Semaglutide & Weight Loss

How It Can Be Used for Long-Term Weight Management

What Are The Benefits Of Semaglutide? 

Semaglutide is a glucagon-like peptide that works in three different ways:

1. Increases our own body’s insulin secretion; insulin helps to decrease our blood sugar
2. Decreases glucagon; glucagon increases our blood glucose 
3. Slows gastric emptying meaning that we get fuller faster

Semaglutide’s ability to decrease appetite has been shown to help patients lose weight. Keeping blood sugar levels balanced can improve energy and mood, while also preventing long-term health issues like heart disease, blood pressure, cholesterol levels and kidney disease. 

How It Started

Belonging to the GLP-1 Receptor Agonist class, semaglutide has been around since 2017 as an effective Type 2 diabetes medication. However, what professionals have found over time is that their patients were also losing weight while treating their diabetes. It has since been approved for weight loss which has caused demand to increase dramatically in the past year. 

The medication is administered chiefly through a small, subcutaneous injection once a week but is also available as an oral tablet. 

Does It Actually Lead To Weight Loss?

Yes! Semaglutide’s STEP 5 trial assessed patients with an average BMI of 38.5 and followed them for 104 weeks. The trial found an average loss of 15% body weight among patients who received weekly 2.4 mg doses and adopted behavior intervention plans. The study also found the most weight reduction within the first 60 weeks and then a plateau in weight loss. Despite the stalling of weight loss, patients were able to maintain positive results through week 104.

What Is Considered “Meaningful” Weight Loss?

Obesity medication professionals use a >5% of weight loss as a meaningful loss with a treatment plan. This was achieved by more than 75% of trial patients at week 104. More than a third lost 20% of body weight. As would be expected with weight loss, there was also improvement in cholesterol levels, inflammatory markers, blood sugar and blood pressure.

“I recommend that you see a professional like myself who can help you with your lifestyle, diet and medications. Weight loss is a journey and semaglutide could be part of that journey!”

Dr. Marguerite Weston

“In your body, insulin takes sugar out of your blood and puts it into your cells. When you have insulin resistance, your cells aren’t listening to the insulin and glucose stays in the blood. Semaglutide makes your cells listen better — among other things — so you can get rid of the sugar. Anytime you can decrease blood sugar, you’re likely to see weight loss.” 

Dr. Marguerite Weston

Another Advantage: It Is Not A Stimulant

In an effort to decrease appetite, stimulants can negatively impact the heart and blood pressure. Semaglutide is not a stimulant — it’s a great drug for some patients because it not only helps them lose weight but also decreases cardiovascular risk. Because of how quickly positive results begin to show, it can also act as a strong motivator early in the weight loss journey, especially for patients who struggle with larger lifestyle changes. 

How Can I Get Semaglutide? 

The FDA regulation requires any patient with a BMI over 30 or a BMI of 27 or more if they have a health-related obesity issue, including but not limited to high blood pressure, insulin resistance, sleep apnea or high cholesterol. Both women and men can use semaglutide with women seeing slightly better results in some studies. 

“It’s not approved to help shed those last 5 lbs., so it’s not an ideal solution for the patient with a BMI of, say, 24. There are a multitude of better options to help you get over that final hurdle!”

Dr. Marguerite Weston

Taking Semaglutide:

Are There Any Side Effects of Semaglutide?

The most common side effects are gastrointestinal, including constipation, vomiting, and stomach pain. Other side effects include: 

• Fatigue 
• Headaches
• Hive-like swelling
• Increased anxiety 
• Nausea
• Skin rash 

Closely monitoring these symptoms in the early stages is critical to ensuring the comfort and sustainability of using semaglutide as a weight loss solution. If a patient begins to form a lump in the neck, difficulty swallowing or shortness of breath, they should immediately call their doctor. 

What Are the Risks? 

This medication may increase the risk that a patient will develop thyroid gland tumors. More information about this risk can be found here. Gall bladder issues may also arise, which is seen with any type of weight loss. Additional long-term usage risks are still being studied. 

Some people will choose not to take this medication or increase their dosage because of the side effects. Also, semaglutide can cost an average of $1,200 without insurance, which creates a pricing barrier. Medicare and some insurance plans will cover the costs but this coverage is heavily dependent on a patient’s unique health circumstances. 

Contraindications include:

• Low blood sugar (especially in diabetics taking other medications)
• Eye damage as a result of diabetes
• A history of pancreatitis or pancreatic cancer
• Kidney disease
• Gallbladder issues
• Medullary thyroid cancer
• MEN2

Other Things To Watch Out For:

• Be sure that the supplying pharmacy is accredited
• The provider should offer a slow ramp-up schedule to work up to the recommended dose
• Alcohol use can impact the effects of semaglutide
• To minimize the reemergence of side effects, patients should adopt regular mealtime routines

Sustainable Change: The Key To Keeping Those Pounds Off 

When people lose weight, they lose both fat and muscle — no matter how much they lift weights throughout their journey. If you gain the weight back, it comes back as fat. This is called “Yo-Yo dieting” and it can negatively disrupt cosmetic proportions. Patients aren’t meant to be on semaglutide forever, which is why you also want to change your lifestyle along the way! 

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About The Author

Dr. Marguerite Weston is a functional wellness specialist at Donaldson Plastic Surgery. She specializes in creating custom weight loss programs for her patients, which sometimes include the usage of semaglutide. Dr. Weston has completed additional training in obesity medicine at the Cleveland Clinic and continues to expand her knowledge by seeking out the most sustainable weight loss methods available. 

Using Semaglutide In Columbus, Ohio

“I use my knowledge and experience in both obesity medicine and semaglutide to bring responsible treatment to patients — from diet and lifestyle management to accredited pharmacy sources.  It’s not all about the medicine; let’s make changes so the weight stays off.”