How Does Semaglutide Work? A Detailed Explanation

Understanding semaglutide

The active ingredient in popular medications used to treat type 2 diabetes and obesity, such as Wegovy, is semaglutide. Compounded Semaglutide* is a non-branded version of semaglutide with the exact same active ingredient as Ozempic and Wegovy. It’s made by specialized pharmacies and goes through rigorous testing to ensure the highest safety and quality standard, while also being up to 80% cheaper than branded alternatives. 

So, why does semaglutide cause weight loss and how does it result in weight loss and blood sugar regulation? Read on to find out.

How semaglutide works

Mechanism of Action

Semaglutide works by mimicking the action of a naturally occurring hormone within the body called GLP-1, or glucagon-like peptide-1. This hormone is involved in several key processes:

Appetite suppression

By targeting GLP-1 receptors in the part of the brain involved in appetite regulation called the hypothalamus, semaglutide reduces feelings of hunger and increases feelings of fullness. 

Delaying gastric emptying

Through actions on the central nervous system, semaglutide decreases the rate of gastric emptying, which is the rate at which food leaves your stomach. This helps you to feel fuller for longer after eating.

Enhancing insulin secretion

After you eat, insulin is released from cells of the pancreas in order to reduce blood sugar levels. Semaglutide enhances this effect, helping to regulate blood sugar levels after eating.

Reducing glucagon levels

The pancreas also releases another hormone called glucagon. Glucagon is usually released during periods of fasting and results in increases in blood sugar levels. Semaglutide works to suppress glucagon release, further contributing to blood sugar control.

Benefits of semaglutide for weight loss

Effectiveness in individuals with obesity

Semaglutide is highly effective in aiding weight loss in individuals with obesity, with clinical trials reporting an average bodyweight reduction of -14.9% after 68 weeks of once-weekly 2.4 mg semaglutide treatment. [1]

Wegovy, which contains semaglutide as its active ingredient, was approved by the FDA as a weight-management treatment in 2021. It is licensed to be prescribed in addition to lifestyle measures such as increased physical activity levels and reduced calorie diet. [2] Eligibility criteria include having a BMI of 30 or over, or 27 or over in the presence of at least one other weight-related health condition (such as prediabetes, high blood pressure or high cholesterol).

Benefits for individuals with type 2 diabetes

Semaglutide was originally approved for the treatment of type 2 diabetes. A 2017 clinical trial reported once-weekly 1 mg semaglutide treatment to significantly reduce HbA1c levels by 1.55% after 30 weeks. [3] Levels of HbA1c – or glycated haemoglobin – provide a snapshot of blood sugar control for the previous 2-3 months, and this clinically significant data transformed the landscape of type 2 diabetes treatments. Improvements in overall bodyweight were also reported, with a treatment difference of 3.54 kg when compared to control patients.

Ozempic, which also contains semaglutide as its active ingredient, was approved to treat type 2 diabetes by the FDA in 2017, to be prescribed alongside lifestyle measures including increased physical activity and a reduced calorie diet. [4] It can also be prescribed to reduce the risk of major adverse cardiovascular events in those with type 2 diabetes and established cardiovascular disease.

Lifestyle modifications

It is important to note that Wegovy and Ozempic are not miracle drugs for weight loss, and are licensed to be prescribed for type 2 diabetes and obesity as an adjunct to lifestyle modifications including a reduced calorie diet and increased physical activity. [2,4] With their appetite suppressing effects, it should be easier to adhere to a reduced calorie diet, while increasing physical activity can help to build or maintain muscle mass.

Dietary changes

Focus on nutrient-dense foods and incorporate non-starchy vegetables, whole grains, nuts and legumes into your diet. Increasing your protein [5] and fiber [6] intake can help you feel fuller longer, build and maintain muscle mass and promote digestive health. Practising portion control by using smaller plates and bowls can help to prevent overeating. Finally, ensure you are hydrated throughout the day by drinking plenty of water - current recommendations are 15.5 cups (3.7 liters) for men and 11.5 cups (2.7 liters) for women. [7]

Exercise and physical activity

According to the Center for Disease Control and Prevention, you should aim for 150 minutes of moderately-intense physical activity per week. [8] This can be split up to look like 30 minutes a day, for 5 days of the week. Additionally, 2 days of muscle-strengthening activity are recommended to promote increases in muscle mass.

Where to get weight loss medication

A GLP-1 medication like Compounded Semaglutide could help you achieve significant weight loss results. Start a consultation today to see if you're eligible for weight loss treatment with ZipHealth.

*Compounded drugs are permitted to be prescribed under federal law but are not FDA-approved and do not undergo FDA safety, effectiveness, or quality review.

References

1. Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, McGowan BM, Rosenstock J, Tran MTD, Wadden TA, Wharton S, Yokote K, Zeuthen N, Kushner RF; STEP 1 Study Group. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021 Mar 18;384(11):989-1002. doi: 10.1056/NEJMoa2032183. Epub 2021 Feb 10. PMID: 33567185.
2. https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/215256s007lbl.pdf
3. Sorli C, Harashima SI, Tsoukas GM, Unger J, Karsbøl JD, Hansen T, Bain SC. Efficacy and safety of once-weekly semaglutide monotherapy versus placebo in patients with type 2 diabetes (SUSTAIN 1): a double-blind, randomised, placebo-controlled, parallel-group, multinational, multicentre phase 3a trial. Lancet Diabetes Endocrinol. 2017 Apr;5(4):251-260. doi: 10.1016/S2213-8587(17)30013-X. Epub 2017 Jan 17. PMID: 28110911.
4. https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/209637s020s021lbl.pdf
5. Halton TL, Hu FB. The Effects of High Protein Diets on Thermogenesis, Satiety and Weight Loss: A Critical Review. Journal of the American College of Nutrition. 2004 Oct;23(5):373–85.
6. Reynolds AN, Akerman AP, Mann J. Dietary fibre and whole grains in diabetes management: Systematic review and meta-analyses. Ma RCW, editor. PLOS Medicine [Internet]. 2020 Mar 6;17(3):e1003053. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7059907/
7. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/water/art-20044256
8. https://www.cdc.gov/physical-activity-basics/guidelines/adults.html