The diabetes medicine Ozempic — used by many without diabetes to lose weight — is becoming incredibly popular. It’s also pricey (Ozempic typically costs upwards of $900 per month before insurance and any discounts) and available only by prescription. So naturally, people are looking to see if they can get the same results for less money and less hassle.
Lately, psyllium (psyllium husk) is being touted as an inexpensive and more natural alternative to Ozempic and the likes. Some people are even dubbing it “the poor man’s Ozempic” or “nature’s Ozempic.” And while it’s true psyllium, a soluble fiber that’s found naturally in food and is available in supplement form, has many benefits, we went straight to nutrition experts to find out if it’s effective, or even safe, to use for weight loss.
Editor’s note: Weight loss, health and body image are complex subjects — before deciding to go on a diet, we invite you to gain a broader perspective by reading our exploration into the hazards of diet culture.
It’s important to note that weight loss is a side effect of using semaglutides, and is not the main use for those with diabetes. Semaglutides are used to stabilize blood sugars, and should only be used when prescribed by a physician.
First, how does Ozempic work?
“Ozempic acts like a hormone that comes from your digestive tract called glucagon-like peptide (GLP-1), [which] helps lower blood sugar and creates a feeling of fullness,” explains Kate Ingram, a Registered Dietitian Nutritionist (RDN) and co-owner of The Vitality Dietitians. “This can change how your body responds to food and can affect your ‘weight set point’—the weight your body feels is ‘safe’ and wants to maintain.” In other words, because your body isn’t signaling the need to eat in order to maintain your usual weight — one reason people find dieting very difficult to sustain — it is easier to eat less and thus lose weight.
“Ozempic is a medicine for adults with type 2 diabetes that, along with diet and exercise, may improve blood sugar,” the drug’s website clearly states. “Ozempic is not a weight-loss drug.” Nevertheless, many people are using it solely to lose weight — and finding that there are some drawbacks.
One major con is the potential side effects, which include gastrointestinal upset. Nausea is the most common side effect, occurring in approximately 15% to 20% of people, reports Drugs.com. And “one of the most serious but rare warnings with Ozempic includes a risk for thyroid tumors or thyroid cancer… [Ozempic] carries a Boxed Warning for this possible side effect, the FDA’s most prominent warning,” says the site.
Concerns have also arisen about the possible aesthetic ramifications of using semaglutide for weight loss, including “Ozempic butt,” “Ozempic face,” and “Ozempic neck” (all problems that involve a sagging, wrinkled appearance of the skin due to rapid weight loss). And if your insurance won’t cover Ozempic, it can be very expensive. The cost of the weekly injections, and the potential side effects, have many people looking for other options — and that’s where psyllium fiber comes in.
What is psyllium?
Fiber is an essential nutrient and an important component of a healthy diet; it can be found in numerous foods, especially a variety of whole grains — but a lot of Americans don’t get enough fiber in their diet and so turn to dietary supplements containing psyllium fiber (psyllium husk). It’s the main ingredient in Metamucil and other over-the-counter supplements, mostly marketed to help with digestion and acts as a laxative.
“Psyllium is made from the husks of the Plantago ovata plant’s seeds; the husks of the psyllium plant are rich in soluble fiber,” says Kara Burnstine, MSRD, LDN, and CDCES at the Pritikin Longevity Center. She explains that soluble fiber “is the type that dissolves in water and turns into a gel, slowing down digestion.” As a result, the body absorbs more nutrients during the digestive process, Burnstine says, and fiber “also increases the weight and bulk of stools, which aids in stimulating bowel movements.”
Fiber supplements can come in many forms, including powder (which can be mixed in with water or coffee), capsules and even crackers. Ingram notes that psyllium fiber “has also been shown to help lower cholesterol, decrease blood pressure and improve glycemic control.”
But is psyllium an alternative to Ozempic?
No. Ingram notes that while “a meta-analysis found that psyllium supplementation did decrease body weight … and waist circumference in overweight/obese participants,” it wasn’t significant, as it can be with Ozempic. The small amount of weight some lost comes down to the feeling of fullness you can get from consuming psyllium husk — it is a possible but mild side effect.
It’s no match for the power of semaglutide, which studies show can lead to approximately 15% loss of body weight over a period of less than two years. Supplements containing psyllium fiber may be inexpensive, but the experts agree that otherwise, comparisons to Ozempic aren’t very convincing.
First, “Psyllium physically gives you a feeling of fullness and may cause a decrease in appetite as a result, but it doesn’t affect your appetite-regulating hormones,” as Ozempic does, explains Ingram. “Psyllium fiber and Ozempic are two entirely different substances with different mechanisms of action and purposes,” Best says.
“[Both] psyllium and Ozempic can create a greater sense of fullness,” agrees Burnstine. “But Ozempic contains a hormone called GLP-1 which aids in weight loss and reducing appetite by acting on specific areas of the brain responsible for hunger and satiety. GLP-1 also slows the gastric emptying which further adds to the feeling of fullness and many report a reduced desire to eat.”
In other words, psyllium is fiber, and we’ve always known that more fiber (whether you get it from a supplement or fibrous foods such as beans, lentils and certain vegetables like broccoli) can help people feel full, possibly reducing their desire to eat. But that’s no match for Ozempic’s ability to actually affect the brain in a way that causes dramatic and prolonged weight loss.
One way in which psyllium fiber and Ozempic do overlap is that they both address blood sugar levels, albeit in entirely different ways. Psyllium fiber’s “ability to slow down the absorption of sugars and cholesterol in the intestines also contributes to its health benefits, as it can help manage blood sugar levels and lower cholesterol levels when consumed as part of a balanced diet,” says Tricia Best, R.D. and consultant with BalanceOne. But “overall, psyllium fiber is valued for its ability to promote digestive regularity and support heart health through its unique mechanisms in the gastrointestinal system.”
So, is it safe to take psyllium?
Just because psyllium isn’t “the new Ozempic,” doesn’t mean it’s not a potentially beneficial and effective addition to your dietary routine, especially if you are prone to constipation. In fact, it’s worth noting that psyllium husk has been used in South Asian medicine for centuries to specifically help with digestion. So, it’s relatively low-risk to take a fiber supplement every day. But there could be some side effects.
“Some people may experience discomfort such as gas, bloating or stomach cramps when starting psyllium supplements, particularly if they begin with a high dose, [so] start with a lower dose and gradually increase it to minimize these effects,” says Ingram. Consulting with your doctor will help you get started — and is important to do for other reasons, too.
Burnstine warns that, “Psyllium could delay the absorption of certain medications, [and] although uncommon, some allergic reactions, such as rashes, itching, or trouble breathing, can result from ingesting or handling of psyllium.”
Bottom line: One thing that psyllium fiber does have in common with Ozempic and other semaglutide-based medicines is that neither is a miracle weight loss solution. “Psyllium is a nice addition to the diet, but it is a small piece of the health puzzle,” says Burnstine. “Whole foods and healthy lifestyles are where it’s at.”
Luisa Colón is a Brooklyn-based writer whose work has appeared in The New York Times, Family Circle, USA Today and many other print and online publications. Her first novel, Bad Moon Rising, will be released in August 2023.
