Obesity is a serious problem in the world today. As of 2016, 39% of adults worldwide were overweight, and 13% were obese. In the U.S., 41.9% of adults over 20 were obese as of 2020. Being overweight and obese is a major risk factor for developing life-threatening diseases, like diabetes, cardiovascular diseases, and cancer. With this in mind, the FDA’s approval of semaglutide in 2021 as an aid for chronic weight management was an exciting development. This drug could potentially save lives – so what exactly is it? How does it work? Are the side effects worth it? Let’s discuss.
Semaglutide is an injectable drug. It was originally approved by the FDA as a treatment for Type 2 diabetes. In these patients, the drug was dosed at 1 milligram weekly and provided moderate weight loss. With this information, doctors and scientists got to work on clinical trials with a higher dose of 2.4 milligrams. The results were so impressive that the drug went on to go through more clinical trials before being approved by the FDA as a treatment for chronic weight loss under the brand name Wegovy.
In a double-blind trial, doctors administered a once-weekly subcutaneous injection of semaglutide (or a placebo) to 1,961 adult participants who were overweight or obese over the course of 68 weeks. All participants also took part in healthy lifestyle interventions.
At the end of the study, people given the semaglutide injections lost an average of 14.9% of their body weight, while those in the placebo group lost just 2.4%. Those who received semaglutide also had a greater improvement in their cardiometabolic risk factors. They also reported better physical functioning from their original baseline compared to those who got the placebo.
Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist. In other words, it increases the secretion of insulin, which is what makes it an effective treatment for Type 2 diabetes. At the higher doses used for weight loss, it actually acts in the brain. It affects the areas of the brain that deal with appetite, making a person feel less hungry. As a result, they consume fewer calories, leading to weight loss.
Semaglutide is not a miracle drug. It can’t do all the work on its own. It must be used in combination with lifestyle intervention. What it really does is help people stick to a lower-calorie diet. Where a person may feel ravenous due to a reduction in calories, semaglutide can help suppress their appetite so they feel less tempted to cheat on the diet.
Semaglutide has also been shown to be cardioprotective. It may help prevent heart attacks and even help protect kidney function.
Like virtually all medications, semaglutide has side effects. In the clinical trials, patients reported that the side effects were mild and eventually decreased as their bodies adjusted to the medication.
The most common side effects include:
- Abdominal pain
- Low blood sugar in patients with Type 2 diabetes
- Flatulence and belching
- Gastroesophageal reflux disease
In the study referenced above, 59 (4.5%) of those receiving semaglutide and 5 (0.8%) of those receiving the placebo chose to discontinue treatment due to gastrointestinal effects. It’s also important to note that the prescribing information for Wegovy contains a boxed warning, noting that this medication may increase the risk of developing tumors of the thyroid gland. These tumors may be cancerous. This is because laboratory animals given the medication developed tumors, but it isn’t yet known if it causes tumors in humans.
For most people, the side effects of semaglutide are mild and become even more benign as time goes on and the body adjusts to the medication. However, some people in the trial experienced such severe gastrointestinal events that they chose to discontinue use. Additionally, there is some concern over the increased risk of thyroid tumors. Although this condition was only noted in laboratory animals, the possibility should be considered before taking this medication. It’s best to speak with your doctor before making a decision.
It’s also important to consider the lifestyle changes necessary for Semaglutide to be successful. You must be willing to adopt a lower-calorie and low-fat diet. Exercise is also part of a healthy lifestyle, which can help you lose weight and then maintain a healthy weight.
Be sure to work with your primary care physician before using this medication or schedule a consultation with one of our health consultants.
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