Everything You Need To Know About Weight Loss Peptides Like Ozempic, Wegovy & Semaglutide

 

In the past few months and years, a brand new “miracle” weight loss drug has been taking the internet by storm. It goes by the brand names of Ozempic or Wegovy, and the generic name semaglutide.

Semaglutide has recently gained popularity as an approach to weight loss…but what exactly is it, how does it work, and what are the benefits and risks? Welcome to your semaglutide guide!

Let’s start with the what…

Semaglutide itself is a peptide, or a chain of amino acids, that mimics a naturally occurring incretin hormone in the body known as GLP-1 (glucagon-like peptide-1). 

Scientifically speaking, semaglutide is called a GLP-1 agonist, which is in a class of medications known as incretin mimetics.

Incretins are hormones released from the gut into the bloodstream after eating that affect blood sugar levels, appetite, and digestion. 

Semaglutide is 94% identical to our natural GLP-1, which allows it to work without provoking a negative immune response while protecting it from breakdown and elimination.

The injectable forms of the medication have two different brand names, Ozempic and Wegovy, that are FDA approved for type 2 diabetes and weight management, respectively. 

Ozempic is used to control blood sugar levels and prevent major cardiovascular events (such as heart attack and stroke) in adults with type 2 diabetes, with or without heart disease.

Note this medication is not indicated for people with type 1 diabetes and is not a replacement for insulin people with type 2 diabetes. 

Wegovy is used to manage weight in adults, and children over 12 years old, who are obese (BMI ≥30) or overweight (BMI ≥27) with associated medical conditions. 

Note: Semaglutide is the active ingredient for both brands. They’re meant to be used in conjunction with a healthy nutrition and lifestyle program. They’re available by prescription only. 

Let’s move on to the how…

Semaglutide’s therapeutic effects have been shown to work by causing the following mechanistic actions in the body: 

  1. Increases insulin levels (in accordance with the level of blood glucose), which helps maintain blood sugar balance 

    1. Insulin is the hormone that moves glucose from the blood into the cells to be used as energy 

  2. Decreases glucagon levels (in accordance with the level of blood glucose), which helps maintain blood sugar balance 

    1. Glucagon is the hormone that increases glucose release from the liver into the bloodstream 

  3. Delays gastric emptying, which decreases glucose absorption into the bloodstream and decreases appetite (and therefore decreases food intake)

    1. Gastric emptying/motility is the movement of food through the stomach. When slowed down, it increases satiation (feeling full) for a longer period 


Semaglutide causes significant weight reductions since healthy management of both blood sugar and caloric intake are key to successful weight loss. 

Let’s dive into its use for weight loss…

Many medical weight loss clinics/programs are offering a compounded form of semaglutide that’s combined with vitamin B12 for increased effectiveness. 

This compounded form has the same active ingredient and function as Ozempic and Wegovy but is often less expensive and can be more individualized to the person. 

Semaglutide injections are administered on the same day and time once weekly, without regard to meals, by a prescribing doctor or healthcare provider. 

Dosages typically start from as low as 0.25 mg and are titrated up every 2-4 weeks to as high as 2.4 mg, depending on the person’s tolerance and progress. 

The person will stay at the dosage level(s) where weight loss is sustained without side effects, until their weight loss goals are achieved. 

At which point, the provider will safely discontinue the medication and should initiate a maintenance program, involving nutrition and lifestyle, to prevent rebound weight gain.

In general, most people start to experience weight loss at 8-12 weeks, although some people can start as early as 4-6 weeks, with an average loss of 1-2 pounds per week. 

Semaglutide has been shown to significantly reduce weight in overweight or obese people without diabetes and improve cardiometabolic risk factors. 

One study showed a total weight loss of 5.9% at 3 months and 10.9% at 6 months in 175 people with overweight or obesity. 

Semaglutide use requires a medical consultation and should include regular follow ups with body composition monitoring. 

Semaglutide injections are often part of a weight loss program/package that may also include interventions like special diets, exercise plans, supplementation, and nutrient IV’s/injections.

And now the benefits and risks…

Semaglutide has been studied for several years and has been proven safe and effective for type 2 diabetes and obesity/overweight. However, all medications come with both benefits and risks 

What are the primary benefits of using semaglutide?

  • Increased weight loss

  • Decreased appetite and food cravings 

  • Improved blood glucose and HbA1c levels 

  • Improved insulin resistance 

  • If compounded with vitamin B12: 

    • Enhanced metabolism

    • Increased energy 


What are common side effects of using semaglutide?

  • Nausea

  • Vomiting

  • Diarrhea

  • Constipation

  • Abdominal pain

Note side effects occur in the first 24-48 hours of administration and should be temporary and mild-to-moderate in severity. 

There have been reports of muscle loss, which is likely due to people losing weight without consuming enough protein or engaging in regular strength/resistance training. 

Consult your prescribing provider about remedies that can help relieve side effects. There are options for minimizing gastrointestinal side effects. 

What are the risks of using semaglutide? 

  • Severe side effects are rare but possible:

    • Seek medical attention immediately 

  • Contraindicated (do not use) for:

    • People with a personal or family history of medullary thyroid carcinoma (MTC) and with multiple endocrine neoplasia syndrome type 2 (MEN 2)

    • People with a hypersensitivity/allergic reaction to semaglutide or its excipients 

  • Caution advised for:

  • Pregnancy and breastfeeding:

    • Avoid pregnancy while using due to risk of fetal harm

    • Use of backup contraception is strongly encouraged 

    • Discontinue use several months before a planned pregnancy 

    • Breastfeeding is not recommended while using due to lacking safety data  

Let’s summarize what we’ve learned…

Semaglutide is a medication used to treat type 2 diabetes and chronic weight management. It is safe and effective, although certain side effects and risks are possible.

If you are ready to get started with compounded semaglutide injections for weight loss, reach out to the EmpowerMed team of naturopathic doctors today. 

We take a collaborative approach to natural medicine (and weight loss), partnering with patients to help them achieve their unique health and wellness goals.

Contact us today at 760-456-7501 or use our booking link to schedule.

EmpowerMed Clinic is located just off the I-15 and Carroll Canyon within the Fitness Quest 10 Wellness Center of Scripps Ranch, San Diego County, CA. 

We serve the communities of North County San Diego, Poway, Rancho Bernardo, 4S Ranch, Mira Mesa, Ramona, Scripps Ranch, Santee, and more.


Written by Dr. Jordan Valdez, ND, RD 


References 

Mahapatra MK, Karuppasamy M, Sahoo BM. Semaglutide, a glucagon like peptide-1 receptor agonist with cardiovascular benefits for management of type 2 diabetes. Rev Endocr Metab Disord. 2022 Jun;23(3):521-539. doi: 10.1007/s11154-021-09699-1. Epub 2022 Jan 7. PMID: 34993760; PMCID: PMC8736331.

Mahapatra MK, Karuppasamy M, Sahoo BM. Semaglutide, a glucagon like peptide-1 receptor agonist with cardiovascular benefits for management of type 2 diabetes. Rev Endocr Metab Disord. 2022 Jun;23(3):521-539. doi: 10.1007/s11154-021-09699-1. Epub 2022 Jan 7. PMID: 34993760; PMCID: PMC8736331.

Kim W, Egan JM. The role of incretins in glucose homeostasis and diabetes treatment. Pharmacol Rev. 2008 Dec;60(4):470-512. doi: 10.1124/pr.108.000604. Epub 2008 Dec 12. PMID: 19074620; PMCID: PMC2696340.

Ghusn W, De la Rosa A, Sacoto D, Cifuentes L, Campos A, Feris F, Hurtado MD, Acosta A. Weight Loss Outcomes Associated With Semaglutide Treatment for Patients With Overweight or Obesity. JAMA Netw Open. 2022 Sep 1;5(9):e2231982. doi: 10.1001/jamanetworkopen.2022.31982. PMID: 36121652; PMCID: PMC9486455.

Gao X, Hua X, Wang X, Xu W, Zhang Y, Shi C, Gu M. Efficacy and safety of semaglutide on weight loss in obese or overweight patients without diabetes: A systematic review and meta-analysis of randomized controlled trials. Front Pharmacol. 2022 Sep 14;13:935823. doi: 10.3389/fphar.2022.935823. PMID: 36188627; PMCID: PMC9515581.

Garvey, W.T., Batterham, R.L., Bhatta, M. et al. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial. Nat Med 28, 2083–2091 (2022). https://doi.org/10.1038/s41591-022-02026-4

 
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