Patient Perceptions of Ozempic (Semaglutide) for Weight Loss: Mixed Methods Analysis of Online Medication Reviews.

BACKGROUND: Ozempic (semaglutide) has received widespread attention for its appetite-suppressing effects, leading to extensive off-label use for weight loss. Although gastrointestinal side effects are well documented, less is known about how users assess the trade-off between perceived benefits and adverse effects, or how these assessments influence treatment discontinuation. Importantly, existing insights are often limited to clinical trial populations and may not fully reflect real-world experiences. OBJECTIVE: This study applies a novel infoveillance approach to examine patient-reported experiences with off-label Ozempic use for weight loss and to identify the factors most strongly associated with user satisfaction and treatment discontinuation. METHODS: We analyzed 60 publicly available, self-selected, anonymous user reviews of Ozempic from Drugs.com. Reviews were initially examined using thematic analysis to identify key themes describing patients' lived experiences with treatment. These qualitative themes were then linked to user-provided ratings of perceived drug efficacy (1-10 scale) and statements regarding intent to continue or discontinue treatment. This mixed methods approach enabled the integration of qualitative depth with quantitative patterns within naturally occurring, deidentified online data. RESULTS: Three major themes emerged from the thematic analysis: (1) change in body weight and appetite, (2) nonweight-related symptoms and side effects, and (3) plans for ongoing use versus discontinuation. Two-thirds of respondents reported reduced appetite, food cravings, or body weight. Gastrointestinal complaints were common (reported by 37 of 60, 62%, reviewers) but did not significantly (P=.39) influence satisfaction ratings or decisions to continue treatment. Instead, minimal/no weight loss and the emergence of nongastrointestinal side effects were more frequently associated with low overall satisfaction and discontinuation. Effective weight loss, even when accompanied by gastrointestinal side effects, was associated with a greater willingness to continue Ozempic treatment. CONCLUSIONS: This study presents a novel application of infoveillance methods to characterize real-world patient attitudes toward off-label Ozempic use. Satisfaction was driven primarily by perceived effectiveness rather than tolerability. Key limitations are the self-selected nature of the sample, reliance on anonymous, self-reported data, and the lack of demographic, dosing, or treatment-duration information. Nonetheless, these findings underscore the value of online health forums as a rich and underutilized source of patient-centered insights to inform obesity treatment strategies, adherence interventions, and public health communication.