Can you take Ozempic while pregnant?

As GLP-1 medications such as Ozempic, Mounjaro, and Wegovy become increasingly popular for treating type 2 diabetes and obesity, new questions are coming into focus. Many people of childbearing age are asking an important question: Can you take Ozempic while pregnant?

Ozempic (semaglutide) is not considered safe to take while pregnant. The US Food and Drug Administration (FDA) urges people to stop taking Ozempic at least two months before a planned pregnancy to allow for a washout period — the time it takes for the medication to fully leave the body.

It’s worth noting that Ozempic and other GLP-1 medications are relatively new, so data on how they affect human pregnancy is limited. However, animal studies have shown birth defects and pregnancy loss in pregnant rats, rabbits, and monkeys given semaglutide. While animal studies don’t always translate perfectly to human outcomes, Ozempic is still considered a risk to the fetus. The FDA recommends talking to your healthcare provider about alternative medications to avoid potential risks to the fetus.  

Diabetes and obesity — both conditions that Ozempic is used to treat — can also affect pregnancy outcomes. Both are associated with higher rates of pregnancy and birth complications for the baby and the parent.

Controlling blood sugar during pregnancy is important for avoiding complications such as gestational diabetes and hypertension. Other medications are available that are considered safer during pregnancy for managing diabetes.

If you unexpectedly become pregnant while taking Ozempic, try not to worry — let your healthcare provider know right away. They can help make the safest, most informed decision about your next steps, including whether the benefits of continuing Ozempic while pregnant outweigh the risks. 

If you’re taking Ozempic or another GLP-1 medication to manage blood glucose for diabetes, your healthcare provider can help you transition to a medication that’s safer for use during pregnancy.

While research is limited, some studies have examined GLP-1 use in early pregnancy. One study found that taking a GLP-1 during the first trimester was not associated with a higher risk of birth defects compared to the baseline risk linked to obesity or diabetes during pregnancy.

Another study similarly found the risk of birth defects to be low when taking a GLP-1 early in pregnancy — though the authors recommend discontinuing the medication as soon as pregnancy is confirmed. 

More data are needed to fully understand whether Ozempic is safe during pregnancy.

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Ozempic may indirectly affect fertility by improving pre-existing health conditions that were negatively impacting it. While Ozempic isn’t known to directly boost or hinder fertility, it is often prescribed off-label to treat obesity — and obesity has a clear link to infertility, causing issues like anovulation (when the ovaries don’t release an egg). If a person is experiencing fertility issues related to their weight, Ozempic may help by supporting their body in reaching a more optimal state to conceive.

Diabetes can also negatively impact fertility. If Ozempic is helping manage your diabetes, that may also improve your likelihood of conceiving.

However, the recommendation to stop taking Ozempic two months before trying to conceive remains the standard, as data on the medication’s safety for the fetus are still limited.

If you’re experiencing infertility and your healthcare provider thinks that obesity or diabetes may be a contributing factor, discuss fertility planning early. This may allow you time to start taking Ozempic or another weight loss or type 2 diabetes medication, reach a weight that supports your health and fertility goals, and complete a washout period before trying to conceive.

Weight loss drugs are not considered safe for pregnancy.

While maternal obesity can have a negative impact on the health of a pregnancy, weight loss during pregnancy — including through weight loss medications — is not recommended. 

Weight management should happen before pregnancy and continue through the postpartum period. Restricting food intake can deprive the fetus of vital nutrients, and no weight loss medications are considered absolutely safe during pregnancy.

Weight and a healthy pregnancy

Maternal weight can have a significant impact on the health of a pregnancy and delivery outcomes. Obesity is linked to higher rates of complications, including gestational diabetes, hypertension, pre-eclampsia, cesarean sections, and preterm birth. 

Multiple professional bodies, including the Institute of Medicine, the National Research Council, and the American College of Obstetrics and Gynecology (ACOG), recommend that people with overweight or obesity attain a healthier weight before becoming pregnant. 

At the same time, weight gain is essential for a healthy pregnancy — it ensures the body can provide adequate nutrition and calories for the fetus to grow, develop key organs, and remain healthy throughout the pregnancy.

There is some debate about how much weight to gain during pregnancy. While some risks may increase with limited maternal weight gain, others decrease as obesity decreases — and it’s not yet clear where that balance point lies. 

The Centers for Disease Control and Prevention (CDC) offers a chart showing recommended weight gain during pregnancy based on pre-pregnancy body mass index (BMI). 

For example, women with a BMI lower than 18.5 (underweight) are advised to gain 28–40 pounds during pregnancy. The Institute of Medicine also offers a helpful weight gain calculator to help determine a healthy target during pregnancy. 

For women with obesity who are pregnant, the evidence isn’t clear-cut enough to support generalized recommendations about weight gain or loss. Staying in close contact with a healthcare provider throughout pregnancy is key to healthy weight management.

Personalized care should account for the trade-offs between risks and benefits for the individual parent and fetus. Depending on a person’s eating habits and lifestyle, weight management may be possible without restricting essential calories — for example, by reducing intake of sugary drinks and fast food.

The pre-pregnancy period is the ideal time to work toward a healthy weight when trying to conceive, and even modest changes can make a meaningful difference. 

For women with obesity, losing as little as 10 pounds has been shown to reduce the risk of developing gestational diabetes by as much as 40% compared to women without weight change. It’s recommended to aim for a slow, steady rate of weight loss — around 10% of body weight over six months — to safely and sustainably lower body weight.

Maintaining a calorie deficit is the most effective way to do this. A calorie deficit means burning more calories than you consume by adjusting your eating habits and increasing your physical activity.  

This can include:

• Cutting back on daily calories, especially from sugary drinks and snacks

• Eating whole, nutrient-dense foods such as whole grains, fish, lean meats, nuts, beans, fruits, and vegetables

• Getting 150 minutes of moderate physical activity each week, including strengthening exercises

For some people who struggle with obesity or managing blood sugar, weight loss medications such as Ozempic are combined with healthy eating habits and exercise to support weight loss before becoming pregnant. 

However, since stopping Ozempic two months before a planned pregnancy is recommended, weight loss medications should be used before trying to conceive.

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Ozempic is a relatively newer medication for treating type 2 diabetes, and research on its safety during pregnancy is limited. Here’s what we know:

• Ozempic is generally not recommended during pregnancy unless a healthcare provider determines the benefits outweigh the potential risks.

• If you are planning to get pregnant, the FDA recommends stopping Ozempic at least two months before trying to conceive.

• Animal studies show an increased risk of birth defects and pregnancy loss with semaglutide use. These findings don't always translate to humans, but they are worth considering.

• Since obesity and diabetes can also affect pregnancy outcomes, managing these conditions before trying to conceive is ideal.