What is the craze with Semaglutide?

The craze 

Over the past few years there has been a new weight loss drug on the market. You may have heard of it - Ozempic or Wagovy. The generic form is called semaglutide. These medications are approved for the treatment of Type 2 Diabetes and obesity, but were made popular by celebrities for their weight loss effect.

Does it work? You bet it does!

What is semaglutide?

Semaglutide is a Glucagon-Like Peptide 1 (GLP-1) agonist. Our body produces a wide variety of peptides, each with different functions. Insulin is a more familiar peptide use by the body to reduce blood sugar levels. The GLP-1 agonist works similar to our natural production of GLP-1 hormone, which acts to: stimulate the secretion of insulin, suppress formation of glucagon, suppress appetite, and increase satiety (feeling of fullness).

 💡 Peptides are small chains of amino acids.
Proteins are multiple, long chains of amino acids.

The appetite suppressant action is what promotes the weight loss. This is why many doctors have begun prescribing semaglutide as an “off-label” medication to patients wanting to lose weight. In a way, I believe this is a safer alternative than using the addictive and highly stimulating medications such as phentermine.

 Semaglutide in the Research

Semaglutide is in a family of peptides with similar actions. Liraglutide is another GLP-1 agonist that has been around for some time. You may also see Tirzepatide, also known commercially as Mounjaro. Tirzepatide is known as a GLP-1 and GIP agonist. It has many of the same actions of semaglutide, and used for the same reasons.

The research, in diabetics, has shown that semaglutide helps with:

• Reducing weight

• Improve glucose control

• Reduce A1c levels

• Improve cardiovascular function

• Improve metabolic function

In the journal Nature Medicine, a two year study published in 2022 found that at least 77% participants taking semaglutide achieved weight loss of more than 5% of their baseline by the end of the study compared to the placebo group.

A 2023 research article in JAMA found that semaglutide reduce cardiovascular disease event risk by 20% in people WITHOUT diabetes.

Is it worth it? Yes! And No.

It is great for diabetic and non-diabetic patients. It helps people achieve their weight loss goals, improve their glucose function, and overall improve their health.

Why do I say No? This medication is freely prescribe without really addressing the underlying issue that gets people to poor metabolic health. Sadly, I’m guilty of doing this myself. When starting this medication one should work on their lifestyle factors.

One should work on their diet - consult with a nutritionist, or follow a low carb/Paleo/Keto-ish dietary plan.

Exercise will help burn up that extra fat and glucose. It doesn’t have to be much, but increasing activity level is better than nothing. Lifting weights or doing High Intensity Interval Training (HIIT) stimulate muscle to take in glucose from the blood, and increase metabolism (burns the fat!). Having good muscle mass is key to optimal metabolic health.

💡 Did you know that sitting or being sedentary is just as bad as smoking?

How to use it?

The most common form is the injectable form. One injects themselves one time per week in the abdomen area with a insulin syringe. One starts at a low dose and slowly increase the dose over many weeks. More is not alway better.

The common recommended dose is too high for most people. I have found that starting with micro-dose helps alleviate any side effects. I can’t get into specific dosing as that would constitute medical advice, which I cannot give here.

What are the cons? 

The medication has some cons:

• Cost - because this medication is used “off-label”, insurance will not cover it. Even if you are diabetic, you may have trouble getting coverage initially.

• Side Effects: nausea, vomiting, upset stomach, constipation, headache.

• Injectable form can cause some redness or bruising to injection site.

• Stopping the medication without making lifestyle changes can cause rebound weight gain.

• Potential for not consuming sufficient nutrients and/or calories leading to temporary nutrient deficiencies.

Lastly

If you decide you want to use this medication, talk with your doctor. Seek out a functional medicine doctor knowledgeable on this medication if your regular doctor does not want to prescribe it. Remember to make lifestyle changes when on the medication, that is working on: diet, exercise, stress management, and sleep.

If you have any questions, reach out by replying to this email.

Recommended Supplements:
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Pick and choose the ones you like, and have them shipped to your house.
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_{Note: supplements will have commonly used ranges. I cannot give specifics as that would be considered medical advice.} 

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To Health,

Dr. Jorge Reveron, ND
Naturopathic Doctor

Sources:

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 Med28, 2083–2091 (2022). https://doi.org/10.1038/s41591-022-02026-4

Harris E. Semaglutide Improved Cardiovascular Health in People Without Diabetes. JAMA. 2023;330(23):2241–2242. doi:10.1001/jama.2023.23508