Semeglutide (Wegovy) and Medical Weight Loss
Semeglutide - Will it Help Me Lose Weight?
Medical weight loss with Semeglutide and ASAP IVs
Written by: Taylor J. Graber MD
Updated: December 15th 2022
Semeglutide for Medical Weight Loss
You may have heard about a recent addition to the medical treatment armamentarium called Wegovy (or Semglutide as the generic name). It is a GLP-1 (glucagon-like peptide 1) agonist and was originally developed as medication to assist with Type 2 Diabetes and Glucose control. It was found through its use that although the primary intention with treatment was glucose control (blood sugar control) it was profoundly effective at being able to achieve significant weight loss. This has been reviewed in many high-quality scientific journals, including the following from the New England Journal of Medicine (one of the pre-eminent medical journals in the world):
Title: Once-Weekly Semaglutide in Adults with Overweight or Obesity
Background: Obesity is a global health challenge with few pharmacologic options. Whether adults with obesity can achieve weight loss with once-weekly semaglutide at a dose of 2.4 mg as an adjunct to lifestyle intervention has not been confirmed.
Methods: In this double-blind trial, we enrolled 1961 adults with a body-mass index (the weight in kilograms divided by the square of the height in meters) of 30 or greater (≥27 in persons with ≥1 weight-related coexisting condition), who did not have diabetes, and randomly assigned them, in a 2:1 ratio, to 68 weeks of treatment with once-weekly subcutaneous semaglutide (at a dose of 2.4 mg) or placebo, plus lifestyle intervention. The coprimary end points were the percentage change in body weight and weight reduction of at least 5%. The primary estimand (a precise description of the treatment effect reflecting the objective of the clinical trial) assessed effects regardless of treatment discontinuation or rescue interventions.
Results: The mean change in body weight from baseline to week 68 was -14.9% in the semaglutide group as compared with -2.4% with placebo, for an estimated treatment difference of -12.4 percentage points (95% confidence interval [CI], -13.4 to -11.5; P<0.001). More participants in the semaglutide group than in the placebo group achieved weight reductions of 5% or more (1047 participants [86.4%] vs. 182 [31.5%]), 10% or more (838 [69.1%] vs. 69 [12.0%]), and 15% or more (612 [50.5%] vs. 28 [4.9%]) at week 68 (P<0.001 for all three comparisons of odds). The change in body weight from baseline to week 68 was -15.3 kg in the semaglutide group as compared with -2.6 kg in the placebo group (estimated treatment difference, -12.7 kg; 95% CI, -13.7 to -11.7). Participants who received semaglutide had a greater improvement with respect to cardiometabolic risk factors and a greater increase in participant-reported physical functioning from baseline than those who received placebo. Nausea and diarrhea were the most common adverse events with semaglutide; they were typically transient and mild-to-moderate in severity and subsided with time. More participants in the semaglutide group than in the placebo group discontinued treatment owing to gastrointestinal events (59 [4.5%] vs. 5 [0.8%]).
Conclusions: In participants with overweight or obesity, 2.4 mg of semaglutide once weekly plus lifestyle intervention was associated with sustained, clinically relevant reduction in body weight.
Our Take: When given as a structured, supervised protocol, Semeglutide has been shown to be very helpful for medical weight loss compared to a control. As a 68 week protocol, the average weight loss in the Semeglutide group was 15.3 kg (33.7 pounds) and only 2.6 kg (5.7 pounds) in the control group. There are mild side effects reports of nausea and vomiting which improved over time. Overall, Semeglutide treatment appears to be a safe and effective weight loss medication when added to a balanced lifestyle adjustment including dieting and exercise.
Frequently Asked Questions About Semeglutide Medical Weight Loss:
How much weight can I expect to lose on Semeglutide:
As a 68 week protocol, the average weight loss in the Semeglutide group was 15.3 kg (33.7 pounds) and only 2.6 kg (5.7 pounds) in the control group.
Are there any major side effects to Semeglutide treatment? :
The most commonly reported side effects are mild nausea and vomiting, or diarrhea, which resolved through the course of the treatment.
How often will I receive an injection:
We administer Semglutide as a subcutaneous injection once per week.
How does Semeglutide lead to weight loss?:
These GLP-1 medications mimic the bodies response to produce insulin and decrease blood glucose levels. This is helpful for controlling Type 2 Diabetes. For weight loss, the exact mechanism is unknown, but Semeglutide does work well as an appetite suppressant by slowing gastric/intestinal transit, helping you feel more full earlier into eating, lasting longer, and leading you to eat less food overall. Semglutide prevents the liver from producing too much insulin, and helps the pancreas produce more insulin when needed.
When should I avoid takine GLP-1 Agonists or Semeglutide?:
You should avoid this treatment for weight loss if you have -
A personal or family history of medullary thyroid cancer,
A personal or family history of multiple endocrine neoplasia type 2 (MEN 2)
Personal history of of pancreatitis.
Already take a glucose lowering agent, as this can increase the risk of developing hypoglycemia (low blood sugar).