Semaglutide & Weight Loss
Semaglutide is one of several GLP1 analogue medications. These medications work by activating the GLP-1 receptor which is involved in the secretion of insulin and control of blood sugar. GLP-1 is normally made in the small bowel. These medications were developed to treat Type II diabetes and have been approved for this indication for over 10 years.
During the development of the GLP-1 analogues, investigators noticed that patients were losing weight in addition to controlling their blood sugars. For this reason, the medications were studied for use in the treatment of overweight and obesity. As of 2022 there are two GLP1 analogues approved by the FDA for this use, liraglutide and semaglutide. Semaglutide is the most readily available and has been used very successfully for the management of overweight and obesity. More recently tirzepatide has also been approved for weight loss. This medication is a GIP analog in addition to GLP analog. Since it interacts with two receptors, theoretically it is more effective than semaglutide for weight loss. Patient response is individual and tirzepatide is more expensive and not necessarily a better option. Patients interested in these medications for weight loss should make an appointment for evaluation and discussion of possible use. Please be aware that these medications will NOT be covered by your insurance for weight loss. Therefore, our office works with an FDA regulated compounding pharmacy to supply these mediations at a lower cost than branded products. Our office does not do prior authorizations (PA) for semaglutide and does not write prescriptions for branded products.
Weight loss with semaglutide use can vary according to the patient's individual factors but studies have shown that patients using semaglutide and lifestyle changes can lose up to 33.7 pounds (15.3 Kg) compared to 5.7 pounds (2.6 Kg) with lifestyle changes alone.
These medications mimic the action of a hormone called glucagon-like peptide 1. When blood sugar starts to rise after eating, these drugs stimulate the body to produce more insulin. The extra insulin helps lower blood sugar levels. Lower blood sugar levels are helpful for controlling type 2 diabetes. It is not clear how the GLP-1 medications lead to weight loss. GLP-1 medications appear to help curb hunger and slow the movement of food from the stomach into the small intestine. As a result, you may feel fuller faster and eat less. In addition, GLP-1 medications appear to have other major benefits, such as decrease in blood pressure, cholesterol and decrease risk of heart disease. These medications may lower the risk of stroke and kidney disease. It is not clear if these benefits are from the medication itself or from the weight loss that the medication induces.
GLP medications are taken by a once weekly subcutaneous injection. Side effects include nausea, vomiting, diarrhea, pancreatitis, gallstone attacks and may increase the risk of adverse events with anesthesia. Caution should be used when giving GLP-1 medications with other diabetes medications due to the risk of low blood sugar. Finally, the GLP-1 medications are not recommended if a person has a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia. These medications have been linked to thyroid tumors in rats but currently there are not any reports in humans. Until more long-term studies are done, the risk to humans is unknown.
If you are interested in making an appointment for semaglutide, ask for a semaglutide consultation with Dr. Jose Garcia. Prices vary patient to patient but in most cases the medication cost under $200 per month.
