Why are people ‘microdosing’ Ozempic?

“Microdosing.” It’s a term you might have heard in reference to psychedelics. But what about Ozempic?
The explosion of interest in weight-loss medication from brands like Ozempic, Wegovy and Mounjaro over the past few years has rocked the medical and pharmaceutical landscape. People everywhere are clamoring for these drugs, and, sometimes, not just to lose weight. A mid-stage study unveiled in July, for instance, found that weight-loss medication may slow cognitive decline. Researchers have also found it may help with nicotine cravings and heart disease too.
All this − along with celebrities like Oprah Winfrey lauding the drugs − doctors say, has led to more and more people to wonder if “microdosing” Ozempic and similar medication is an option for them. Though an off-label use, microdosing, or taking these drugs at a dose smaller than the standard amount, can have serious health benefits, according to experts − when done under the care and guidance of a doctor.
That last part is key.
“It’s basically a tailored approach to dosing Ozempic to meet the needs of the individual,” says Dr. Britta Reierson, a board-certified family physician and obesity medicine specialist at the healthcare company knownwell. “Now, where we get concerned is when this is happening without any guidance from a medical professional.”
There are many reasons people seek out microdoses of weight-loss medications. For some, they’ve been on standard doses before and now need microdoses to maintain their new weight. For others, they may only want to lose a small amount of weight or lose weight more gradually. Others may only be able to afford these drugs at smaller doses.
Dr. Aria Vazirnia, a leading lipedema surgeon with the Advanced Lipedema Treatment Program at The Roxbury Institute, says Ozempic’s breakthrough into popular culture has also fueled interest in microdosing. Even people who aren’t in dire need of Ozempic are still curious to try it at a microdose.
“I think a lot of it has to do with social media,” he says. “It’s been with the celebrity scene… People have been talking about it in podcasts. So there’s a lot of interest in it.”
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Dr. Brett Osborn, a neurosurgeon and longevity expert, says he microdoses weight-loss medication for other health benefits, like managing his blood sugar and cholesterol.
He says microdosing is essential for those who’ve lost weight on standard doses to keep the weight off. He compares it to driving on the freeway: At first, you need to hit the gas hard enough to get up to the speed of traffic. Once you’re going fast, however, you still need to tap the pedal, but only slightly.
“The medications are not to be stopped,” he says. “You just keep the gas pressed, albeit smaller amounts, and that weight loss will be maintained.”
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Some people seek microdoses out of shame.
Dr. Alexandra Sowa, an obesity medicine specialist and founder of SoWell, says she’s seen many patients who ask for microdoses because of the stigma around using these drugs. She says these people feel less guilt if they take weight-loss medication at a smaller dose, when, in reality, what’s wrong is the stigma, not the dosage.
“Often in managing weight, there’s so much stigma and bias from both the clinician side and the patient side that often people’s brains want to try to tell them that they can outsmart the system,” she says. “They’ll feel better about the fact that they’re on a medication if they go to a smaller dose, and, really, what we need to get to the root of is, let’s make this patient feel whole from the beginning, that there’s nothing wrong with using a medication.”
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As with any prescribed medicine, weight-loss drugs should only be taken under the recommendation and supervision of a doctor. Do not microdose them unless your doctor tells you to, and follow their instructions closely.
Side effects and bad reactions are bound to happen when people take weight-loss medication on their own, and doing so only further stigmatizes these drugs for those that need them, Osborn says.
“Do not ever blame this on the medication. It is not the medication’s fault,” he says. “The burden is on us as physicians to be able to modulate the dose.”