The Skinny on Semaglutide (Wegovy) for Weight Loss: The Top Burning Questions Answered

In a world where fad diets come and go and weight loss supplements flood the market, it's easy to feel overwhelmed and skeptical about what truly works for shedding those extra pounds. But a promising peptide on the weight loss scene is causing quite a buzz: semaglutide (Wegovy). 

If you've got questions about this weight loss medication, you're in the right place. In this podcast, we'll answer the top questions about semaglutide for weight loss.  

What is semaglutide?

Semaglutide is an injectable medication used to help manage weight. It may also lower your blood pressure, improve your cholesterol, and lower your blood sugar. And it must be used in addition to lifestyle changes (healthy diet and increased physical activity).

It was originally approved in 2017 (Ozempic) to help with blood sugar control in type 2 diabetes. People taking Ozempic for diabetes also lost weight, so the manufacturer conducted trials to see if people without diabetes had the same benefit. They found this to be the case, and the FDA approved the medication's use to include weight loss in adults (Wegovy) in 2021. 

How does semaglutide (Wegovy) work for weight loss?

Semaglutide mimics a hormone in your gut that controls hunger (GLP-1). When you eat, GLP-1 is released from the gut and tells your brain you are full. GLP-1 also slows down how fast food leaves your stomach, suppressing your appetite. And GLP-1 tells your pancreas to release insulin after you eat. This lowers your blood sugar. You'll then use the sugar from your food instead of storing this excess sugar as fat. All of these things together lead to weight loss.

Is semaglutide (Wegovy) safe?

Yes, semaglutide for weight loss is FDA-approved and has undergone rigorous testing to ensure its safety and effectiveness. But this doesn't mean that everyone can take it. You should consult a healthcare provider to determine if it suits your specific health conditions.

Who shouldn't take semaglutide?

You should not use semaglutide if you have the following:

• A personal or family history (first-degree relatives such as a parent, sibling, or child) of thyroid cancer or adrenal gland or parathyroid tumors.

• If you are pregnant or breastfeeding

• Type 1 diabetes

• Bariatric surgery (within the past 18 months)

• Active gallbladder disease

• Kidney disease or transplant

You also shouldn't take semaglutide if you're taking other GLP-1 agonists like semaglutide, which include medications like Trulicity, Victoza, or Saxenda.

Who is semaglutide (Wegovy) for?

Semaglutide for weight loss is typically prescribed for adults with a body mass index (BMI) of 30 or higher or those with a BMI of 27 or higher with weight-related medical conditions like high blood pressure, high cholesterol, or diabetes.

What are the most common side effects of semaglutide?

The most common side effects of semaglutide are stomach-related, including:

• nausea

• diarrhea

• vomiting

• constipation

• bloating

• Burping

Most of these stomach-related side effects are due to slowing down digestion.

People have also reported headaches and tiredness (usually due to fewer calories-feeling full and eating less).

How much weight can I lose with semaglutide?

Healthy, sustainable weight loss is 0.5 to 2 pounds per week. And some people routinely lose more than this. 

But what do the clinical studies say? A 68-week study with almost 2,000 adult participants reported an average weight loss of nearly 15% of their body weight (approximately 35 pounds). The placebo group lost an average of 2.5% of their body weight. 

How fast does semaglutide work?

The short answer is that many patients will lose weight in the first week of taking semaglutide if they make lifestyle changes. The first 4 doses are small and are primarily used to gently introduce the peptide to the body without risking stomach-related side effects. 

You need to remember that it's possible to "out-eat" any weight loss medication. So, you may see little to no weight loss in the early weeks without making lifestyle changes. 

But what do the clinical studies say? In clinical trials, people lost about 10% of their body weight during the first 20 weeks. They lost an additional 8% of their body weight through week 68.

How and when do I take semaglutide?

You can inject semaglutide into the fatty tissue of your upper arms, stomach, or upper thighs.

Typically, the dose of semaglutide is increased no faster than once every 4 weeks. For example, you would receive 4 weeks of 0.25mg, then 4 weeks of 0.5mg, and so forth, assuming your side effects are not bothersome. 

Most clinics consider three factors when deciding how to increase the dose for their clients. Each month, you should discuss whether you've experienced bothersome side effects, how well semaglutide managed your hunger, and how much weight you lost. How fast your dose increases depends on the needs of each patient. 

Do I have to take semaglutide on the same day every week?

Yes. It's recommended that you take semaglutide on the same day every week. However, if you need to change the day of the week you take semaglutide (e.g., vacation, illness), you may change the day of the week you take semaglutide as long as your last dose was given 2 or more days before.

Will I have to take semaglutide forever?

The answer to this is complicated. The short answer is it depends on the person. 

Nutrition, physical activity, and good-quality sleep are essential for weight loss. And unfortunately, stress can also impact your ability to maintain a healthy weight. Semaglutide is helpful but may only be necessary for a while if you can adopt lifestyle changes and continue to use them after you stop semaglutide. 

Semaglutide is a medication that's meant to be taken long-term. But some people may want to stop taking it or need to because of side effects or other reasons.

It is possible to regain some weight you've lost after you stop taking semaglutide. The STEP 4 trial found that people switching from semaglutide (Wegovy) for weight loss to placebo regained about 7% of their body weight in 48 weeks.

Why do I regain weight after stopping semaglutide?

It's important to know that regaining weight isn't unique to semaglutide. It's possible to regain weight after stopping any weight loss medication.

Because semaglutide suppresses your appetite, stopping treatment can cause your appetite to return. Also, keep in mind that semaglutide should be used with lifestyle changes, including a healthy diet and exercise. Getting enough quality sleep is important, too. You'll likely regain weight if you stop incorporating these healthy habits into your routine when you stop semaglutide treatment.

Do I need to wean off semaglutide?

No, you don't need to wean off semaglutide. Your healthcare provider will provide instructions for stopping treatment based on your individualized needs.

Where should I store my semaglutide?

Semaglutide should be stored in the refrigerator. Never put your syringes in the freezer.

Although there's no one-size-fits-all approach to weight loss, making informed decisions that align with your personal weight loss goals is very important. 

Remember, semaglutide for weight loss may not be clinically appropriate for everyone. But it can be life-changing for people where it is appropriate. When you're not hungry all of the time, it's much easier to focus on nutrition, regular exercise, stress management, and getting good, quality sleep. 

Thanks again for listening to The Peptide Podcast, we love having you as part of our community. If you love this podcast, please share it with your friends and family on social media, and have a happy, healthy week!