Weight loss can be challenging for many people, even when they follow a healthy diet and exercise regimen. Because of this, some people may look for other methods to support weight loss.  Clinical guidelines suggest that supportive medication therapy, particularly for adults with a body-mass index of 30 or greater, or BMI of 27 or greater in persons with coexisting health conditions (e.g., hypertension, type 2 diabetes, or abnormal cholesterol levels) may be helpful. 

FDA approves Semaglutide

One popular medication that the Food and Drug Administration (FDA) has recently approved is Semaglutide.  Semaglutide is a glucagon-like peptide 1 (GLP-1) agonist, which means it mimics a naturally produced hormone called glucagon-like peptide 1 (GLP-1).  An agonist is a drug that produces a similar response as the substance or hormone our body naturally produces.  GLP-1 is a hormone that your body naturally produces. It has many roles but is best known for its role in regulating hunger and food intake.

Glucagon-like Peptide 1

The hormone glucagon-like peptide 1 (GLP-1) can help delay emptying of the stomach, so food stays in your stomach longer and you feel full longer. It also helps suppress another hormone, called glucagon. This can prevent you from feeling hungry.  So, glucagon-like peptide 1 is partly responsible for regulating hunger, potentially supporting weight loss by helping to reduce hunger and food intake.  An additional benefit is that GLP-1 agonist medications also help to remove excess sugar from your blood and thereby lower blood sugar levels.  

Obesity in the USA

Obesity is a growing epidemic within the USA. Because weight gain is associated with an increased risk of developing potentially life-threatening diseases, such as hypertension, cardiovascular disease, nonalcoholic fatty liver disease or type 2 diabetes, there is great interest in developing non-invasive pharmacotherapeutics to help combat obesity. Glucagon-like peptide-1 (GLP-1) receptor agonists are a class of antidiabetic medications that have shown promise in encouraging blood sugar control and promoting weight loss in patients with or without type 2 diabetes.

Obesity can precipitate a never-ending cycle of negative health consequences.  Obesity can cause insulin resistance leading to type 2 diabetes, hypertension, lipid abnormalities, cardiovascular disease, and nonalcoholic fatty liver disease and reduced life expectancy.  Obesity is a strong risk factor for Type 2 Diabetes, about 80% of adults with Type 2 Diabetes have BMIs in the overweight or obese range. Greater levels of obesity confer a higher risk for Type 2 Diabetes.

The Semaglutide Treatment   

The Semaglutide Treatment Effect in People with Obesity (STEP) trials have demonstrated the efficacy of Semaglutide for the treatment of obesity.  In large random controlled studies patients receiving Semiglutide 2.4 mg, lost a mean of 6% of their body weight by week 12 and 12% of their body weight by week 28. The treatment group also had significant reductions in waist circumference, hemoglobin A1C (HbA1c) levels, systolic blood pressure, total cholesterol, and triglycerides.

Those who should not take GLP-1 agonists include women who are pregnant or planning to become pregnant, women who are breast-feeding, people with a history of thyroid cancer or pancreatitis and those who are allergic or sensitive to Semaglutide.  An additional contraindication for any weight loss medication would be for individuals with past or current eating disorders. Further, this medication may have other potential drug interactions, which are not well understood. So, it would be important to discuss any possible interactions with the prescribing healthcare professional.

Though GLP-1 agonists may support weight loss, it’s important to be aware of the possible side effects:

  • nausea
  • vomiting
  • stomach pain
  • headache
  • fatigue
  • dizziness
  • constipation or diarrhea
  • heartburn, indigestion, or GERD (gastroesophageal reflux disease)
  • low blood sugar in people with type 2 diabetes
  • bloating, belching, and flatulence
  • mood changes
  • drug interactions

Ultimately, it’s important to discuss any concerns you have with a healthcare professional to make sure this medication is right for you.

An important point to remember is that healthy weight maintenance is not merely a matter of balancing calories in and calories out, however.  Your weight and your body’s ability to regulate weight is also influenced by genetics, sex, hormones, medications, health conditions, stress levels, sleep quantity and quality, physical activity, body composition, age, dieting history or weight cycling, microbiome/gut health, inflammation, and other factors.  

At AustinMD we do address these additional factors that may impact your ability to lose weight to assure you will obtain the maximum outcome of your Semaglutide protocol.  


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