Additional Therapies

Semaglutide (Brand name Ozempic) is an injectable medication which, when used in combination with diet and exercise, helps with blood sugar control in type 2 diabetics. Semaglutide belongs to a class of medications called glucagon-like peptide-1 (GLP-1) agonists, which mimic the hormone GLP-1 in your body to lower blood sugar levels after you’ve eaten a meal.

Glucagon-like peptide 1 (GLP-1) is a hormone that causes huge effects on the regulation of blood sugar by stimulating glucose-dependent insulin secretion. Insulin is a hormone that promotes sugar uptake by the cells, stores sugar as glycogen, promotes the building of fat, and signals the body to build skeletal muscle. In addition, GLP-1 inhibits glucagon release (which slows down the release of sugar into the blood so that you burn more fat), slows down gastric emptying (makes you feel full), and lowers the desire for food intake (because you feel full).

No, Semaglutide is not a type of insulin or a substitute for insulin. Semaglutide does stimulate your pancreas to release insulin when glucose (sugar) is present. Because Semaglutide relies upon your body’s own insulin to have this effect, Semaglutide isn’t used when your pancreas can’t make insulin, such as in patients in type 1 diabetes.

No, Semaglutide is not a stimulant. While other weight loss medications, like phentermine, have stimulating effects that help curb your appetite, Semaglutide works differently (see above).

GLP-1 agonists like Semaglutide help to control your blood sugar, but people taking them also tend to lose weight. GLP-1, the key hormone involved, slows down how fast your stomach empties food (called gastric emptying). And in addition to causing your pancreas to release insulin, Semaglutide also blocks a hormone that causes your liver to release sugar (glucagon). Together, these functions can help you feel less hungry, causing you to eat less food and lose more weight.

Yes, it is believed that Semaglutide can help curb your appetite. In addition to slowing gastric emptying to make you feel full for longer, GLP-1 also plays a direct role in how your appetite is regulated.

With Semaglutide, you will slowly work your way up to the target dose at which time you will see the most amount of weight loss. This was the case in the clinical trials, where participants had their dose adjusted until they reached 2.4 mg once weekly. In the phase 3 trial that measured outcomes at 20 weeks, most participants were able to reach the full dose and also lost weight as their dose was increased. They saw additional weight loss over the remaining 48 weeks at the full dose. It is important to keep in mind that weight loss can take time, and you’ll see the best results when you are using your medication in combination with a healthy diet and exercise. Sometimes the medication may not work for you, or you may not be able to tolerate the full dose due to side effects.

Currently, Semaglutide is only FDA-approved to help with blood sugar control in type 2 diabetes and to lower the risk of major cardiovascular events (like heart attack and stroke) in people with both type 2 diabetes and heart disease. If you are taking Semaglutide for either of these reasons, you’ll take it as directed by your healthcare provider since you are using it to manage a chronic condition. But if you do not have type 2 diabetes and are looking to try Semaglutide to help you lose weight, we’ll have a better idea of long-term safety once the FDA reviews data for this new indication. What we do know is that study participants received treatment for a period of 68 weeks (about 1.5 years) during each of the four trials conducted by the company.

Yes. Semaglutide is considered to be safe and effective when used as indicated. But safe doesn’t mean that there aren’t risks. Semaglutide also carries a boxed warning about thyroid C-cell tumors occurring in rodents (with unknown risk in humans), and Semaglutide shouldn’t be used if you or your family have a history of certain thyroid cancers. Semaglutide should not be used in people with type-1 diabetes or a history of pancreatitis. Semaglutide should be used cautiously for people on other blood sugar lowering medications.

Here are a few things to keep in mind if you are on Semaglutide.

First, you’ll want to limit how much alcohol you’re drinking while taking Semaglutide, especially if you are diabetic. Alcohol can have an effect on your blood sugar, and there is a risk that it may drop too low in combination with Semaglutide, especially if you are drinking on an empty stomach. Alcohol can irritate your stomach, too. This might make you feel worse in combination with some of the GI side effects from the medication.

You’ll also want to exercise caution if you are taking any oral medications. Since Semaglutide slows down gastric emptying, this can potentially impact the amount of oral medication your body is absorbing. And while trials haven’t shown this to be significant with Semaglutide, you’ll want to make sure your provider is aware of any other medications you are taking before starting Semaglutide.

• Nausea
• Vomiting
• Diarrhea
• Stomach pain
• Constipation

Since the higher dose has not been FDA-approved, we don’t have a list of known side effects yet. However, trial results suggest that they’ll be similar to those above, with effects like nausea and diarrhea being the most common.

While no magic weight loss pill currently exists, available medications can help. But they should be used in combination with diet and exercise to get the most benefit and set you up for long-term results.