Medications like semaglutide have transformed the public conversation around weight loss, but much of that discussion has focused on dramatic results or uncomfortable side effects. New research suggests that for many users, how effective the drug feels matters more than how unpleasant it makes them feel.
In a study from Rutgers University, researchers examined why people using semaglutide for weight loss continue treatment despite experiencing side effects such as nausea and vomiting. The findings, published in the Journal of Medical Internet Research, suggest perceived effectiveness is the strongest factor shaping satisfaction and intent to stay on the medication.
Rather than relying on clinical trial data, the researchers used an approach known as “infoveillance,” analyzing 60 publicly available, anonymous online reviews from a health information website. These reviews offered patient-reported experiences that are often absent from traditional studies.
Across the reviews, users who reported weight loss or reduced appetite were far more likely to express satisfaction with semaglutide and to say they planned to continue using it. Gastrointestinal side effects were common, reported by 62% of users, but did not significantly influence whether people felt the medication was worth continuing.
“Ozempic has become a cultural phenomenon, but much of the public conversation has been driven by celebrity endorsements and social media trends rather than the voices of everyday users,” said Abanoub Armanious, lead author of the study. “Our study cuts through the noise to ask a simple question: What do people actually experience when they use this medication for weight loss, and what shapes their decision to keep going or stop?”
By contrast, users who experienced little or no weight loss or who reported non-gastrointestinal side effects were significantly more likely to discontinue treatment. About two-thirds of reviewers reported weight loss or reduced appetite, a proportion that aligns with outcomes seen in controlled clinical trials.
“There’s been a lot of focus on the side effects of GLP-1 medications — nausea, digestive issues — and whether they’re worth it,” said Morgan James, senior author of the study. “What we found is that for many users, the calculus is straightforward: If the drug helps them lose weight, they’re willing to tolerate significant discomfort.”
The authors emphasize that this study reflects perceptions, not medical outcomes. The sample was small, lacked demographic detail and drew from self-reported online reviews, which may not represent all users. Still, the findings highlight how people weigh benefits and drawbacks in real-world settings, often differently than clinicians might expect.
The researchers note that understanding these tradeoffs could help clinicians better support patients using semaglutide, particularly as side effects fluctuate and weight loss may plateau over time. Clear conversations about expectations, risks and long-term use may help people make more informed decisions about whether continuing treatment makes sense for them.
This research was supported by the National Science Foundation through the Garden State-LSAMP program; the University of Sydney; the National Institute on Drug Abuse; the National Heart, Lung, and Blood Institute; Rutgers Optimizes Innovation; the New Jersey Health Foundation; and Rutgers Global.