Wanting to lose weight is a common concern for many people. Unfortunately, it is not often an easy thing to do. That’s why many people hope for a medication that can make the process work faster and more effectively.
Recently, certain medications developed to treat diabetes have been shown to aid weight loss. There are at least 8 different ones with a similar mechanism of action.
One of them is semaglutide (brand names include Ozemoic, Rybelsus, and Wegovy). The last brand is the only one intended for use for weight management for a person who does not have diabetes.
Semaglutide is a GLP-1 agonist, which stimulates insulin secretion when glucose enters the blood stream. It also stimulates brain receptors involved in regulating appetite so that its use reduces hunger. There are currently 8 different GLP-1 medications available.
Semaglutide is given by subcutaneous injection once a week. The dose is gradually increased over time.
The NIH published a review article indicating that semaglutide produces an average weight loss of 9.6% of the starting weight after 68 weeks of use.
It should not be used by pregnant women or people with serious GI illnesses. The most common side effects are nausea, vomiting, and diarrhea. Other less common ones include dizziness, increased heart rate, infections, headache, and upset stomach.
Recently, Reuters (5/19 Rigby) reported on a study by the Mayo Clinic that showed that semaglutide not only produced weight loss but also reduced the risk of heart attacks and strokes.
The researchers used a risk assessment tool from the American College of Cardiology and found that the risk for these two conditions dropped from 7.6% to 6.3%. The study primarily involved white women with no history of heart disease and who had a starting BMI averaging 39.8.
A more detailed study is underway, the 5-year SELECT TRIAL. It is expected to provide more precise information about the benefits and potential harms of using semaglutide.
It is also important to keep in mind that most people will regain some of the weight they lost when they stop the medication.
Also, although the GLP-1 medications can be an aid in weight management for select patients, it is not intended to be the sole means of weight loss. Diet, exercise and other “lifestyle” measures remain a critical part of weight management.
Peter M. Hartmann, MD
Family Medicine & Psychiatry
