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What is Semaglutide and how does it work?

What is Semaglutide

Semaglutide has changed the medical weight loss world’s landscape with industry experts referring to this medication as the “Game Changer”. Semaglutide, under the brand name Ozempic, is an FDA approved medication that has been used to treat type II diabetes since 2017. Given the substantial weight loss seen with diabetic patients taking Ozempic, Semaglutide was sent for clinical trials in 2018 for weight loss management purposes. Trial data demonstrated that the average participant lost an average of 14.9% of their initial weight. The data was solid and the weight loss seen in the trials was far superior to the FDA-approved weight loss medications on the market at that time. Semaglutide received FDA-approval in 2021 as a medical weight loss medication and has since taken the medical weight loss community by storm and has been coined the “Game Changer”. Simply put, we have not seen a medication as effective as Semaglutide in helping overweight patients lose substantial weight.

Semaglutide for weight loss

Semaglutide, sold under the brand name Wegovy, belongs to a class of medications called GLP-1 receptor agonists. Semaglutide mimics the action of the incretin hormone, glucagon-like peptide-1, which leads to a decrease in glucose levels. This hormone acts as an incretin mimetic and has multiple mechanisms of action in the body. Eating food results in the release of GLP-1 which tells your body and brain you are full. The ultimate end point of Semaglutide is appetite suppression resulting in reduced cravings and lower food intake. A key function of Semaglutide is to increase the secretion of insulin thereby lowering glucose levels in the blood. Additional mechanisms of action include delayed gastric (stomach) emptying which slows down the motility of the digestive tract making you feel full. Semaglutide also decreases both the release and breakdown of stored carbohydrates as well as the synthesis of new glucose by inhibiting the production of glucagon which is a hormone responsible for increasing glucose levels in the body.

Furthermore, Semaglutide is able to exert its effects for an extended period of time as its half-life is about seven days. For these reasons, it is apparent why Semaglutide is such a powerhouse as a master appetite suppressant.

Is Semaglutide safe?

Semaglutide is a relatively safe medication for most individuals, however like all medications there are contraindications and common side effects. The most common side effects include gastrointestinal symptoms such as bloating, nausea, constipation or diarrhea. With that being said, over 95% of our patients develop no side effects. For the minority of patients that do experience adverse effects, their symptoms are typically mild, short-lived and are self-limiting. In order to mitigate the likelihood of side effects, the medication is started at a low dose and titrated up slowly. The low and slow titration method of Wegovy is recommended by the drug manufacturer.

How quickly will I lose weight?

This is the most common question I encounter in my practice. We humans, love nothing more than quick and easy gratification. Results vary however I’d say the majority of our patients lose an average of 8-12 lbs. in the first month.

Why are my losses slower than some of your other patients?

There could be multiple reasons for this. First, not all people are created equal. Varying genetic makeups, microbiomes, metabolic rates, starting BMIs all account for discrepancies amongst patients. Also, everyone’s commitment and dedication to their weight loss journey can vary drastically. Some patients choose to continue drinking Coca-Cola and snacking on calorie-dense foods while others opt for very low-calorie intermittent fasting diets.

Additionally, as explained Semaglutide is started at a low dose and titrated up. You may not achieve adequate appetite suppression at lower doses. Individuals can be more sensitive vs more tolerant to specific medications. Because of this not all patients in our program follow the standard titration model. Depending on medication tolerance, degree of appetite suppression, and number of pounds lost, your Semaglutide titration schedule may vary and will be individualized to facilitate your weight-loss goals. With that being said, the patients that lose the most weight are those that make meaningful lifestyle changes. It is not uncommon for patient to lose 20-25% of their body weight while on Semaglutide.

How long do I need to be on Semaglutide?

Once again, this varies based on weight loss goals and the rate of weight loss which is impacted by multiple factors. Interestingly, GLP-1 receptors are located throughout the body in various organs such as the pancreas, intestines, heart, and brain. Studies have demonstrated benefits outside of the scope of weight loss such as cardioprotective (heart) effects as well as gastrointestinal and cognitive (brain) benefits. I have attended many seminars where industry leaders continue to recommend indefinite, low dose Semaglutide for these systemic benefits.

Why do I love Semaglutide?

I could go on for hours about this medication. Unprecedented weight loss data, once weekly dosing leading to greater patient compliance, and the numerous health benefits outlined above. Oh, and did I mention, unlike the majority of appetite suppressants on the market, patients taking Semaglutide do not develop a tolerance. In other words, continuing Semaglutide for a prolonged period of time will not lead to a diminishing effect on appetite suppression.

A study published in the New England Journal of Medicine showed that one third of participants lost at least 20% of their weight. Wow. That is unheard of with a weight loss medication and comparable to those undergoing bariatric surgery. This really is a truly unique medication. It’s an ideal tool for the metabolically inflexible patient and is a driver for increasing insulin sensitivity which has profound health benefits such as reducing the risk of developing diabetes.

If all of this resonates and you are considering starting your weight loss journey and transforming your life, please give us a call at 561-922-8418 for your free consultation and to discuss how Semaglutide may benefit you!

Written by: Dr. Nadav D Fields

Board Certified in Internal Medicine & Obesity Medicine

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