Introduction
The revolutionary drug semaglutide not only lowers elevated blood sugar levels, but also promotes weight loss, and significant weight loss, at that. Even celebrities have attested to its efficacy, as it has already reached household name status.
With all the buzz around it, how do you use semaglutide for weight loss? How does it affect appetite and metabolism? Let’s explore its mechanisms and how you can maximize its benefits.
What is semaglutide?
There’s a hormone in our gut, particularly in the lower gastrointestinal tract, GLP-1. prompts the pancreas to release insulin after meals. Insulin helps lower blood sugar by moving glucose into cells for energy or storage.
Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), mimics this process to manage type 2 diabetes and obesity effectively. GLP-1 also helps sweep glucose into the body’s cells, where the body will either use or store it as future energy.
Semaglutide is a glucagon-like peptide-1 receptor agonist, or a GLP-1 Ra. It treats either type 2 diabetes or obesity. Basically, semaglutide acts like a doppelganger of GLP-1, copying the same actions such as triggering insulin secretion and glucose movement.
Semaglutide and weight loss
Now that we have a basic understanding of how semaglutide works as a GLP-1, let’s comprehend its mechanism of action. The mechanism of action is a comprehensive explanation of how it creates an effect on the body. In this case, how it reduces blood sugar levels and promotes weight loss.
Activates GLP-1 receptors
Semaglutide binds to and activates GLP-1 receptors in the pancreas’ beta cells, similar to how the hormone GLP-1 works. When blood sugar levels are high, this prompts the pancreas to release blood insulin, reducing blood glucose after meals.
Inhibits glucagon
Another process under semaglutide’s mechanism of action is glucagon inhibition, which elevates blood sugar levels and stimulates glucose release. As semaglutide prevents the release of glucagon, the body controls overall blood sugar levels.
Slows down gastric emptying
Studies show that semaglutide delays digestion, resulting in people feeling full long after eating. Participants retained 37% of a meal in their stomach even if it had already been four hours since they had eaten. Because people taking semaglutide felt full for longer, they were not as frequently hungry, reducing their appetite and food intake.
Reduces appetite
As GLP-1 receptors are also in both the periphery and central nervous system, the binding of semaglutide triggers changes in behavior. In particular, semaglutide reduced food cravings, especially that of fatty foods, in participants suffering from obesity. As semaglutide curbed a desire for food, so did it increase dopamine reward signaling. Dopamine is a kind of neurotransmitter in the brain that triggers feelings of pleasure, satisfaction, motivation, and learning.
In a 2023 study, mice received sucrose, a kind of sugar, every time they did something they were conditioned with. Each time, researchers would also inject them with semaglutide. Semaglutide reduced the mice’s rewards while dopamine neuron activity increased in the brain’s ventral tegmental area. This signified that the mice felt good even when they were not rewarded as much.
No remarkable effect on metabolism
Does semaglutide boost metabolism? Sure, it has a link to less food cravings, better eating control, and a reduced preference for fatty foods. However, it did not have any significant effect on metabolism. There was no remarkable difference between testing metabolic rate between treatments.
Dr. Charlie Seltzer, a Philadephia-based physician with board certifications in obesity and internal medicine, points out, “Ozempic causes appetite suppression and increases the time it takes food to exit the stomach, leading to feeling full longer. It does nothing magical to metabolism.”
Variants of semaglutide
In order to achieve optimal results with semaglutide, you must properly administer it, depending on what brand you’re using.
Semaglutide has three variants, namely the massively popular Ozempic, Wegovy, and Rybelsus. Both Ozempic and Rybelsus treat type 2 diabetes, while Wegovy is treats obesity. However, all three are essentially the same, with semaglutide as their active ingredient. Hence, many healthcare providers opt to prescribe Ozempic and Rybelsus off-label for their weight loss effect.
Apart from their different uses, these drugs also come in different formats. For instance, both Ozempic and Wegovy come in an injectable dosing pen format, while Rybelsus comes in tablet form. This allows consumers to choose to administer semaglutide the way they prefer: either subcutaneously (injecting under the skin) or orally.
Dosages
These three brands also vary in dosages, but generally, doctors will instruct patients to take them at a low dose. Gradually, they’ll move up to a maintenance dose to give the body time to adjust.
Ozempic is in an injectable pen format and you should administer it once a week. It comes in 0.5 mg, 1 mg, and 2 mg doses and is only available for purchase with a prescription.
Wegovy, on the other hand, also comes in injectable pen format, but in five various dose strengths. The different doses come in pens of different colors.
You take Rybelsus, meanwhile, at 3mg once per day during the first 30 days of use. After this initial month, your doctor will increase your dose to 7 mg per day. This dose is typically what it takes for your body to regulate its blood sugar levels. After another 30 days on 7 mg, your doctor might increase the dosage to 14 mg per day.
Administration
You must administer Ozempic and Wegovy subcutaneously under the skin. Specifically, you can inject them in three different areas: the 1) abdomen, 2) thigh, or 3) upper arm. It is important that you are not injecting into a muscle or vein. Also, It is best to use a different injection site with every injection. However, if you want to use the same injection site, pick a different spot in that area.
You can take semaglutide injections with or without meals at any time of the day. For optimal results, semaglutide manufacturer Novo Nordisk notes that you should take semaglutide along with a balanced diet and exercise.
For Rybelsus, meanwhile, take it on an empty stomach when you first wake up. You can drink it with no more than four ounces or 120 ml of plain water. Do not split, chew, or crush the tablet. You must swallow it whole. Wait at least 30 minutes before eating, drinking, or taking other oral medications by mouth.
To maximize results, it is best to eat 30 to 60 minutes after taking Rybelsus. It’s essential that you take it the same way every time.
Every body is unique
In a previous article, we looked into what people can expect on their first week of semaglutide. We looked at its onset of results, why some people feel hungry on it, and why some don’t lose weight.
It’s important to note that everybody will react to a drug differently due to a variety of factors. As such, your appetite and metabolism may not be affected in the same way as with others.
In clinical trials, researchers found that those taking semaglutide could lose 15 to 18 percent of their body weight. However, you must still take Ozempic, Wegovy, and Rybelsus as supplement to a nutritious diet and ample physical activity.
Safety and efficacy of semaglutide
Many studies have proven just how safe and effective semaglutide is for weight loss, particularly in people with obesity.
In the STEP 5 trial, researchers looked at the two-year effects of semaglutide in adults who were overweight or obese. Participants lost an average of 15 percent of their body weight with semagutide. Meanwhile, those on placebo lost just 2.6 percent of their body weight.
Semaglutide was also associated with greater reductions in waistline circumference and systolic blood pressure. Versus the placebo group, participants on semaglutide also experienced improved diastolic blood pressure, blood sugar levels, total cholesterol, and triglycerides.
Another study in December 2022 found that participants on semaglutide lost more body fat than body mass. In addition, they ate less due to reduced appetite, had less cravings, and had a lower desire for fatty foods.
Adverse effects
As with any drug, patients may experience certain side effects while on semaglutide. Gastrointestinal reactions account for 10% or more of semaglutide’s side effects. These include nausea, diarrhea, vomiting, constipation, and abdominal pain.
There are also other common side effects of semaglutide which occured in 1 to 10% of cases. This includes indigestion, belching, gassiness, gastroenteritis, or gastritis. Gastroenteritis is the short-term infection and inflammation of the digestive system. Gastritis, meanwhile, refers to the inflammation of the stomach lining.
Note that these common side effects are mild and you can manage these with the help of your doctor.
What’s next for semaglutide?
In 2024, six obesity clinical trials will reach completion. These studies aim to support the development of not just GLP-1 drugs but also other active ingredients. These include monoacylglycerol acyltransferase 2 (MGAT2) inhibitors and calcitonin gene-related peptide (CGRP) inhibitors.
Conclusion
Amid a growing obesity health crisis, semaglutide is helping improve lives with its blood sugar regulating and weight loss effects.
Semaglutide’s brands Ozempic and Rybelsus are targeted towards treating type 2 diabetes, while Wegovy is targeted towards addressing obesity. Despite only Wegovy being approved for weight management, many doctors prescribe Ozempic and Rybelsus off-label for their weight loss effect.
As a glucagon-like peptide-1 receptor agonist, semaglutide triggers the pancreas to release insulin, which lowers elevated blood sugar levels. Because it also delays gastric emptying, people on semaglutide feel fuller for longer, have fewer food cravings, and lose weight. However, it does not do anything remarkable for metabolism.
As with any medication, every person will react differently to semaglutide due to a variety of factors. This includes medical history or genetic makeup, among others. There are also potential side effects, however, the common ones are mild and manageable while the severe ones are rare.
It is important to remember that semaglutide is not a magic pill that will rid people of all excess weight. Medication is just one part of the equation. Patients must adopt a nutritious diet and have ample physical activity in addition to taking semaglutide. They must also constantly coordinate with their doctor for the most suitable treatment plan.
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