What is semaglutide?
Semaglutide is an injectable glucagon-like peptide-1 (GLP-1) agonist that’s
administered once weekly. It was originally approved in 2017 — at a lower dose under
the brand name Ozempic — to help control blood sugar in Type 2 diabetes. People
taking Ozempic for blood sugar control also tend to lose weight as an additional benefit.
Because of this, Novo Nordisk studied the medication in people without Type 2
diabetes, but at a higher dose. Now, semaglutide (under the brand name Wegovy) is FDA approved for weight loss. It can be used by adults with a body mass index (BMI)greater than or equal to 30 mg/kg2 alone or 27 mg/kg2 with at least one weight-relatedcondition (e.g., high blood pressure, high cholesterol, Type 2 diabetes). Semaglutide is also approved for chronic weight management in adolescents ages 12 and older. Eligibility is based on having an initial BMI at or above the 95th percentile for sex and age. Semaglutide should be used in combination with lifestyle changes, including a healthy diet and exercise.
How does semaglutide work for weight loss?
GLP-1 is an incretin hormone that plays a role in your appetite and digestion. Incretins — hormones released by your digestive tract — are sent out by your body after you’ve eaten a meal. They help lower your blood sugar by triggering insulin release and blocking sugar production. They also slow down how quickly food leaves your stomach (called gastric emptying). The result of these actions causes you to feel full — lowering your appetite and causing you to lose weight. Medications like GLP-1 agonists are referred to as incretin mimetics since they “mimic” these effects. As mentioned above, GLP-1 agonists, like semaglutide, were originally used to treat Type 2 diabetes. This was due to their blood sugar-lowering effects. However, the weight loss side effect has been shown to benefit people without Type 2 diabetes as well.
What do we know about semaglutide side effects?
As introduced earlier, gastrointestinal (GI) side effects tend to happen most frequently
when taking this medication. The most common are nausea, diarrhea, and vomiting. You may experience these effects more strongly when your healthcare provider increases your dose.
Additional common side effects can include:
• Constipation
• Stomach pain
• Headache
• Fatigue
• Indigestion
• Dizziness
• Bloating
• Burping
Serious side effects
In some cases, semaglutide may cause more serious side effects. The medication ha a boxed warning — the FDA’s most serious warning — for a potential risk for thyroid C-cell tumors. This risk has been seen in animal studies, but it hasn’t been confirmed in people. Because of this, you shouldn’t take semaglutide if you have a personal or family history of certain thyroid tumors. Other serious side effects can include:
• Pancreatitis (inflamed pancreas)
• Cholelithiasis (gallbladder disease)
• Kidney damage
• Low blood sugar (hypoglycemia)
• Allergic reactions (including swelling of the face, tongue, or throat; difficulty
breathing)
• Certain eye problems in people with Type 2 diabetes
• Fast heart rate
Suicidal thoughts and behaviors are another risk listed on the medication’s labeling
because it’s been reported with other weight loss medications. Let your healthcare provider know right away if you’re experiencing any changes in mood or behavior, or if you’re having suicidal thoughts.
Can semaglutide interact with other medications?
Since semaglutide can lower your blood sugar, it can interact with other blood sugar-lowering medications. Examples include insulin and medications that cause insulin to be released, like sulfonylureas. Combining these medications can result in dangerously low blood sugar levels.
If you’re taking one of these medications, your healthcare provider may lower the other medication’s dose while starting you on semaglutide. And as a general rule, it’s
important to diligently monitor your blood sugar if you have Type 2 diabetes. This is
especially the case before and during treatment to ensure that your readings stay within a safe range. Another potential interaction is with oral medications. Semaglutide slows down how quickly food leaves your stomach. This may affect how certain oral medications are absorbed by your body when they’re taken together. Your healthcare provider can determine which interactions potentially affect you and how to manage them.
How does semaglutide compare to other weight loss medications?
One of the reasons there’s a lot of buzz around semaglutide is the amount of weight
people lost during clinical trials. Typically, we tend to see an average of 5% to 10%
weight loss with other medications. The largest clinical trial studying semaglutide in adults showed an average weight loss of about 15% of initial body weight over 68 weeks (almost 16 months). Over the same
length of time in another study, adolescents lost 16% of their initial body weight on
average. Oral weight loss medications tend to be less expensive than the injectable options, but you may not lose as much weight. Let’s review a few of the more popular weight loss medications and how they compare to semaglutide.
The bottom line
Semaglutide is an FDA-approved injectable weight loss medication. Compared to other
medications on the market, it may help you lose more weight. It takes a few months to
reach the target dose, and you may experience side effects like nausea, vomiting, and
diarrhea. But this is typically managed by slowly increasing your dose over time.
Talk to your healthcare provider to learn more about semaglutide for weight loss. Theycan recommend the best chronic weight management option for you.
