Semaglutide CAS:204656-20-2

Description

Semaglutide belongs to a class of medications known as glucagon-like peptide-1 receptor agonists, or GLP-1 RAs. It mimics the GLP-1 hormone, released in the gut in response to eating.

One role of GLP-1 is to prompt the body to produce more insulin(Link is external) (Link opens in new window), which reduces blood sugar (glucose). For that reason, health care providers have used semaglutide for more than 15 years to treat Type 2 diabetes.

But GLP-1 in higher amounts also interacts with the parts of the brain that suppress your appetite and signal you to feel full. When used in conjunction with diet and exercise, it can cause significant weight loss - and a reduced risk of cancer, diabetes and heart disease(Link is external) (Link opens in new window) - in people who are obese or overweight.

Semaglutide injections for weight loss

Currently, semaglutide is only approved for weight loss under the brand name Wegovy. The typical dose for weight loss is 2.4 milligrams, administered weekly as subcutaneous (under the skin) self-injections.

But as interest in semaglutide for weight loss continues to grow, health care professionals are finding ways to manage the demand. Many prescribe other brands of semaglutide, such as Ozempic and Rybelsus, off-label (using a drug that is FDA-approved for a different reason).

"Many people use semaglutide off-label to help manage weight," Dr. Surampudi says. "The demand has become so high, that now there is a shortage for people who need this medication to help manage their diabetes."

How effective is semaglutide for weight loss in non-diabetics?

There have been several anti-obesity medications that help suppress appetite and achieve weight loss. But semaglutide performs on a new level.

An early study(Link is external) (Link opens in new window) of 2,000 obese adults compared people using semaglutide plus a diet and exercise program with people who made the same lifestyle changes without semaglutide. After 68 weeks, half of the participants using semaglutide lost 15% of their body weight, and nearly a third lost 20%. Participants who incorporated only lifestyle changes lost about 2.4% of their weight.

Since then, additional studies have shown similar results. But they've also revealed that participants tend to regain the weight lost when they stop taking semaglutide.

"The fundamentals of obesity management will always be changes to diet and exercise," Dr. Surampudi says. "But having anti-obesity medications is another tool in the toolbox - depending on the person's clinical history."

What are the side effects of semaglutide injections?

The side effects of semaglutide are typically mild - especially when compared to the complications associated with overweight and obesity.

People taking semaglutide for weight loss may experience:

Dizziness

Fatigue

Gastrointestinal issues, such as diarrhea, constipation and gassiness

Headache

Stomach issues, including nausea, vomiting, pain or distension (bloat)

Gastrointestinal issues are the most common complaint among people just starting semaglutide. But you may be able to reduce the side effects by beginning on a lower dose and then slowly increasing the amount you take.

Who should (and should not) take semaglutide for weight loss?

The FDA recommends Wegovy for weight loss if you meet one of the following criteria:

Have a body mass index (BMI) of 27kg/m2 or greater and at least one weight-related condition, such as high blood pressure, Type 2 diabetes or high cholesterol

Have a BMI of 30kg/m2 or greater

Avoid semaglutide if you have:

History of medullary thyroid cancer

History of gallbladder disease

History of pancreatitis

Multiple endocrine neoplasia syndrome type 2 (MEN2)

If you're considering semaglutide for weight loss, your first step should be consulting your primary care physician (PCP). They know your personal and family medical history and can guide you in the best treatment for your condition. If you have diabetes and already take a different medication, talk to your physician about acceptable (and safe) combinations of diabetes medication.

FDA Approval and Regulation of Semaglutide

In 2019, the U.S. Food and Drug Administration approved semaglutide, under the brand name Wegovy, for chronic weight management in obese and overweight adults. This approval was based on clinical trials that showed significant loss in body weight when compared to a placebo after a year of treatment for non-diabetic individuals and those with type 2 diabetes.

The clinical trials revealed that participants achieved reduced overall body weight and an improved cardiometabolic health such as blood pressure and lipid profile. Participants also gained an improved quality of life following its administration, indicating general improvements in lifestyle and increased physical activity.

Dosage and Administration Guidelines

The U.S. Food and Drug Administration approved the once to weekly semaglutide injection for chronic weight management in adults with a body mass index of 27 or greater, along with at least one other obesity related comorbidity such as high cholesterol or type 2 diabetes.

The two FDA approved doses are 1.7mg per week and 2.4mg per week administered subcutaneously on designated days each week, either Monday or Thursday. This depends on the prescription filled by the patient's provider by healthcare guidelines from the United States National Library of Medicine or Medline Plus and Centers for Disease Control.

Although not a cure, it is important to remember that when taking semaglutide injections for weight loss, patients must adhere to all dosage instructions provided by their physicians. This includes following specific directions on timing and frequency.

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