Is Semaglutide Safe? Risks And Benefits Explained

Overview of Semaglutide

Semaglutide is the active ingredient in popular medications used to treat type 2 diabetes and obesity, such as Ozempic and Wegovy. 

Semaglutide mimics the action of a naturally occurring hormone in the body called GLP-1, or glucagon-like peptide-1. By targeting GLP-1 receptors present throughout the body, semaglutide works to increase insulin secretion from the pancreas in response to eating, helping to lower blood sugar levels.

It also works on the region of the brain involved in appetite regulation, by signalling a feeling of fullness and reducing appetite. Semaglutide also slows down the rate at which food leaves your stomach, helping you to feel fuller for longer.

Effectiveness in Weight Loss

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 in individuals with a BMI of 30 or over, or in those with a BMI of 27 and over in the presence of at least one other weight-related health condition (such as prediabetes, high blood pressure and high cholesterol). [2]

Compounded Semaglutide* is a non-branded version of semaglutide which contains the exact same active ingredient as Wegovy, therefore it is also highly effective in achieving substantial weight loss. 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. 

Side Effects of Semaglutide

Like all medications, semaglutide can have various side effects, ranging from common and mild to more severe.

Common Gastrointestinal Issues

Studies have shown that the most common side effects of semaglutide are gastrointestinal issues, with 43.9% of patients on 2.4 mg semaglutide reported to have experienced nausea, 29.7% experienced diarrhea, 24.5% experienced vomiting, and 24.2% experienced constipation. [3] 

Severe Conditions: Pancreatitis and Thyroid Cancer

More severe side effects can include pancreatitis, which is inflammation of the pancreas, and thyroid cancer. 

Pancreatitis has been noted in clinical trials, and symptoms to look out for include persistent and severe abdominal pain, which sometimes radiates to the back, which may or may not be accompanied with vomiting. [2] It is important that semaglutide treatment is stopped if pancreatitis is suspected.

Studies of semaglutide treatment in rodents have found the formation of thyroid C-cell tumours. While this effect is not yet known in humans, semaglutide-containing medications come with a boxed warning and cannot be prescribed to patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with multiple endocrine neoplasia syndrome type 2 (MEN2). [2]

Psychological Implications

Mental Health Considerations

There are mixed results regarding semaglutide treatment and mental health disorders. A clinical trial found no clinically meaningful change in average depression scores among participants taking semaglutide. [4]

However, a study analyzing the World Health Organization's global database found a slightly higher than expected rate of suicidal ideation reports associated with semaglutide use, particularly among patients with anxiety or depression. [5]

The FDA recommends that patients taking Wegovy should be monitored for depression or suicidal thoughts, and treatment should be discontinued if symptoms develop. [2]

Connection to Disordered Eating

A clinical trial is currently underway to assess the effect of semaglutide treatment on disordered eating behaviour in overweight patients with type 2 diabetes. [6]

Due to the roles of semaglutide on appetite regulation and eating behaviour, research is ongoing to assess its potential effects in binge eating disorder and bulimia nervosa [7], to aid a better understanding of its impact on disordered eating.

FDA Concerns and Unapproved Forms

It is important to note that while Compounded Semaglutide* is permitted to be prescribed under federal law, these medications are not currently approved by the FDA and therefore do not undergo FDA safety, effectiveness, or quality review.

However, Compounded Semaglutide* is made by specialized pharmacies to ensure a high-quality product that adheres to strict safety protocols, with a proven track record of consistency and medical effectiveness.

Risks of Compounded Versions

The risks of Compounded Semaglutide* are the same as the branded alternatives of the medication, due to the active ingredient being semaglutide. Therefore, the mild and more severe side effects are the exact same as those listed above.

ZipHealth ensures an extensive quality, safety testing and monitoring process is followed for all of our compounded medication.

Dosing Errors 

Semaglutide treatment begins with a low dose which gradually increases every four weeks to ensure optimal results and minimize side effects. When starting Compounded Semaglutide*, the initial dose is 0.25 mg, injected once a week for the first four weeks.

After this period, the dosage will be increased every four weeks, as tolerated. If you miss a dose of Compounded Semaglutide*, your healthcare provider will advise you when to take your next dose or if you should skip the missed dose and begin again on the next scheduled day.

How to Buy Semaglutide Safely

Semaglutide is available to buy on ZipHealth. Find out what treatment is suitable for you on our website.

Conclusion: Weighing the Risks and Benefits

Semaglutide is considered safe for most patients. Like all medications, it can cause side effects, but there are no unexpected safety issues that have arisen to date.

It is important to consult with your healthcare provider to assess individual risks and benefits. You will be closely monitored during semaglutide treatment to manage potential side effects and ensure optimal safety.

*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. Wharton S, Calanna S, Davies M, Dicker D, Goldman B, Lingvay I, Mosenzon O, Rubino DM, Thomsen M, Wadden TA, Pedersen SD. Gastrointestinal tolerability of once-weekly semaglutide 2.4 mg in adults with overweight or obesity, and the relationship between gastrointestinal adverse events and weight loss. Diabetes Obes Metab. 2022 Jan;24(1):94-105. doi: 10.1111/dom.14551. Epub 2021 Oct 4. PMID: 34514682; PMCID: PMC9293236.
4. Wadden TA, Brown GK, Egebjerg C, Frenkel O, Goldman B, Kushner RF, McGowan B, Overvad M, Fink-Jensen A. Psychiatric Safety of Semaglutide for Weight Management in People Without Known Major Psychopathology: Post Hoc Analysis of the STEP 1, 2, 3, and 5 Trials. JAMA Intern Med. 2024 Nov 1;184(11):1290-1300. doi: 10.1001/jamainternmed.2024.4346. PMID: 39226070; PMCID: PMC11372653.
5. Schoretsanitis G, Weiler S, Barbui C, Raschi E, Gastaldon C. Disproportionality Analysis From World Health Organization Data on Semaglutide, Liraglutide, and Suicidality. JAMA Netw Open. 2024;7(8):e2423385. doi:10.1001/jamanetworkopen.2024.23385
6. https://mentalhealth.networkofcare.org/Lake/CommunityResources/ClinicalTrials/Detail/NCT06243536?keyword=%22Semaglutide%22
7. Aoun L, Almardini S, Saliba F, Haddadin F, Mourad O, Jdaidani J, Morcos Z, Al Saidi I, Bou Sanayeh E, Saliba S, Almardini M, Zaidan J. GLP-1 receptor agonists: A novel pharmacotherapy for binge eating (Binge eating disorder and bulimia nervosa)? A systematic review. J Clin Transl Endocrinol. 2024 Feb 29;35:100333. doi: 10.1016/j.jcte.2024.100333. PMID: 38449772; PMCID: PMC10915596.