The quest for effective and safe weight loss solutions seems endless. However, the latest anti-obesity medication, semaglutide, continues to make headlines more than a year after its approval by the U.S. Food and Drug Administration in 2021.

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Originally developed for diabetes management, this injectable drug is the first since Saxenda (2014) to be approved for chronic weight management in the 70% of American adults who are obese or overweight. Research demonstrates the effectiveness of semaglutide injections for weight loss and emphasizes the importance of treating obesity as a chronic metabolic disease, rather than relying solely on willpower and lifestyle changes. However, it's important to note that semaglutide is not a miracle solution and may not be suitable for everyone.

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Here are the essential details you should be aware of regarding semaglutide:

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What is semaglutide?

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Semaglutide is a medication that falls under the category of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), which mimic the hormone GLP-1 released in the gut after eating. GLP-1's functions include stimulating insulin production, thereby lowering blood sugar levels, which is why healthcare providers have prescribed semaglutide for over 15 years to manage Type 2 diabetes. Additionally, elevated levels of GLP-1 influence brain regions that curb appetite and enhance feelings of fullness, leading to significant weight loss when combined with a healthy diet and exercise, along with a decreased risk of cancer, diabetes, and heart disease in individuals who are overweight or obese.

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Semaglutide injections for weight loss

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Semaglutide is currently approved for weight loss under the brand name Wegovy, typically administered as a weekly 2.4 milligram subcutaneous injection. As interest in its weight loss capabilities grows, healthcare professionals are increasingly prescribing other semaglutide brands like Ozempic and Rybelsus off-label for this purpose. Dr. Surampudi notes that the soaring demand has led to shortages for those relying on semaglutide for diabetes management.

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​How effective is semaglutide for weight loss in non-diabetics?​

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Several anti-obesity medications aid in appetite suppression and weight loss, but semaglutide stands out for its effectiveness. In an early study involving 2,000 obese adults, those using semaglutide alongside a diet and exercise regimen lost significantly more weight after 68 weeks, with half losing 15% and nearly a third losing 20%, compared to just 2.4% for those making lifestyle changes alone. Subsequent studies have echoed these findings but also noted that participants often regain lost weight upon cessation of the medication. Dr. Surampudi emphasizes that while diet and exercise remain the core of obesity management, anti-obesity medications like semaglutide provide valuable support tailored to individual clinical histories.

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What are the side effects of semaglutide injections?

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The side effects of semaglutide are generally mild, especially when contrasted with the health risks linked to being overweight or obese. Individuals using semaglutide for weight loss might encounter symptoms like dizziness, fatigue, gastrointestinal issues (such as diarrhea, constipation, and gas), headaches, and stomach problems, including nausea, vomiting, and bloating. Gastrointestinal complaints are the most frequent among new users, but starting with a lower dosage and gradually increasing it may help minimize these side effects.

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​Who should (and should not) take semaglutide for weight loss?

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The FDA endorses Wegovy for weight loss if you either have a body mass index (BMI) of 27 kg/m² or higher accompanied by at least one weight-related health issue, such as high blood pressure, Type 2 diabetes, or high cholesterol, or if you have a BMI of 30 kg/m² or above. However, semaglutide should be avoided if you have a history of medullary thyroid cancer, gallbladder disease, pancreatitis, or multiple endocrine neoplasia syndrome type 2 (MEN2). If you're considering semaglutide for weight loss, consult your primary care physician (PCP) first, as they can provide tailored guidance based on your medical history, and if you have diabetes, discuss safe medication combinations with them.

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