Among participants without type 2 diabetes in the STEP 1 and 3 trials, once-weekly s.c. semaglutide 2.4 mg plus lifestyle intervention led to significant placebo-subtracted weight losses that appeared to plateau around week 60.
Semaglutide San Diego was associated with greater reductions from baseline to week 104 in waist circumference and systolic blood pressure (both were co-primary endpoints) than placebo (Table 2 and Extended Data Fig. 7).
In combination with a low-calorie diet and regular exercise, semaglutide can help people lose an average of 1-2 pounds per week or 8-10 pounds per month. However, results vary by person, as do side effects. Some common side effects include nausea and gastrointestinal issues, such as diarrhea. People can often reduce these symptoms by starting on a lower dose or slowing up their dosage over time.
People who are considering starting this medication should talk to their primary care doctor, as they can determine if the drug will be a good fit for them and will work with other health conditions they may have. People who have other diabetes medications should make sure they discuss how semaglutide interacts with them to avoid complications or a negative interaction. Additionally, women who are pregnant or breastfeeding should not take semaglutide.
Another option is to consult an experienced weight loss doctor, who can assess a patient’s medical history and current health to determine if the medication is right for them. Typically, a weight loss specialist will recommend semaglutide as the best option for those who want to lose significant amounts of weight and improve their overall health.
Some of the most important reasons to consider taking this medication is its potential to lead to weight loss, especially in those with type 2 diabetes or obesity. This is because it helps people control their appetite, making eating a healthy amount of calories less difficult. This, in turn, leads to greater weight loss over the long term.
It’s also important to remember that, in addition to promoting weight loss, semaglutide can help treat other health conditions related to obesity. These can include osteoarthritis, sleep apnea and more. Garvey says that patients who are on high doses of semaglutide “are not just losing X number of pounds, they’re really improving their health,” as recommended in the American Association of Clinical Endocrinology obesity treatment guidelines.
Although not FDA-approved for weight loss, doctors sometimes prescribe semaglutide off-label to treat obesity. This can happen for a variety of reasons, including the fact that it’s cheaper than other prescription drugs and can be easier to obtain. However, it’s important to note that these off-label medications can be dangerous if not administered correctly.
Blood Sugar Control
GLP-1 receptor agonists, such as semaglutide, control the pace at which food moves from the stomach into the small intestine, slowing the absorption of sugar and other nutrients. This can create a feeling of fullness and may reduce overall food intake, helping patients lose weight. Additionally, GLP-1 can increase your own insulin secretion to improve blood glucose control.
In a study, participants with Type 2 diabetes who took oral semaglutide at either 14 mg or 25 mg saw improved A1C levels, the percentage of sugars in the blood that indicate diabetes. A1C levels below 7% are considered healthy in diabetics. Patients taking the 25 mg dose were more likely to reach their A1C goal than those who took the 14 mg dose.
Researchers analyzed data on 23,442 adults who received weekly injections of semaglutide at either 0.25, 0.5 or 1 mg as part of the Maccabi Health Services diabetes registry from August 2022 through December of 2022. A measure called proportion of days covered (PDC) was used to evaluate adherence to treatment, with the aim of measuring the ability to consistently deliver a prescription medication as prescribed.
Patients who were able to take their medications as directed showed a high level of adherence and, in turn, improved their glycemic outcomes. In particular, those who were able to stick to their prescribed dosages of semaglutide and other medicines were more likely to achieve the A1C target of 7% or below.
Semaglutide is available in tablets (Rybelsus brand) and as a once-weekly prefilled injection pen that is given subcutaneously (under the skin) once a week, usually on the same day each week (for example, every Monday). The medication should be stored in a refrigerator until first use and then kept at room temperature.
It is important to talk with your doctor before you start this or any other diabetes medication. You should also let your doctor know if you are pregnant or plan to become pregnant, as this medication is known to pass into breast milk and can harm an unborn child. Also, discuss how to manage your diet and exercise program while taking this medication.
Blood Pressure Control
In addition to lowering blood sugar, semaglutide also appears to improve blood pressure. In fact, many studies have shown that semaglutide lowers blood pressure in patients with type 2 diabetes and obesity (BMI > 30). In one study of 656 participants who were treated with oral or subcutaneous semaglutide, the authors found that compared to placebo, treatment with semaglutide significantly reduced systolic blood pressure by 2.5 mmHg and diastolic blood pressure by 1.75 mmHg.
A major reason why semaglutide is associated with lowered blood pressure may be related to its ability to foster better endothelial function, which can help the vessels relax and lower blood pressure. This is an area of active research, and a growing interest in the medical community.
During the SELECT trial, semaglutide was shown to reduce both systolic and diastolic blood pressure in obese people without diabetes who were at high risk for cardiovascular disease (CVD). This effect on BP was observed even when adjusting for co-primary and confirmatory secondary outcomes, including waist circumference, total cholesterol, triglycerides, fasting plasma glucose, hemoglobin A1c, C-reactive protein, HDL cholesterol, very low-density lipoprotein cholesterol, and IL-6.
This is an exciting finding because it shows that semaglutide, with its long-term efficacy and safety, has the potential to exert protective cardiometabolic effects in people with high-risk factors who are overweight or obese without diabetes. This is an important advance, because the prevailing treatment options for this population are limited and expensive.
Semaglutide is available in capsule form (Rybelsus brand) or as a prefilled injection pen that is administered under the skin once per week (Ozempic brand). It can be taken alone or with other medications to treat obesity and weight-related conditions such as high blood pressure, high blood sugar, or heart failure. It can be used as part of a healthy eating and exercise plan to achieve sustainable weight loss. Talk with your healthcare provider to learn more about whether semaglutide is right for you. Semaglutide should not be used in people who have a history of thyroid cancer or Multiple Endocrine Neoplasia Syndrome type 2. It also has been linked with pancreatitis in some cases, and should only be started under the care of a physician.
Emotional Well-Being
It’s no secret that excess weight can take a toll on an individual’s emotional well-being. People who struggle with obesity often face a number of emotional issues, including depression, anxiety, low self-esteem, and social isolation. Shedding excess weight has been shown to help reduce these burdens and improve mental health. However, the benefits of Semaglutide extend beyond assisting with weight loss.
By helping individuals maintain healthy blood sugar levels, Semaglutide can also dramatically reduce the risk of complications associated with diabetes. This not only greatly improves an individual’s quality of life but also significantly cuts down on long-term healthcare costs.
Research has demonstrated that, when used in conjunction with a diet and exercise regimen, Semaglutide can also lead to improved mental health. In particular, this medication has been shown to help alleviate symptoms of depression and anxiety. Additionally, Semaglutide can reduce suicidal thoughts in those who are struggling with these conditions.
The effects of Semaglutide on mental health can be attributed to its role as a GLP-1 receptor agonist, which works by stimulating the brain’s natural production of GLP-1 and inducing a sense of fullness. As a result, the brain becomes less focused on food and cravings.
In addition, studies have found that semaglutide can improve eating behaviors. For example, a study found that when combined with an intensive behavioral therapy program, once weekly semaglutide was associated with significant reductions in emotional and external eating as well as binge episodes and savory and sweet cravings.
Researchers have also discovered that, in some patients, Semaglutide can reduce non-alcoholic steatohepatitis (NASH), a liver disease associated with both diabetes and obesity. NASH is characterized by liver inflammation and cell damage and can be difficult to treat. Fortunately, early research has shown that Semaglutide may be able to slow the progression of NASH in those who have type 2 diabetes and obesity.
Despite these amazing benefits, there are some risks of using Semaglutide that should be discussed with your doctor. These include the potential for hypoglycemia, a condition in which blood sugar levels are too low, and for some people, this can lead to confusion, irritability, anxiety, or mood changes. Additionally, individuals who are pregnant or breastfeeding should not use this medication as it can be harmful to unborn babies.