Semaglutide Article Key Points:
- Semaglutide shots caused an average weight loss of 17.3% compared to placebo of 2.0%.
- Semaglutide shots resulted in significant improvements in cardiovascular risk factors with semaglutide treatment.
- When semaglutide shots were stopped, subjects regained two-thirds of their prior weight loss with similar changes in cardiovascular risk factors.
- Participants in the semaglutide trial with greater weight loss during the 68-week treatment period tended to regain body weight after semaglutide withdrawal
Introduction:
Obesity is a significant global health issue with numerous associated health problems and socioeconomic burdens that caused 5 million deaths globally in 2019. (Guh et al., 2009; Roth et al., 2020) Despite the availability of various weight management strategies, the prevalence of obesity continues to rise. Therefore, there is an urgent need for effective interventions to combat this growing public health challenge.
Semaglutide Shots: A Miracle Weight Loss Drug?
Semaglutide, marketed under brand names like Ozempic and Wegovy, has gained popularity among celebrities because of its potential benefits in weight management and weight loss.
A medication that belongs to the class of drugs known as glucagon-like peptide-1 (GLP-1) receptor agonists, semaglutide is commonly used for the treatment of type 2 diabetes.
Administered through subcutaneous injection, semaglutide works by increasing insulin production, reducing glucose levels in the blood, and promoting weight loss.
While semaglutide and Ozempic are primarily used to manage blood sugar levels and promote weight management, they have shown potential benefits in other areas of health.
Studies have indicated that GLP-1 receptor agonists may have positive effects on conditions such as diabetic retinopathy and heart disease.
The U.S. Food and Drug Administration (FDA) has approved semaglutide as a safe and effective treatment option for individuals with type 2 diabetes who struggle with weight management.
Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, increases satiety, reduces food intake, and improves glucose control. There has recently been a term called “Ozempic Butt” and “Ozempic Face,” which causes loose skin on the butt or the face when rapid weight loss occurs.
What is Semaglutide?
Semaglutide, a medication originally developed for type 2 diabetes management, has recently emerged as a potential treatment option for weight loss. (Kushner et al., 2020) The medication semaglutide is a glucagon-like peptide-1 (GLP-1) analog recently approved by the US Food and Drug Administration, Health Canada, and the UK Medicines and Healthcare Products Regulatory Agency for chronic weight management, as an adjunct to lifestyle intervention, at a once-weekly subcutaneous dose of 2.4 mg in adults with overweight (with≥1 weight-related condition) or obesity.
Another GLP-1 receptor agonist that has gained attention for its potential weight-loss benefits is Ozempic (semaglutide). Ozempic, like semaglutide, is administered through injection and helps in controlling blood sugar levels. It works by stimulating the pancreas to release insulin when blood sugar levels are high and reducing the amount of glucose produced by the liver. Ozempic may aid in weight loss, it can also lead to side effects such as dizziness, lumps at the injection site, and gastrointestinal issues like nausea, vomiting, diarrhea, and constipation. It is
Semaglutide Weight Loss Research
Concerns about the widespread use of semaglutide without proper understanding or medical guidance exist. Weekly 2.4 mg of semaglutide can induce up to 10-18% of weight loss, twice the weight loss efficacy achieved with previous behavioral and pharmacological approaches. (Colin & Gérard, 2022) A recent trial showed that oral semaglutide at doses of 3 mg, 7 mg, and 14 mg reduced body weight by 20.1 kg (9.1 lbs.), 20.9 kg (9.5 lbs.), and 22.3 kg (10.1 lbs), respectively, compared to placebo. (Aroda et al., 2019)
Additionally, a meta-analysis of randomized clinical trials showed that subcutaneous and oral administration of semaglutide resulted in substantial weight loss. (Zhong et al., 2021) So, what everyone wants to know is what happens when you stop taking Ozempic? Do you keep the weight off? This article aims to evaluate the efficacy and safety of semaglutide for weight management. It includes an analysis of relevant clinical trials and a thorough literature review on semaglutide’s impact on weight loss and weight regain. The study highlights the promising results of semaglutide in promoting weight loss and preventing weight regain and provides insights into its safety and tolerability.
Semaglutide Causes Weight Loss, but What Happens When You Stop
The efficacy of semaglutide for weight loss has been extensively investigated in clinical trials. The STEP 1 trial was conducted at 129 sites across 16 countries. The study was a 68-week, randomized, double-blind, placebo-controlled study in which participants with obesity received once-weekly subcutaneous injections of semaglutide or placebo. The results demonstrated that participants receiving semaglutide achieved significant weight loss compared to the placebo group. The mean weight loss in the semaglutide group was 15.3% of baseline body weight, while the placebo group only achieved 2.6% weight loss. (Wilding et al., 2021) Moreover, a higher proportion of participants in the semaglutide group achieved a clinically meaningful weight loss of at least 5% and 10% of baseline body weight compared to the placebo group.
Semaglutide for Weight Regain Prevention
While semaglutide has shown promising results for weight loss, assessing what happens when treatment stops is equally important. Long-term weight management is challenging, as many individuals tend to regain weight after initial success. Therefore, evaluating the potential of semaglutide in preventing weight regain is crucial.
A recent which examined the effects of once-weekly subcutaneous semaglutide 2.4 mg on body weight and cardiometabolic risk factors in adults overweight or obese for 68 weeks. The semaglutide group included a lifestyle intervention for all participants consisting of counseling every 4 weeks on a diet (500 kcal deficit per day relative to total estimated energy expenditure at randomization) and physical activity (150 minutes per week). The study followed the subjects after semaglutide was discontinued for 1 year.
Results
Cardiovascular Risk factors
During semaglutide treatment, greater improvements in cardiovascular risk factors were observed with semaglutide than with placebo, and the semaglutide subjects improved C Reactive Protein (i.e., a marker of inflammation), HDL cholesterol, VLDL cholesterol, and triglycerides. The semaglutide groups also decreased HbA1c (i.e., a market of blood sugar control) more than the placebo and maintained a small relative improvement in HbA1c versus placebo. Greater magnitudes of weight loss were associated with the most favorable changes in cardiometabolic risk factors from baseline till the end of treatment. Participants with prediabetes at baseline had a greater improvement with semaglutide than with placebo.
Semaglutide Withdrawal
During the main treatment phase (from baseline [week 0 to week 68), semaglutide reduced body weight more than placebo. The observed mean weight loss was 17.3% with semaglutide versus 2.0% with placebo. This resulted in an average weight loss of 8 pounds. The placebo group lost an average of 1 pound. After the subjects stopped using semaglutide, the results were shocking. After discontinuing semaglutide, patients gained two-thirds of their weight back; however, almost half the people were able to keep their weight below baseline values. (i.e., 5.6% below the initial weight of starting the trial). Participants in the semaglutide trial with greater weight loss during the 68-week treatment period tended to have greater regain in body weight after semaglutide withdrawal.
Still, they ultimately retained greater weight loss at week 120 versus subgroups who lost less weight during the 68-week treatment period. Despite weight regain, the subjects taking semaglutide maintained small improvements in cardiovascular markers such as LDL, VLDL, HDL, tryglycerides, and CRP. However, many patients reverted to prediabetes after stopping semaglutide. (Wilding et al., 2022)
The study found that once-weekly semaglutide plus lifestyle intervention led to a substantial reduction in body weight during 68 weeks of treatment. However, subsequent treatment withdrawal led to most of the weight loss being regained within 1 year, and a similar change in some cardiometabolic variables back to baseline. This reinforces the need for continued treatment to maintain weight loss and cardiometabolic benefits.
III. Safety and Tolerability
Semaglutide shows promising results in terms of weight loss, but it may also cause certain side effects. Nausea, vomiting, and diarrhea are common side effects. In rare cases, it may cause pancreatitis, a condition characterized by inflammation of the pancreas. If you experience persistent abdominal pain, it is essential to seek medical help immediately, as pancreatitis can be a serious complication. It should be used with caution in individuals with a history of pancreatitis.
In some cases, there have been concerns about the potential risk of thyroid cancer with the use of medications like Ozempic. Studies have shown that these medications may increase the risk of developing medullary thyroid carcinoma, a rare type of thyroid cancer. If you have a family history of thyroid tumors or a history of pancreatitis, talk to your healthcare provider before starting treatment with these medications. Regular monitoring and periodic check-ups can help detect any potential abnormalities or concerns.
Safety is a critical aspect when considering any medication for weight management. Semaglutide’s safety profile is high with only minor side effects. Serious adverse events are rare, and no significant safety concerns have emerged from the trials conducted thus far. (Amaro et al., 2022; Bergmann et al., 2023)
Conclusion:
In conclusion, semaglutide and Ozempic are medications that offer potential benefits for individuals with type 2 diabetes and weight-related concerns. These GLP-1 receptor agonists can help control blood sugar levels, promote weight loss, and potentially improve certain health conditions associated with obesity. However, it is important to be aware of possible side effects such as nausea, vomiting, diarrhea, and constipation.
References:
Amaro, A., Sugimoto, D., & Wharton, S. (2022). Efficacy and safety of semaglutide for weight management: evidence from the STEP program. Postgraduate Medicine, 134(sup1), 5-17. https://doi.org/10.1080/00325481.2022.2147326
Aroda, V. R., Rosenstock, J., Terauchi, Y., Altuntas, Y., Lalic, N. M., Morales Villegas, E. C., Jeppesen, O. K., Christiansen, E., Hertz, C. L., Haluzík, M., & Investigators, P. (2019). PIONEER 1: Randomized Clinical Trial of the Efficacy and Safety of Oral Semaglutide Monotherapy in Comparison With Placebo in Patients With Type 2 Diabetes. Diabetes Care, 42(9), 1724-1732. https://doi.org/10.2337/dc19-0749
Bergmann, N. C., Davies, M. J., Lingvay, I., & Knop, F. K. (2023). Semaglutide for the treatment of overweight and obesity: A review. Diabetes Obes Metab, 25(1), 18-35. https://doi.org/10.1111/dom.14863
Colin, I. M., & Gérard, K. M. (2022). Once-weekly 2.4 mg Semaglutide for Weight Management in Obesity: A Game Changer? touchREV Endocrinol, 18(1), 35-42. https://doi.org/10.17925/ee.2022.18.1.35
Guh, D. P., Zhang, W., Bansback, N., Amarsi, Z., Birmingham, C. L., & Anis, A. H. (2009). The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health, 9, 88. https://doi.org/10.1186/1471-2458-9-88
Kushner, R. F., Calanna, S., Davies, M., Dicker, D., Garvey, W. T., Goldman, B., Lingvay, I., Thomsen, M., Wadden, T. A., Wharton, S., Wilding, J. P. H., & Rubino, D. (2020). Semaglutide 2.4 mg for the Treatment of Obesity: Key Elements of the STEP Trials 1 to 5. Obesity (Silver Spring), 28(6), 1050-1061. https://doi.org/10.1002/oby.22794
References
Roth, G. A., Mensah, G. A., Johnson, C. O., Addolorato, G., Ammirati, E., Baddour, L. M., Barengo, N. C., Beaton, A. Z., Benjamin, E. J., Benziger, C. P., Bonny, A., Brauer, M., Brodmann, M., Cahill, T. J., Carapetis, J., Catapano, A. L., Chugh, S. S., Cooper, L. T., Coresh, J., . . . Fuster, V. (2020). Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study. Journal of the American College of Cardiology, 76(25), 2982-3021. https://doi.org/10.1016/j.jacc.2020.11.010
Wilding, J. P. H., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., McGowan, B. M., Rosenstock, J., Tran, M. T. D., Wadden, T. A., Wharton, S., Yokote, K., Zeuthen, N., & Kushner, R. F. (2021). Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine, 384(11), 989-1002. https://doi.org/https://www.nejm.org/doi/full/10.1056/NEJMoa2032183
Wilding, J. P. H., Batterham, R. L., Davies, M., Van Gaal, L. F., Kandler, K., Konakli, K., Lingvay, I., McGowan, B. M., Oral, T. K., Rosenstock, J., Wadden, T. A., Wharton, S., Yokote, K., & Kushner, R. F. (2022). Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab, 24(8), 1553-1564. https://doi.org/10.1111/dom.14725
Zhong, P., Zeng, H., Huang, M., He, G., & Chen, Z. (2021). Efficacy and Safety of Subcutaneous and Oral Semaglutide Administration in Patients With Type 2 Diabetes: A Meta-Analysis [Systematic Review]. Frontiers in Pharmacology, 12. https://doi.org/10.3389/fphar.2021.695182
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