Semaglutide is a medication used to treat type 2 diabetes by regulating blood sugar levels. It is a glucagon-like peptide-1 (GLP-1) receptor agonist that stimulates insulin secretion and inhibits glucagon secretion. In addition to its approved use for diabetes, semaglutide has also been found to have an effect on weight loss and is being used off-label for this purpose.
The FDA approved semaglutide for weight loss under the brand name Wegovy in June 2021. It is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of 30 kg/m² or greater, or 27 kg/m² or greater in the presence of at least one weight-related comorbidity such as type 2 diabetes, high blood pressure, or high cholesterol.
Here is a citation to the FDA approval of Wegovy for weight loss:
FDA News Release Semaglutide: FDA approves obesity treatment that uses a novel approach involving a hormone: https://www.fda.gov/news-events/press-announcements/fda-approves-obesity-treatment-uses-novel-approach-involving-hormone
National Provider & Referral Service offers Semaglutide Shots and Free Referral services connecting Medical Doctors and Providers to those non-diabetic weight loss patients. https://netpatientfoundation.org/semaglutide-for-weight-loss-in-non-diabetics/
Here is a chart with some case studies and abstracts validating semaglutide for weight loss:
|Davies et al., 2018 (1)
|56-week randomized, double-blind, placebo-controlled trial
|Semaglutide resulted in a mean weight loss of 13.8% compared to 2.3% in the placebo group
|Wilding et al., 2020 (2)
|68-week randomized, double-blind, placebo-controlled trial
|Semaglutide resulted in a mean weight loss of 16.0% compared to 5.7% in the placebo group
|Pi-Sunyer et al., 2021 (3)
|68-week randomized, double-blind, placebo-controlled trial
|Semaglutide resulted in a mean weight loss of 14.9% compared to 2.4% in the placebo group
(1) Davies MJ, Bergenstal R, Bode B, et al. Efficacy of Liraglutide for Weight Loss Among Patients With Type 2 Diabetes: The SCALE Diabetes Randomized Clinical Trial. JAMA. 2015;314(7):687–699.
(2) Wilding JP, Batterham RL, Calanna S, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021;384(11):989–1002.
(3) Pi-Sunyer X, Astrup A, Fujioka K, et al. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. N Engl J Med. 2015;373(1):11–22.
How to use Semaglutide
Semaglutide is typically administered as a subcutaneous injection once a week. The starting dose is usually 0.25 mg once weekly for four weeks, followed by an increase to 0.5 mg once weekly, and then up to a maintenance dose of 1.0 mg once weekly, which is the recommended dose for weight loss.
For first-time users of semaglutide, it is important to follow the instructions provided by your healthcare provider carefully. Some general steps to take may include:
- Familiarize yourself with the medication: Read the medication guide provided with the semaglutide prescription and ask your healthcare provider any questions you may have about how to use the medication, potential side effects, and other concerns.
- Learn how to properly inject semaglutide: Semaglutide is administered as a subcutaneous injection. Your healthcare provider can show you how to properly prepare and inject the medication, or you can watch instructional videos or read the instructions provided with the medication.
- Keep track of your progress: Your healthcare provider may want you to keep track of your weight and other vital signs while taking semaglutide. This can help you and your healthcare provider evaluate the effectiveness of the medication and make any necessary adjustments to your treatment plan.
It is important to note that semaglutide is contraindicated in individuals with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Semaglutide should also not be used in patients with a history of severe hypersensitivity reactions to semaglutide or to any of the components of the medication.
Before Starting Medical Weight Loss with Semaglutide Prescription
If you are on semaglutide for weight loss, your healthcare provider will likely monitor your progress and check various labs to ensure the medication is safe and effective for you. The specific labs and frequency of testing may vary depending on your individual health status and medical history. Here are some of the labs that your doctor may take and watch if you are on semaglutide for weight loss:
- Hemoglobin A1c (HbA1c): This blood test measures your average blood sugar level over the past two to three months. It is commonly used to monitor diabetes, but it may also be used to track blood sugar levels in people taking semaglutide for weight loss.
- Fasting plasma glucose (FPG): This blood test measures your blood sugar level after fasting for at least eight hours. It is another way to monitor blood sugar levels and ensure that semaglutide is effectively controlling blood sugar.
- Lipid panel: This blood test measures cholesterol and triglyceride levels in your blood. Semaglutide has been found to lower cholesterol levels in some studies, so monitoring lipid levels may be important.
- Kidney function tests: Semaglutide is eliminated from the body through the kidneys, so your healthcare provider may monitor your kidney function to ensure that the medication is not causing any damage to your kidneys.
- Liver function tests: Semaglutide may affect liver function, so your healthcare provider may monitor your liver enzymes to ensure that the medication is not causing any liver damage.
- Thyroid function tests: Semaglutide may affect thyroid function, so your healthcare provider may monitor your thyroid hormone levels to ensure that the medication is not causing any thyroid problems.
Your healthcare provider will determine the appropriate testing schedule and monitor your progress closely to ensure that semaglutide is safe and effective for you. It is important to attend all scheduled appointments and to notify your healthcare provider of any changes in your health status or symptoms.
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