Robert Ziltzer, MD FACP, FAAP, FOMA
We’re always skeptical about new treatments for obesity, and for good reason. Marketers flood the web with miracle cures for obesity that often fails to deliver. But every once in a while, a drug comes to the market that changes the landscape in the treatment of obesity. Today, one such drug is Semaglutide.
What is Semaglutide?
Semaglutide is a modified molecule our bodies make, GLP1. It’s a protein made in the intestine and results in a decrease in blood sugars and appetite. A small change in the molecule allows the drug to last weeks in our bodies rather than minutes. Originally used for diabetes and sold under the name Ozempic®, Semaglutide is a higher dose of the same drug for weight loss. The results were dramatic.
Wilding et al, Once-Weekly Semaglutide in Adults with Overweight or Obesity. NEJM, February 10, 2021.
Research on Semaglutide and Weight Loss
In the study above, participants with obesity (BMI >30) took 2.4 mg Semaglutide each week for 68 weeks. The treatment group lost about 15% body weight (37 lb for a 250 lb individual). The placebo group lost 2.4% body weight. You can expect even better results combined with a medical weight loss program. This includes medical-grade diets and other anti-obesity medications.
How Does Semaglutide Work?
Semaglutide acts in the following ways:
- Delays stomach emptying. This leads to a feeling of fullness and satisfaction with smaller meal sizes.
- Slows intestinal motility.
- Lowers blood sugars, in part by reducing the production of sugar in the liver.
- Stimulates insulin secretion by the pancreas.
Weight Loss Medications for Diabetes
Semaglutide is currently FDA-approved for the treatment of diabetes (type 2) at a dose of 1mg daily. It offers some of the best weight loss results of any diabetes medication. Some diabetes medications cause weight gain, like sulfonylureas and insulin. People with diabetes who need to lose weight should consider Semaglutide or one of the other GLP1 drugs (Bydureon, Trulicity, Victoza, Rybelsus-an oral form of Semaglutide).
More about Semaglutide
Source: Holst, Jens J The physiology of glucagon-like peptide 1.Physiol Rev. 2007 Oct;87(4):1409-39.
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