Originally appeared on E! Online
Oh, are we still talking about Ozempic? We are.
And for those who are considering giving the injectable medication—originally marketed for treating Type 2 diabetes—a shot, well, Jillian Michaels has a few words of caution.
"I think the situation is becoming even more concerning as new information gets out about the drugs," the trainer noted in an exclusive interview with E! News. And, as one might expect from the no-bulls--t host of podcast Keeping It Real, she didn't hold back when asked about her apprehension toward the semiglutide injectable used by stars like Sharon Osbourne (who has since said she's struggled to put weight back on) and Chelsea Handler, who said she didn't like how it made her feel.
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"With anything medical, whether we're talking about a vaccine or antibiotics, there are always side effects," she explained, listing the potential downsides. "So let's start out with the side effects that are on the f--king website: We've got thyroid tumors, gallbladder problems, pancreatitis, kidney issues, vision loss, stomach problems now including stomach paralysis. There's a class action lawsuit for stomach paralysis." (A spokesperson for Novo Nordisk told Reuters, the company "believes that the allegations in the lawsuit are without merit, and we intend to vigorously defend against these claims." A hearing is set for Jan. 25.)
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More anecdotally, she continued, experts like Dr. Peter Attia have warned of significant muscle loss and the oft-mentioned "Ozempic face," in which the drastic weight loss can lead to sagging and other facial changes.
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"People are always like, 'Oh, It's because of rapid weight loss," noted Michaels. "No, it's not."
Across 11 seasons on "The Biggest Loser " and even more as a personal trainer, "I've taken a tremendous amount of weight off of arguably tens of thousands of people," explains the founder of The Fitness App. "I've seen a bazillion before and afters to my website. For everything I've ever done, personally, people always looked better, they never look worse. So anecdotally there's something happening, in my opinion, that's arguably causing the breakdown of collagen."
Throw in vomiting, diarrhea and the number of hairdressers speculating about why they've been seeing increased hair loss in their clients, and it's a strong no from Michaels.
And, to be clear, she's not shaming those who have considered giving the seeming cure-all a shot. "I form zero, and I mean, zero judgment on this," she insisted. "And what's sad is that people are like, well, I don't want to take the easy way out. And trust me, life is hard enough. If this was an easy way out, I would be the first one signing everybody up and selling the drugs through my website."
But the way she sees it, hopping onto the Ozempic bandwagon "is the opposite of an easy way out."
For starters, she explained, she doesn't see a clear path for getting off of the drug. "And if you do all of the meta analyses shows that you gain the weight back—two-thirds within the first year alone and then some," Michaels explained. "It is yo-yo dieting on crack." (Responding to a 2022 study that showed patients regain the weight, Novo Nordisk, the makers of Ozempic and Wegovy, said in a statement, "Not unexpectedly, patients experience weight regain once they stop taking the medication. Obesity is a chronic disease that requires long-term management, much like high blood pressure or high cholesterol.")
With the medication imitating GLP-1—a hormone that naturally occurs in the body, to lower blood sugar levels—it manages appetite by affecting both the stomach and brain.
"If I'm not giving my body food, and I'm consistently eating less than I burned in a day, it's not like f--king Stephen King's Thinner, where you eventually disappear," continued Michaels. "The body is like, 'Oh, wow, we've got to change some things around here biochemically. And we've got to lower our metabolic setpoint.' And it does this by changing out what hormones are released when and so on and so forth. So now you've lowered your metabolism, you've f--ked up your hormone balance, you've lost a ton of muscle. You're working from all the way behind the eight ball if you ever get off of it."
It's also worth noting that Ozempic maker Novo Nordisk previously told E! News that the drug is not FDA-approved for chronic weight management, nor is it marketed as a weight loss aid.
For those that plan to keep using the medication forever and are willing to navigate both the hefty price tag and the supply issues caused by its increased popularity, a plateau looms.
While the experience varies from patient to patient, basically, hypothosized Michaels, the body will adapt to the medication "the way you adapt to coffee. Just the way people adapt to any other drug. Just the way we become insulin resistant or leptin resistant. And you plateau."
Which is why she predicts a backlash will come next.
"Two years from now, you're going to see the fallout from this, just like we did with all the other diet drugs over the years," said Michaels. "And the fallout will be significant. Right now everyone is like, 'I've been on for six months, I look and feel great.' And then what happens when it's no longer impacting your appetite and you plateau in a year and a half? Or what happens when you experience one of these side effects? Or all of a sudden your hair starts falling out six months in or you look like complete s--t?"
In other words, she summed up, "I cannot issue a strong enough warning."
For those curious what Michaels is recommending it's a return to the basics: Eat less, move more.
"I'm not saying it's easy," she admitted, "I'm saying it's simple."
She suggests springing for a smartwatch like her go-to iTOUCH Wearables and using it to track how many calories you burn each day.
From there, "You've got to spend two weeks learning how many calories are in the things you eat regularly," she said. And while she understands calorie-counting gets a bad rap, "if I don't tell you how to do it, you won't be able to actually effectuate change. And then you don't believe what I'm saying because you don't realize how much you're eating and you get discouraged and become vulnerable to more fads and trends."
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The goal, she continued, is to create a 500-calorie-a-day deficit, which will translate to losing roughly a pound each week.
And while, yes, she jokes, "I want you to eat, like, Moringa greens, grown by Tibetan monks in the third phase of the crescent moon," she also wants to meet people where they're at.
"If it's too much to ask people to switch that pizza to a chicken salad, here's what we're going to do," Michaels said. "Instead of half the pie, you're going to do one slice of pizza and you're going do a side salad. Or two slices of pizza and a side salad with the dressing on the side. And we're going to opt out of the Coke. Or the two glasses of wine. Done. And all of this will work. I promise."
In fact, noted Michaels, one of the benefits of the Ozempic obsession has been that "it's evidenced what I've said for three decades. When you eat less food, you will lose weight."
It's just that her way of doing things, she noted, while undoubtedly slower, is also safer. "We're not dealing with significantly less food forever, we're eating a little bit less food," she explained. "And we're still able to get the nutrients from our food, we're not messing with our biochemistry and our hormones. So we don't have any of those negative side effects biochemically."
Of course, the fitness pro isn't the first to sound off on Ozempic's increasing popularity.