The Ozempic myth: Why the most famous GLP-1 isn't the one most people are taking

Roughly 1 in 8 American adults has taken a GLP-1 medication, according to KFF health tracking polling, and Ozempic is the best known GLP-1. It's the brand that turned this drug class into a cultural phenomenon, showing up in headlines, late-night jokes, and celebrity interviews ever since weight loss injections went mainstream.

The usage data tells a different story, though. Logged medication data from users of the MeAgain app shows Ozempic accounting for just 7.1% of use, while tirzepatide-based options like Zepbound and compounded tirzepatide are among the top GLP-1 medications being used now. National numbers point the same way. Truveta research analyzing de-identified health records from 3.5 million GLP-1 patients found tirzepatide holding the top spot in both anti-obesity and anti-diabetes prescribing as of June 2026, while first-time semaglutide prescriptions fell 13.3% between March and June of this year. The most famous GLP-1 isn't the one most people are actually taking.

To understand why culture and clinical reality have drifted so far apart, I spoke with Dr. Marsha Novick , Chief Medical Officer at MeAgain, who works with GLP-1 patients every day and has watched the shift happen in real time.

About Our Expert:Dr. Marsha Novick, MD, DABOM, FAAFP, FTOS, is a board-certified family medicine and obesity medicine physician and the Chief Medical Officer at MeAgain, a leading GLP-1 tracking app.

Ozempic is everywhere, except in the data

The numbers surprised me, but they didn't surprise Dr. Novick. "Ozempic is prescribed for type 2 diabetes. At the same time, there is more competition in the GLP-1 market for treatment of obesity, including the semaglutide (Wegovy) injection, tirzepatide (Zepbound) injection, semaglutide (Wegovy) pill and orforglipron (Foundayo) pill, compounded semaglutide, and compounded tirzepatide to account for a loss in market share," she explained.

That's a crowded field, and it's grown dramatically in just the past year. Novo Nordisk won FDA approval for its oral Wegovy pill in December 2025, and Eli Lilly followed in April 2026 with Foundayo, the first GLP-1 pill for weight loss that can be taken any time of day without food or water restrictions.

How Ozempic became a household name

If Ozempic isn't the most used GLP-1, why does everyone still talk about it like it is? "The marketing for Ozempic was brilliant with catchy advertising," Dr. Novick said. "At the time, even though Ozempic was prescribed for the treatment of type 2 diabetes, studies also showed Ozempic to be more efficacious for weight loss compared to other FDA-approved weight loss medications."

"In addition, because other diabetes medications, such as insulin and sulfonylureas, cause weight gain, the invention of Ozempic, which helped people with diabetes to lose weight, was a new phenomenon- and it took off from there!" she added.

The research backs that up. In the landmark STEP 1 trial published in The New England Journal of Medicine , adults taking semaglutide, the active ingredient in both Ozempic and Wegovy, lost an average of 14.9% of their body weight over 68 weeks, results that older weight loss medications simply couldn't match.

The fine print most people miss: Ozempic is a diabetes drug

Here's the part of the story that explains the most. Ozempic was FDA-approved in 2017 to treat type 2 diabetes, not obesity. Its sister drug Wegovy, which contains the same active ingredient at a different dosing, is the version approved for chronic weight management . For a while, that distinction didn't matter much in practice, because some insurance companies covered Ozempic for weight management and prediabetes anyway. However, those days are over.

"The clinical reality is that Ozempic is FDA-approved for type 2 diabetes, not for weight management. As a result, insurance companies stopped covering Ozempic for weight management a few years ago and will only cover Ozempic for patients with type 2 diabetes. The lack of insurance coverage for Ozempic for weight loss treatment appropriately led to increasing prescriptions of other FDA-approved medications for weight management treatment while decreasing prescriptions for Ozempic," Dr. Novick shared.

Affordability pressures have squeezed the diabetes side, too. Many patients with diabetes now face deductibles so high that filling an Ozempic or Mounjaro prescription is out of reach, which shrinks the pool of people buying these medications for diabetes management even further. In that same KFF polling , about half of adults who had taken GLP-1 drugs said they were difficult to afford.

Why your insurance, not the brand name, picks your GLP-1

Patients tend to assume their doctor chooses their medication based purely on the science and what would be best for their health. Unfortunately, the reality is often far more complex and not always in the doctor's control. "Insurance coverage plays a very large role in steering patients toward or away from specific brands," Dr. Novick explained.

Each medication in this class carries its own specific FDA approvals, and those labels determine what insurance will pay for. "In terms of GLP-1 medications, semaglutide (Ozempic) and tirzepatide (Mounjaro) are FDA-approved for type 2 diabetes. Semaglutide (Wegovy) is FDA-approved for obesity, cardiovascular risk reduction (for those who have had a heart attack or stroke), and MASH (metabolic dysfunction-associated steatohepatitis). Tirzepatide (Zepbound) is FDA-approved for obesity and moderate to severe obstructive sleep apnea," she pointed out.

Wegovy was approved for cardiovascular risk reduction in 2024 and for MASH in 2025, while Zepbound became the first prescription medicine approved for moderate-to-severe obstructive sleep apnea in adults with obesity.

Cost is also a factor in prescribing decisions. "Insurance coverage and cost are a huge factor in determining which GLP-1 medication should be prescribed. Besides insurance coverage, side effects, the patient's medical history, and medication efficacy are also important factors that doctors consider when determining which medication to prescribe," Dr. Novick said.

"From personal experience, cost and insurance coverage is a very big consideration when prescribing weight loss medication. If a patient cannot afford the medication prescribed, alternative cost-containing medication options should be discussed and prescribed instead," she added.

Tirzepatide vs. semaglutide: what the head-to-head data shows

Tirzepatide, the active ingredient in Zepbound and Mounjaro, works on two hormone pathways, GLP-1 and GIP, while semaglutide targets GLP-1 alone. In the SURMOUNT-5 trial , the first major head-to-head comparison published in The New England Journal of Medicine , adults with obesity taking tirzepatide lost an average of 20.2% of their body weight over 72 weeks, compared to 13.7% for those taking semaglutide.

Still, the efficacy gap doesn't automatically make tirzepatide the right call for everyone. There are patient populations where semaglutide remains the better clinical choice despite tirzepatide's popularity. "This is based on the patient's medical history and insurance coverage," Dr. Novick confirmed.

What patients are really asking for now

You might expect an obesity medicine specialist to spend her days redirecting patients who came in demanding Ozempic by name. That's not what's happening anymore. "At this time, my patients are walking into my office asking for a GLP-1, not necessarily Ozempic. Most people understand that there are many medication options now available, and they are interested in discussing those options," Dr. Novick observed.

The brand name that once represented the entire category in people's minds is becoming exactly what it always was on paper, one diabetes medication. "It's important to note that Ozempic is prescribed for type 2 diabetes," she stressed.

The compounded versions of these medications, which surged during the drug shortages, are also in transition. The FDA has clarified its policies for compounders as the national GLP-1 supply stabilizes, another force reshaping which products patients actually use.

New GLP-1 pills are changing the race

"Ozempic is used for type 2 diabetes and is not in competition with tirzepatide, which is prescribed for obesity. In the next few years, there will be other GLP-1 and non-GLP-1 medications that will enter the market, potentially placing a ceiling on Wegovy and Zepbound. How doctors prescribe the medications will highly depend on insurance coverage," Dr. Novick said.

The oral Wegovy pill delivered roughly 17% average weight loss in its pivotal trial for patients who stayed on treatment, and Foundayo launched with a self-pay option starting at $149 per month, a price point designed to reach patients whose insurance won't cover injectables. For people who fear needles or can't afford brand-name injections, the pills could redraw the map all over again.

How to find the GLP-1 that's right for you

If the lesson of Ozempic's fading dominance is that fame is a poor guide to medicine, what should patients do instead? "Patients usually get the safest and most effective care by working closely with their primary care provider or a board-certified obesity medicine physician, who can monitor side effects, blood sugar, blood pressure, current medications, and overall weight loss progress. It is worth asking your doctor about all GLP-1 and non-GLP-1 options that are available, based on your individual medical needs and insurance coverage situation," Dr. Novick shared.

You can find a physician certified in obesity medicine through the American Board of Obesity Medicine , and the medication itself is only one piece of the plan. Dr. Novick said, "In addition, I cannot emphasize enough that these medications are to be used with a lifestyle plan, including improved quality of the diet, increasing physical activity, getting adequate sleep, and strengthening stress management. This plan should also be discussed with your doctor. Tracking progress with apps like MeAgain can help with staying consistent with your lifestyle and medication plan. Logging your experience may also be helpful for ongoing conversations with your physician and/or dietitian."

Thank you for reading. For more health and wellness stories, I invite you to follow me on Yahoo.

More About Our Expert:

Dr. Marsha Novick , MD, DABOM, FAAFP, FTOS, is the Chief Medical Officer at MeAgain , the all-in-one GLP-1 tracking app that helps users log medications, side effects, nutrition, and progress. She is a Diplomate of the American Board of Obesity Medicine, a Fellow of the American Academy of Family Physicians, and a Fellow of The Obesity Society. She brings years of clinical experience caring for patients with obesity, type 2 diabetes, and related conditions.

Please Note: This article is for informational purposes only and is meant to be a friendly starting point, not medical advice. Everyone's health story is different, so please talk with your doctor or another qualified healthcare provider before starting, stopping, or changing any medication, including GLP-1s. Never disregard professional medical advice or delay seeking it because of something you've read here.