Ozempic before and after: what results are realistic?

How much weight do you lose per month on Ozempic?

In the first month you usually lose 1 to 3% of your weight, then on average 1 to 2% per month until it levels off after about a year. At 100 kilos, that often means 2 to 3 kilos in month one and then about 1.5 kilos per month.

The range is wide, and that is not an evasive answer. In the STEP 1 trial, published in Diabetes, Obesity and Metabolism, the group using semaglutide lost an average of 17.3% of their body weight in 68 weeks, compared with 2.0% in the placebo group. Behind that average are people who lost 25% and people who barely responded.

The table below translates that research curve into what you can expect per period. Read it as an order of magnitude, not as a schedule you are tied to.

Note one thing about these figures: the research used semaglutide at a dose of 2.4 mg per week, the dose that belongs to Wegovy. Ozempic goes up to a maximum of 2 mg per week. So expect results closer to the lower end of the range.

And the kilos you see in photos? They almost always come from people with a high starting weight, over a long period, often combined with major lifestyle changes. That is why we do not post before and after photos. They show the extreme, never the average.

How fast do you lose 10 kilos on Ozempic?

With a starting weight of 100 kilos, losing 10 kilos on semaglutide takes an average of five to eight months. With a higher starting weight it goes faster in kilos, because the loss is calculated as a percentage of your body weight.

Wanting to go faster is understandable and rarely wise. The dose is deliberately increased slowly, because your stomach and bowels need time to adjust. Increasing too quickly mainly brings more nausea, not better results.

Without a protein-rich diet and exercise, part of your weight loss also consists of muscle mass. That makes it harder to maintain your result later on.

What do you feel after the first injection?

In the first week, most people mainly feel less hungry and sometimes slightly nauseous. The effect rarely hits suddenly. It is more like a quietening: the constant thoughts about food become softer.

According to the Farmacotherapeutisch Kompas (the Dutch national drug reference), you start with 0.25 mg per week, and the dose only goes up after four weeks. This starting dose is deliberately low and is not yet an effective weight loss dose. If you feel little in week one, that is exactly the intention.

What people mention most often in the first weeks:

• Feeling full sooner and no longer finishing your plate
• Less craving for sweet and fatty food and alcohol
• Nausea, especially after a large or fatty meal
• Tiredness in the first few days after the injection

With us, you usually see the first effect after about four weeks, when the dose has gone up for the first time. That is also the point at which medical weight loss really starts to pay off: you then have someone who checks whether the dose matches what you are feeling.

Ozempic reviews: what goes well and what disappoints

Users name the calm in their head as the biggest benefit, and the nausea plus the costs as the biggest disappointments. That split comes up in almost every conversation.

What surprises people positively is that it does not feel like a struggle to keep going. The background noise about food, the counting, the negotiating with yourself at four in the afternoon: it all gets quieter. For someone who has been dieting for twenty years, that is a strange and liberating experience.

The disappointments deserve just as much attention. The first weeks can be tough in terms of stomach complaints. Some people see the scales stand still after a few months and think the medication has stopped working, when the body has simply reached a plateau. And there are people for whom it just does not do enough.

Our doctors also often hear that the social side is underestimated. Going out for dinner and leaving half your plate, family asking why you eat so little. You can read more medical weight loss reviews from our own practice on our success stories page.

Do you recognise yourself in this, after years of trying without lasting results? At Qlinic, your own BIG-registered doctor (the BIG register is the Dutch register of healthcare professionals) first assesses whether medical support is appropriate for you, before anything at all is prescribed. Take the eligibility check →

What is the downside of Ozempic?

The biggest downside is that you can get stomach and bowel complaints, and that the effect disappears once you stop. It is also not something you simply try out: it belongs in a medical treatment with check-ups.

Nausea and diarrhoea occur in more than ten percent of users. Abdominal pain, constipation, reduced appetite and dizziness are also reported regularly. These complaints are usually most intense around a dose increase and ease off afterwards.

Rarer, but serious: pancreatitis, gallbladder problems and severe allergic reactions. That is why a doctor who can assess your complaints should always be involved. With us, you can turn to your own doctor for this, especially if you are unsure whether something is part of it. In a separate article we look more closely at Ozempic side effects and whether Ozempic is dangerous.

Two practical downsides that are mentioned less often: the medication is not suitable for everyone, and rapid weight loss can make your face thinner and looser. The latter is not a separate medical problem, but it is something that startles people.

What happens to your result when you stop?

After stopping, an average of two thirds of the weight lost comes back within a year. That is not failure and not a lack of discipline. It is biology.

The figures are clear. In the STEP 1 extension study, participants were followed after stopping semaglutide. Of the 17.3% weight loss, 11.6 percentage points came back, leaving a net loss of 5.6% at week 120. The researchers conclude that obesity is a chronic condition and that ongoing treatment fits that picture.

What happens is this: the hunger signal that was dampened comes back. And because your body also uses less energy at a lower weight, you gain weight on an amount of food at which you used to stay stable. This is the same reason most diets end with the question why am I not losing weight.

That is why we think about the next phase from day one. Tapering off instead of stopping abruptly, protein and strength training to maintain muscle mass, and a lifestyle that is sustainable without medication. With us, you always discuss pausing or stopping with your doctor.

Costs and insurance cover in the Netherlands

A programme with semaglutide (Ozempic) at Qlinic costs €250 per month or €699 per three months, plus a one-off supervision fee of €400. This includes the consultation, the prescription, home delivery and follow-up by your own doctor.

For comparison, our other programmes:

One-off supervision fee: €400. The full overview of the cost of medical weight loss is on our prices page, and you can read how the programme is structured under medical weight loss with injections.

Reimbursement through basic health insurance (basisverzekering) is only possible for registered weight loss medication in cases of severe obesity with related conditions, and then under strict conditions and after a lifestyle programme. That reimbursement does not apply to an off-label programme with semaglutide (Ozempic) at an online clinic. So expect to pay the costs yourself. Read more about whether Ozempic is covered by insurance.

We are deliberately not a budget clinic. You pay for your own doctor who knows your file, not for a form and a parcel.

How our BIG-registered doctors guide your programme

At Qlinic you have one doctor of your own, a BIG-registered doctor who personally speaks with you every four weeks. No changing faces and no call centre between you and the person treating you.

The programme runs in three steps. First a consultation and intake in which the doctor assesses whether medical support is right for you. Then the prescription and home delivery. After that the programme itself, with a follow-up every four weeks by the same doctor.

Those four weeks are not an arbitrary choice. They coincide with the moments when the dose can be adjusted and when side effects tend to appear. Thuisarts.nl (the Dutch GP association's patient website) describes the same principle: after about three months, the doctor checks whether the medicine is doing enough, and if it is not working sufficiently, it is stopped.

We have now supported around fifty people and have a 5.0 rating on Google from more than twenty reviews. Small and personal, with delivery to your home.

Would you like to know whether a medical programme is right for you, without committing to anything straight away? The online check shows whether you are eligible, after which one of our doctors personally reviews your situation. Take the eligibility check →

Frequently asked questions about Ozempic before and after

How much weight do you lose per month on Ozempic?

On average 1 to 2% of your body weight per month, after a slightly faster start of 1 to 3% in the first month. At 100 kilos, that comes to about 1.5 to 3 kilos per month. The pace slows the longer you continue.

What do you feel after your first Ozempic injection?

Usually you mainly notice less hunger and sometimes slight nausea. The starting dose of 0.25 mg is not yet an effective weight loss dose, so a big effect in week one is not to be expected. You usually feel the real difference around week four.

What is the downside of Ozempic?

The most common downsides are nausea, diarrhoea and abdominal pain, especially in the first weeks and after a dose increase. The biggest long-term downside is that your weight comes back if you stop without a tapering and lifestyle plan.

How fast do you lose 10 kilos on Ozempic?

With a starting weight of around 100 kilos, it takes an average of five to eight months. With a higher starting weight it goes faster in kilos. Individual differences are large, partly because not everyone responds equally strongly to semaglutide. More about how fast Ozempic works.

Are the before and after photos you see online realistic?

Rarely. Those images show outliers, often of people with a high starting weight and over a period of more than a year. An average result of 15% weight loss is visible in a photo, but much less dramatic than the well-known transformations.

Can you buy Ozempic without a prescription?

No. In the Netherlands, weight loss medication is only available on prescription. The CBG explicitly warns against online offers without a prescription: you do not know what you are buying, and counterfeit pens have already been found in Europe. Always go through a doctor and a registered pharmacy.

Does Ozempic also work if you do not have diabetes?

Yes, the appetite-suppressing effect of semaglutide also occurs without type 2 diabetes. In the Netherlands, Ozempic is only registered for type 2 diabetes, so for overweight it is off-label use. A doctor weighs up whether that is responsible in your situation.