Everything You Need to Know About the Weight-Loss Drug Semaglutide

In June of last year, the FDA approved Wegovy, a brand-name injectable drug called semaglutide for chronic weight management. It wasn’t until this summer that the drug became a household name after countless headlines about Hollywood celebrities and Upper East Side moms using it to shed pounds. While Elon Musk tweeted about being on Wegovy and Andy Cohen considered going on Ozempic (another semaglutide drug for Type 2 diabetes) on his radio show, the celebrity weight-loss sensation was becoming a household name. According to Google Trends, the search for semaglutide has skyrocketed in the last few months. 

Attention-grabbing headlines aside, the drug has been a beacon of hope for those struggling to maintain a healthy weight. According to the Centers for Disease Control, more than 42 percent of adults in the U.S. are considered currently obese while nearly three-quarters are overweight. For those prescribed either Ozempic (off label) or Wegovy, the journey has not been easy. High demands have led to shortages in the U.S. and worldwide making it harder for both weight loss patients and Type 2 diabetes patients to get their medication. Here, we explore how the popular medication works, the common side effects that come along with it and how some physicians are dispensing the wonder drug directly to patients with compounded formulations. 

What is Semaglutide?

“The main active ingredient in Ozempic and Wegovy is semaglutide,” explains New York endocrinologist Judith Korner, MD, who is the director of the Metabolic and Weight Control Center at Columbia University. “They belong to a family of medicines known as GLP-1 analogues that are designed to regulate hunger.” Dr. Korner says patients who participated in the clinical trial lost up to 15 percent of their weight, which is an impressive result compared to other weight-loss medications. 

How Does Semaglutide Work?

According to Dr. Korner, the drug works by mimicking a hormone that our body makes when it senses food in the intestine. “This helps the pancreas make insulin when glucose levels are high. The GLP-1 receptor agonists were initially developed to treat Type 2 diabetes,” she explains. 

“The main way semaglutide works is in the stomach, in the gut,” shares Dr. Chioma Okafor-Mbah, a board-certified obesity specialist. “It slows the intestinal transit, or the motility. It basically makes you feel full for longer so you’re not craving in between meals. You’re also fuller for longer because the food is moving much slower through your system. The other way that it works is on the appetite center of the brain. It sends a message to your brain telling you that you’re not hungry.”

How Effective Is Semaglutide?

Dr. Korner says that in a 68-week trial with nearly 2,000 participants with a BMI of 27 or more, the group taking semaglutide dropped an average of 15 percent, compared to the only 2.4 percent in the placebo group. Both groups involved in the clinical trials included diet and exercise in their treatment. 

What Is Compounded Semaglutide?

The name brand of semaglutide is Ozempic and Wegovy, but some practitioners are now offering compounded semaglutide which is dispensed in their own office. This can lower the price of the medication substantially, with some physicians charging $400 versus the over $1,000 monthly cost of the branded drug. “When we write a prescription, you can have a compounding pharmacy mix the formula based on what the doctor has prescribed, and then they will provide that specifically for you,” Dr. Chioma explains. “You want to make sure that if you’re getting medication compounded, especially medication that should be sterile, that its coming from a pharmacy that’s FDA-regulated and that they’ve met all the standards for safety and the products they’re producing are sterile.”

Are the Side Effects Really That Bad?

It’s important to remember that every medication has side effects, says Dr. Chioma, who runs a weight-management program at LC Medical Spa in New York. “The most common side effects of semaglutide or any medication in that same GLP-1 category, is nausea, diarrhea, constipation, and upset stomach. Some people might experience vomiting, too, or burping or gassiness—so a lot of gastrointestinal side effects, but everyone reports different experiences. Some may have one or two side effects for a few days, some may not experience them at all. It really varies but for many patients it’s an easy tradeoff for the movement they’re able to see on the scale.”

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