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Semaglutide for Long Term Weight Control

Injection of the peptide Semaglutide (Wegovy) has been found to offer long-term weight control, even for the obese. The peptide has been used along with a diet and exercise program to control blood sugar levels in adults with type 2 diabetes when other medications did not work well enough. Semaglutide injection is also used to reduce the risk of a stroke, heart attack, or death in adults who have type 2 diabetes and to help control heart vessel diseases. It’s no wonder that in 2021 the FDA approved subcutaneous injections of Semaglutide for long-term weight loss- the first diet drug approved since 2014. Those who may have high blood pressure, diabetes, or high cholesterol and are also overweight might particularly benefit from injectable Semaglutide. “Approximately 70% of American adults have obesity or are overweight. Obesity or being overweight is a serious health issue associated with some leading causes of death, including heart disease, stroke, and diabetes, and is linked to an increased risk of certain types of cancer. Losing 5% to 10% of body weight through diet and exercise has been associated with a reduced risk of cardiovascular disease in adult patients with obesity or overweight.” (FDA)


How does it work?


Semaglutide is an incretin mimetic. It works by helping the body to release the right amount of insulin when blood sugar levels are high which helps move sugar from the blood into other body tissues to be stored for energy. Specifically, by mimicking a hormone called glucagon-like peptide-1 (GLP-1) that targets areas of the brain that regulate appetite and food intake. Semaglutide injections can also slow the movement of food through the stomach and may decrease appetite and cause weight loss. The drug is injected once a week over a 16-20 week period and was proven effective during “ four 68-week trials. Three were randomized, double-blind, placebo-controlled trials (including 16 weeks of dose increases) and one was a double-blind, placebo-controlled, randomized withdrawal trial in which patients receiving Wegovy either continued with the treatment or switched to a placebo” (FDA announcement, cited above) 


The trials of Semaglutide showed that “The largest placebo-controlled trial enrolled adults without diabetes. The average age at the start of the trial was 46 years and 74% of patients were female. The average body weight was 231 pounds (105 kg) and average BMI was 38 kg/m2. Individuals who received Wegovy lost an average of 12.4% of their initial body weight compared to individuals who received a placebo. Another trial enrolled adults with type 2 diabetes. The average age was 55 years and 51% were female. The average body weight was 220 pounds (100 kg) and average BMI was 36 kg/m2. In this trial, individuals who received Wegovy lost 6.2% of their initial body weight compared to those who received placebo.” These are incredible results and demonstrate how effective this peptide can be for weight loss when combined with modifying your diet and exercise.


Other studies have shown that not just long-term weight loss occurs, but the worst outcomes of obesity can also perhaps be avoided “Semaglutide not only showed improvement in diabetes and body weight but also lowered the rate of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke in patients with diabetes mellitus type 2 at high risk of cardiovascular disease” (Singh, et al 2022). That is really good news for those that have been struggling to keep the weight off- particularly as we get older, it gets harder and harder to shed those pounds, and the possible effects of that weight get scarier and scarier.


How does it compare to other weight loss therapies?


The studies done on Semaglutide were pretty good studies, and they did compare them to patients that got a placebo but still had diet modification and exercise. Sometimes that’s just not enough, and you need something else to help keep the weight off. Also, Semaglutide has been found to be an appetite suppressant, so it can be effective at curbing the desire to eat and snack. Singh, cited above, reviewed a number of other studies that compared Semaglutide to a number of other weight loss drugs, including ones that also control blood sugar, and found “Wegovy (Semaglutide) is not only superior at reducing body weight compared with other antidiabetic drugs, but it is also cardioprotective. Another significant benefit of Semaglutide is that it can be used for long-term management of weight. With the recent approval of Wegovy, we could expect improvement in patients’ weight loss-related outcomes and quality of life.”


What if I’m not obese?


If you are classified as “overweight” and have any health problems stemming from that condition, the FDA has approved the use of Semaglutide in those cases. If you are not overweight but are concerned about becoming so, there are other peptide therapies that might be right for you. If you fit the description of someone who might benefit from Semaglutide injections, it is important to realize that most people are helped, but not all. It’s important to converse with your healthcare practitioner to see if it’s right for you. If it is, it can really help train your brain to eat differently. One patient, as reported by Yale Medicine, commented that “It worked for me because my issue is mindlessly overeating. Because the drug often makes me feel incredibly full after just a few bites, it has been a real change to my eating habits,” the participant says. She used to consume 3,000 calories a day “easily,” and in the trial, she has been unable to take in more than 1,500. “One serving of Oreos is three cookies, and it was always a struggle to stop at three,” she says. “In the trial, I found it a real struggle to eat more than three.