Ozempic microdosing: Weight-loss hack or just a placebo?

Global News

06-05-2025

As weight-loss injectables like Ozempic skyrocket in popularity, a new offshoot trend is starting to take hold: microdosing.
Instead of following the standard dosing guidelines, some people are experimenting with smaller amounts of GLP-1 medications like Ozempic, Wegovy and Mounjaro. The reasons vary — from trying to stretch out expensive prescriptions to avoiding the side effects that can come with higher doses.
This off-label approach has picked up traction online. Podcasts, social media posts and YouTube videos feature users sharing personal stories of shedding pounds through lower-than-recommended doses.
But here's the thing: using smaller doses for weight loss hasn't been rigorously studied. Because it's considered off-label, there's little clinical evidence to show whether this kind of do-it-yourself dosing is actually effective, or just anecdotal.
So, can people really lose weight on a dose that hasn't been prescribed?
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'It's not impossible, but there's no evidence,' said Hertzel Gerstein, a professor of medicine and a diabetes specialist at McMaster University and Hamilton Health Sciences.
'But a lack of evidence doesn't mean that it doesn't work. It means no one has really studied it in any systematic way. And you can always go online, on social media and you can find anecdotes. But the trouble is that a placebo works in anecdotes, right?'
Gerstein noted one study published in Diabetes Care in March 2025, which suggested that microdosing might have some benefits for people with diabetes. But the study also made it clear: there's still not enough solid clinical evidence to back it up. Since microdosing is considered off-label and not officially supported by the drug makers, it needs to be done carefully, and only under the guidance of a health-care professional.
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Novo Nordisk, the maker of Ozempic, told Global News in an email Monday that its drugs are prescription-only medicines used with the Health Canada-approved product monograph.
'Novo Nordisk does not recommend the use of Ozempic at doses or frequencies that deviate from the dosing instructions approved in the product monograph,' a spokesperson told Global News.
Why microdose?
In Canada, Ozempic is officially approved for managing Type 2 diabetes. It's also used off-label for weight loss. Its sister drug, Wegovy — which contains a higher dose of the same active ingredient, semaglutide — is approved for chronic weight management in adults living with obesity or weight-related health issues.
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The semaglutide drugs help control blood sugar by imitating a hormone called GLP-1. This hormone boosts insulin production while also slowing down digestion and curbing hunger — a combination that's led to its growing use as a weight-loss aid.
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Because of Ozempic's off-label use, many insurance companies may not cover weekly injections. This can cost anywhere from $200 to $500 monthly in Canada.
And like many medications, Ozempic can cause side effects, including nausea, vomiting, diarrhea, stomach pain, headaches, dizziness and in some cases, a condition known as stomach paralysis.
'This could be a situation where, for some reason, you can't tolerate some of the fixed doses that you have, so in which case you might want to use a little bit more or a little less,' Gerstein said.
So the cost and the side effects may be reasons people are experimenting with lower doses, he said.
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Is microdosing Ozempic dangerous?
Bottom line, Gerstein said, there are no official guidelines for microdosing these drugs — and no solid data on how safe it is or what the effects might be, good or bad. It's an experimental approach, and we just don't know enough yet.
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For example, when you're prescribed a GLP-1 medication like Ozempic, you usually start on the lowest dose — typically 0.25 milligrams. If your body handles it well, your doctor may gradually increase it to 0.5 milligrams, and eventually even higher, depending on your response.
Doctors prescribe this amount because it's based on clinical testing done by the drug manufacturers, ensuring the dose is both effective and safe for most patients.
'The dosages that are marketed are what work based on clinical studies,' Gerstein explained.
Since there's no evidence to support that microdosing — using amounts smaller than the prescribed dose, like 0.25 milligrams — can produce the same results, Gerstein emphasized that any positive outcomes could just be the placebo effect.
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'Microdosing within the known therapeutic range, where the drug is proven to work, is one thing,' he said. 'For example, some people find that one milligram works for them, and when they increase it to 1.5 milligrams, they see better results. That's still within the range that's been studied.
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'But microdosing below that therapeutic range? It's less likely to have an effect, though not impossible. The problem is, we don't have any evidence, just anecdotes and guesswork.'
Gerstein added that because much of the microdosing talk centres around weight loss, it's worth noting that studies show weight loss with semaglutide is dose-dependent. The more you take (within reason), the more weight people tend to lose.
For example, one milligram usually leads to more weight loss than 0.5, and Wegovy, which is 2.4 milligrams, tends to deliver even better results.
'Could someone lose a lot of weight on 0.1 milligrams — basically a microdose? Or 0.25 milligrams? Anything's possible, but at this point, it's purely an untested hypothesis.'
Are there benefits?
Until microdosing is rigorously tested in a clinical setting, Gerstein strongly recommends discussing the potential benefits with your doctor before trying it.
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'As a physician, if someone told me they wanted to try microdosing, I'd say, 'There's no evidence it works. Why not start with the standard dosage? If you tolerate it well, I'd suggest sticking with that,'' he explained.
He also points out that the cost of microdosing could be a concern, as it's not clear whether the practice is effective.
'My feeling is that you might end up paying whatever money you're paying for nothing … other than a placebo effect,' he said.