You have quite likely heard about a new weight loss drug called “Semaglutide”. It has been in use for some time already for treating type 2 diabetes. however the Food and Drug Administration (FDA) approved it in 2021 to also be used for weight loss in obese individuals. Research is still ongoing for its safety and long-term effects. Semaglutide is also known under the names Ozempic and Wegovy, they are essentially all the same drug except for their dosages.
I don’t normally write about this subject, but I have received many requests to do so. Before discussing how it works and what you need to be cautious of, I must always assert that no weight loss drugs can ever replace diet and exercise, so please keep that in mind as you read this.
As you probably already know, 70 percent of Americans are overweight or obese. This can lead the individual on to many other diseases, including cancer. So, how do these weight loss drugs actually work? Researchers have discovered GLP-1 (glucagon-like peptide-1), an incretin hormone with important effects on glycemic control (blood sugar and insulin) and body weight regulation. They stimulate the natural release of insulin in the body and also inhibit the hormone glucagon, which is commonly known as the hunger hormone.
Ozempic works by mimicking the functions of the natural incretin hormone GLP-1. Its primary action is to stimulate the secretion of insulin from pancreatic β-cells in a glucose-dependent manner. This function is crucial as it allows for the reduction of blood glucose levels, particularly after meals, without causing a substantial risk of hypoglycemia. Semaglutide also inhibits glucagon secretion from pancreatic α-cells. Glucagon is a hormone that raises blood glucose levels, so its suppression contributes to lower blood glucose levels. Additionally, Semaglutide has effects beyond glycemic control, as it slows gastric emptying which can promote feelings of fullness and reduce energy intake. This delayed gastric emptying can help with weight loss and better control of post-meal blood glucose spikes.
GLP-1 exerts its effects primarily by stimulating insulin secretion from pancreatic β-cells in a glucose-dependent manner, thereby modulating postprandial glucose levels. This effect is thought to occur through its action on the central nervous system, particularly areas involved in appetite regulation like the hypothalamus. It also has an effect on brown adipose tissue, which creates heat in the body and thus increases the metabolic rate. GLP-1 has therefore been proposed as a potential treatment for obesity.
However, beyond its role in glucose homeostasis, GLP-1 has a wide range of physiological effects, many of which have been discovered only in recent years. GLP-1 stimulates insulin secretion from the pancreas in response to elevated blood glucose levels. It also suppresses glucagon secretion, a hormone that typically raises blood glucose levels. Through these mechanisms, it helps to regulate postprandial (after meal) blood glucose levels and prevent hyperglycemia, a hallmark of diabetes. It has a short half-life in the bloodstream due to the action of an enzyme called dipeptidyl peptidase-4 (DPP-4), which rapidly degrades it. This rapid degradation has clinical implications, as the effectiveness of GLP-1 as a potential treatment for type 2 diabetes would be limited by its short duration of action.
Many people report that GLP-1 suppresses appetite and makes them feel fuller sooner. This will lead to a lower calorie diet and eventually to weight loss. For those with type 2 diabetes, it is very important to keep insulin and blood glucose within a healthy range so consuming fewer calories could definitely help individuals struggling to stick to their diet. These drugs mimic the GLP-1 hormone, which is released in the gut in response to eating.
I can see the potential for individuals who have tried many diet types and have not been successful, especially if their health conditions pose a high risk. If it can promote a significant amount of weight loss then of course the individual could also benefit greatly by reducing their risk factors for other diseases such as heart disease and cancer. So far these drugs seem like a miracle, but like all drugs they also have side effects. These include nausea, vomiting, severe headaches, abdominal pain, constipation, and hypoglycemia (very low blood sugar). Other side effects can include inflammation, and kidney and gallbladder problems. Even so, this drug could really change the treatment of obesity and type 2 diabetes although you should certainly be aware of the side effects.
Another potential side effect is muscle loss. Almost any diet will probably result in some muscle loss. However, when you’re not hungry and not getting the protein that your body needs, this could increase muscle loss. So you still need to exercise and consume a sufficient amount of protein, simply taking a drug will not substitute that.
My greatest concern is that you can buy these drugs online, and if you’re not consulting with your physician then that be very dangerous. Another issue is that what some companies are selling may not be genuine.
Finally, if you do need to lose 10 or 15 pounds, or even quite a bit more, then you can definitely do so with the correct nutrition plan and exercise without risking any potential side effects. Remember, no drugs can even come close to the benefits of lifestyle modifications.
References:
“Once-Weekly Semaglutide in Adults with Overweight or Obesity”. Wilding JP, Batterham RL, Calanna S, et al. N Engl J Med. 2021
“Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes”. Marso SP, Bain SC, Consoli A, et al. N Engl J Med. 2016
“Once-Weekly Semaglutide in Adults with Overweight or Obesity” . Wilding JP, Batterham RL, Calanna S, et al. N Engl J Med. 2021
“GLP-1 agonism stimulates brown adipose tissue thermogenesis and browning through hypothalamic AMPK”. PubMed https://pubmed.ncbi.nlm.nih.gov/24917578/
“SGLT1 inhibition: Pros and cons”. PubMed https://pubmed.ncbi.nlm.nih.gov/30240793/
“SGLT2 Inhibitors and Bladder Cancer: Analysis of Cases Reported in the European Pharmacovigilance Database”. PubMed https://pubmed.ncbi.nlm.nih.gov/32827151/
“How Ozempic® works to lower blood sugar and A1C in adults with type 2 diabetes”. Ozempic https://www.ozempic.com/why-ozempic/how-ozempic-works.html
“Glucagon Physiology”. National Library of Medicine https://www.ncbi.nlm.nih.gov/books/NBK279127/
“Glucagon and regulation of glucose metabolism”. American Journal of Physiology https://journals.physiology.org/doi/full/10.1152/ajpendo.00492.2002
“Semaglutide for weight loss — what you need to know”. UCLA Health https://www.uclahealth.org/news/semaglutide-weight-loss-what-you-need-know
“FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014” US Food & Drug Administration https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014
