the intestinal absorption of glucose.


Ozempic is a once-weekly self-administered injectable that is used for diabetes management and may help with weight loss[4] in several key ways:

  • Increases insulin secretion by mimicking hormones that tell the pancreas to release insulin in response to a spike in blood sugar.
  • Regulates sugar absorption by slowing digestion.
  • Reduces appetite by delaying stomach emptying and telling your brain you’re full after eating.

How Much Weight Can You Lose On Ozempic And Metformin Together?

metformin and ozempic for weight loss
Ozempic and metformin together is a breakthrough weight loss strategy. Photo: RossHelen/Shutterstock

In a clinical trial featuring Wegovy (semaglutide 2.4mg), participants lost an average of 15% of their body weight after a 68-week trial that included lifestyle adjustments. Clinical trials[5] featuring Ozempic (semaglutide 1 mg) found an average loss of more than 5% after 12 weeks.

If you’re wondering how long it takes to lose weight, you should expect each pound to take up to a week or two.

Foods To Avoid While Taking Ozempic And Metformin Together For Weight Loss

Diets that focus only on how many calories you should eat might fall short of managing your obesity long-term. If your goal is to lose belly fat and reduce your risk of metabolic disease, you’ll want to seek out foods that promote low blood sugar. Here’s are some foods to avoid or limit:

Foods High in Refined Carbohydrates and Sugars

It’s no secret that an excess of carbs and sugars contribute to a slew of metabolic complications.[6]Top culprits of high sugar content include:

  • Sugary beverages: Skip the soda, sweetened teas, fruit juices, dressed-up lattes, and anything containing alcohol.
  • Sugary fruits: Some fruits, such as berries and watermelon and green apples, are lower in sugar than options such as grapes or bananas.
  • Sweets and desserts: Cakes, candies, cookies, ice cream, and others have long been on the naughty list.
  • White bread and pasta: In the absence of the fiber of whole grains, these foods absorb into the system quickly, causing rapid spikes in blood sugar.

Processed Foods

The list of problem foods for weight loss[7] includes those that have been subjected to heavy processing and additives.

  • Processed meats: Sausages, hot dogs, bacon, and other highly processed meats not only have hidden sugars but introduce lots of sodium, which isn’t a good idea when you have diabetes, hypertension, or other chronic diseases.
  • Fast food: Cut this from your diet to avoid a whole lot of unhealthy fats, salt, and hidden sugars.
  • Snack foods: If it’s shelf-stable and quick to grab on the go, be wary. Chips, crackers, and other “easy” snack foods are often high in unhealthy fats and refined carbs.
  • Fried foods: The best oils for frying are not the healthiest oils for your system. Save for special occasions if you have to eat fried foods at all.

Foods That Can Cause Digestive Issues

Both metformin and Ozempic can cause major stomach upset. Avoiding certain foods can help reduce the risk of this side effect.

  • High-fat foods can lead to heartburn and worsen the negative side effects of weight loss medications. Be careful with the amount of high-fat foods that you eat while taking metformin and Ozempic.
  • Spicy foods can be a trigger for upset stomach and bowel distress.

Even if you do take Ozempic and metformin for weight loss, lifestyle improvements are still vital to your long-term success. It’s important that you eat balanced meals on a regular schedule, starting with a healthy breakfast.

Side Effects

All medications cause side effects in certain populations. While both Ozempic and metformin are generally well-tolerated, some users experience side effects. Below are listed the most common side effects and complications of these drugs.

Side Effects Of Metformin

Metformin is generally well-tolerated, but common side effects include:

  • Gastrointestinal distress, including diarrhea, nausea, and abdominal pain.
  • Vitamin B12 deficiency.
  • Lactic acidosis. Metformin can rarely cause lactic acidosis–a serious metabolic complication of excess lactic acid buildup in the body.

Side Effects Of Ozempic

Ozempic is a powerful medication that can cause some serious side-effects. Some concerns to monitor include:

  • Pancreatitis. Semaglutide and other GLP-1 agonists have been linked to a rare risk of pancreatitis.
  • Diabetic Retinopathy Complications.
  • Hypoglycemia.
  • Acute Kidney Injury.
  • Gastrointestinal reactions.
  • Hypersensitivity or allergic reactions.
  • May impact the absorption of other drugs.

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Side Effects Of Metformin And Ozempic Together

Both metformin and GLP-1 agonists like Ozempic can cause digestive upset, such as nausea, vomiting, diarrhea, and abdominal pain. The risk of these side effects may go up when both drugs are used together.

Semaglutide is associated with a low risk of hypoglycemia (low blood sugar), as it is designed to increase insulin production. When used with other medications that lower blood sugar, the risk can increase. Metformin doesn’t generally cause hypoglycemia, but its combination with Ozempic needs monitoring.

The potential kidney issues generated by either drug can turn severe if a patient gets dehydrated due to stomach distress. This is also a reason to minimize sodium intake and avoid drinking alcohol when taking these medications.

This is not a complete list of possible side effects but includes the most common complications observed in clinical trials.[8] To learn about less common side effects, explore the prescribing and safety information for Ozempic[9] and metformin.[10]

If you’re taking one or both of these drugs for weight loss, our other tips to lose weight may help you reach your goals.


If you are considering combining metformin and Ozempic for weight loss, studies have shown that it can be effective.[11] However, this course of treatment isn’t ideal for all patients.

Talk with your healthcare provider to evaluate each possible treatment approach’s potential benefits and risks and monitor your progress. You may find that you’re not the best candidate for a prescription diabetes drug and that you might do better with an over-the-counter weight loss option.

Frequently Asked Questions

Is metformin or Ozempic better for weight loss?

Ozempic. A study[12] in 2021 indicated that the class of drugs that include Ozempic generates average weight loss of over 5% of body weight, in contrast to less than 3.2% for metformin and similar diabetes drugs.

How long does it take to lose weight on Ozempic and metformin?

Patients who start Ozempic and metformin together to lose weight may notice faster  weight loss. However, for healthy and sustainable weight loss, the aim should be gradual weight loss.

Should I take metformin or Ozempic?

It depends on the condition you’re trying to treat. Metformin is considered a first-line treatment for type 2 diabetes and improves insulin sensitivity. Ozempic is also FDA-approved for type 2 diabetes, but it’s also prescribed off-label for weight loss.

Does Ozempic help lose weight if not diabetic?

Yes, Ozempic should help with weight loss in non-diabetics,[13] and may even yield better results if you don’t have diabetes.

What does Ozempic do to your face?

Ozempic did not report side effects specific to the face. However, side effects such as weight loss, dehydration, and water retention can cause the face to look plumper or slimmer than usual.

Is Ozempic bad for kidneys?

It depends. Ozempic has been associated with acute kidney injury and worsening of existing kidney disease. The majority of reports of this complication[14] were in people who experienced serious gastrointestinal side-effects.


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  2. Lazzaroni, E., Moufida Ben Nasr, Cristian Loretelli, Pastore, I., Plebani, L., Maria Elena Lunati, Vallone, L., Andrea Mario Bolla, Rossi, A., Montefusco, L., Ippolito, E., Berra, C., D’Addio, F., Gian Vincenzo Zuccotti and Fiorina, P. (2021). Anti-diabetic drugs and weight loss in patients with type 2 diabetes. Pharmacological Research, [online] 171, pp.105782–105782. doi:
  3. Armen Yerevanian and Soukas, A.A. (2019). Metformin: Mechanisms in Human Obesity and Weight Loss. Current Obesity Reports, [online] 8(2), pp.156–164. doi:
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  5. Lazzaroni, E., Ben Nasr, M., Loretelli, C., Pastore, I., Plebani, L., Lunati, M.E., Vallone, L., Bolla, A.M., Rossi, A., Montefusco, L., Ippolito, E., Berra, C., D’Addio, F., Zuccotti, G.V. and Fiorina, P. (2021). Anti-diabetic drugs and weight loss in patients with type 2 diabetes. Pharmacological Research, [online] 171, p.105782. doi:
  6. Ma, X., Fang, N., Liang, H., Shu, P., Fan, X., Song, X., Hou, Y. and Zhang, D. (2022). Excessive intake of sugar: An accomplice of inflammation. Frontiers in Immunology, [online] 13. doi:
  7. Roe, L.S. and Rolls, B.J. (2020). Which strategies to manage problem foods were related to weight loss in a randomized clinical trial? Appetite, [online] 151, pp.104687–104687. doi:
  8. Haddad, F., Ghadeer Dokmak, Bader, M. and Karaman, R. (2023). A Comprehensive Review on Weight Loss Associated with Anti-Diabetic Medications. Life, [online] 13(4), pp.1012–1012. doi:
  10. [email protected] (2023). FDALabel. [online] Available at:
  11. Haddad, F., Ghadeer Dokmak, Bader, M. and Karaman, R. (2023). A Comprehensive Review on Weight Loss Associated with Anti-Diabetic Medications. Life, [online] 13(4), pp.1012–1012. doi:
  12. Lazzaroni, E., Moufida Ben Nasr, Cristian Loretelli, Pastore, I., Plebani, L., Maria Elena Lunati, Vallone, L., Andrea Mario Bolla, Rossi, A., Montefusco, L., Ippolito, E., Berra, C., D’Addio, F., Gian Vincenzo Zuccotti and Fiorina, P. (2021). Anti-diabetic drugs and weight loss in patients with type 2 diabetes. Pharmacological Research, [online] 171, pp.105782–105782. doi:
  13. Wissam Ghusn, De, A., Sacoto, D., Cifuentes, L., Campos, A., Feris, F., Hurtado, M.D. and Acosta, A. (2022). Weight Loss Outcomes Associated With Semaglutide Treatment for Patients With Overweight or Obesity. JAMA network open, [online] 5(9), pp.e2231982–e2231982. doi:

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