Can Ozempic cause muscle weakness?

Ozempic (generic name: semaglutide) is a prescription medication commonly used to manage type 2 diabetes and support weight loss. It belongs to a class of drugs known as GLP-1 receptor agonists, which help regulate blood glucose levels by enhancing insulin secretion, slowing digestion, and reducing appetite.

GLP-1 receptor agonists work by:

• Increasing insulin release when blood glucose levels are high.
• Reducing the amount of glucagon (a hormone that raises blood glucose).
• Slowing gastric emptying, which helps with feeling full and may aid in weight loss.

While Ozempic is effective and generally well tolerated, some users report physical side effects, including muscle weakness or fatigue. This article explores whether Ozempic may be indirectly contributing to these symptoms—and what can be done about it.

Common side effects of Ozempic

Commonly reported side effects of Ozempic include:

• Nausea and vomiting
• Diarrhoea or constipation
• Stomach discomfort
• Fatigue
• Decreased appetite

These symptoms often lessen over time as people adjust to the medication. However, some people also report muscle cramps, weakness, or an overall drop in physical strength—symptoms not routinely listed but worth understanding.

Muscle weakness: Is It linked to Ozempic?

Muscle weakness is not recognized as a primary side effect in Ozempic’s clinical trial data or product information. However, there are several plausible, indirect mechanisms through which it may occur:

Nutrient absorption and appetite suppression

By slowing digestion and reducing appetite, Ozempic may affect the intake and absorption of key nutrients such as:

• Protein
• Vitamin D and B12
• Calcium, magnesium, and potassium

If an individual’s diet is insufficient in these nutrients—or they are eating significantly less—this can contribute to muscle weakness and fatigue.

Weight loss and muscle mass (sarcopenia risk)

Weight loss is a common and often desirable effect of Ozempic. However, rapid or unbalanced weight loss can lead to a reduction in lean muscle mass—a condition known as sarcopenia.

Sarcopenia risk increases with:

• Low protein intake
• Sedentary lifestyle
• Underlying chronic illnesses
• Ageing

To prevent this, it’s important to maintain a balanced diet and engage in regular physical activity, including resistance and weight-bearing exercises. These strategies help preserve muscle mass and bone health during weight loss.

Potential impact on bone density (osteopenia)

While direct evidence linking Ozempic to osteopenia is limited, some studies suggest GLP-1 receptor agonists could influence bone metabolism.

Possible contributing factors include:

• Reduced mechanical loading on bones from weight loss
• Insufficient calcium and vitamin D intake
• Poor nutrient absorption due to slower digestion

Monitoring bone health is especially important for older adults or those at risk of osteoporosis.

Fluctuations in blood glucose (hypoglycaemia)

Although Ozempic alone has a low risk of causing hypoglycaemia, combining it with other diabetes medications (such as insulin or sulfonylureas) can increase this risk. Symptoms of low blood glucose include:

• Weakness
• Shakiness
• Fatigue
• Confusion

If your client is experiencing these symptoms, it’s essential to monitor they monitor their blood glucose and speak with their General Practitioner.

Other medical conditions

Muscle weakness may also stem from unrelated health issues, such as:

• Electrolyte imbalances
• Thyroid dysfunction
• Neuromuscular disorders
• Vitamin deficiencies

How to help clients experiencing muscle weakness?

If you have a client who reports feeling weaker after starting Ozempic, suggest the following steps:

1. Advise them to speak with their GP. who may:

• Check for medication interactions
• Order blood tests (for nutrients, thyroid function, glucose levels, or bone health)
• Review the dosage or consider alternatives

2. Focus on nutritional support

A balanced diet is essential while on Ozempic, especially if appetite is reduced. People should aim for:

• Adequate protein to support muscle
• Foods rich in calcium and vitamin D for bone strength
• Proper hydration

A dietitian can provide personalised guidance if needed.

3. Stay active safely

Exercise helps prevent sarcopenia and maintain physical function. It is recommended people start with low-impact resistance exercises and increase gradually. Even short daily walks and bodyweight exercises can improve muscle strength.

4. Review medication

If symptoms are persistent or worsening, the GP might:

• Adjust the Ozempic dose
• Recommend additional supplements
• Explore alternative diabetes treatments

Remind your client to not stop taking Ozempic without their GP’s supervision.

When to seek urgent medical attention

Seek immediate medical attention if your client experiences:

• Sudden or severe muscle pain or weakness
• Difficulty breathing or swallowing
• Disabling cramps
• Symptoms of low blood glucose that don’t improve with treatment

These could be signs of more serious complications.

Ozempic has significantly improved outcomes for people with type 2 diabetes and obesity. While muscle weakness is not a typical side effect, indirect issues such as nutrient deficiencies, sarcopenia, or blood glucose fluctuations may play a role.

Advising your client to stay informed and maintain regular communication with their GP is the best way to ensure safe and effective treatment. With the right combination of medication, nutrition, and physical activity, it is possible they can benefit from Ozempic while minimising any negative impact on muscles or bones.

By Robbie Tyson, Credentialled Diabetes Educator