What Is Semaglutide? Everything You Need To Know

Semaglutide is the active ingredient in popular medications used to treat type 2 diabetes and obesity, such Wegovy. Here, we unpack exactly how it works, common side effects and how to find out if you're eligible for treatment. 

How semaglutide works in the body

Semaglutide works as a GLP-1, or glucagon-like receptor-1, agonist. It mimics the action of a naturally occurring hormone in the body called GLP-1. By doing so, semaglutide works to increase insulin secretion from the pancreas in response to eating, lowering blood sugar levels to help reduce cravings. 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.

Benefits of semaglutide

Weight management

Semaglutide under the brand name Wegovy was approved by the FDA as a weight management treatment in the USA in 2021. It is licensed to be prescribed in addition to lifestyle measures such as increased physical activity levels and reduced calorie diet. [1] It proved to be highly effective in aiding weight loss, with clinical trials reporting an average bodyweight reduction of 14.9% after 68 weeks of once-weekly 2.4mg semaglutide treatment. [2]

Glycemic control in type 2 diabetes

Semaglutide under the brand name Ozempic 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. [3] A clinical trial reported once-weekly 1mg semaglutide treatment to significantly reduce HbA1c levels by 1.55% after 30 weeks. [4] HbA1c (glycated haemoglobin) levels provide a snapshot of blood sugar control for the previous 2-3 months. Higher HbA1c levels indicate a higher likelihood of developing diabetes, meaning this data transformed the landscape of type 2 diabetes treatments.

Compounded Semaglutide* is a non-branded version of semaglutide but works in the same way as Wegovy. It’s made by specialized pharmacies and can be up to 80% cheaper than branded alternatives. It is important to note that Compounded Semaglutide* goes through rigorous testing to ensure the highest safety and quality standard.

Side effects of semaglutide

Common side effects

Like any medication, semaglutide can cause side effects. The good news is that these are mainly gastrointestinal and usually mild. Studies have shown that 43.9% of patients on 2.4mg semaglutide experienced nausea, 29.7% experienced diarrhoea, 24.5% experienced vomiting, and 24.2% experienced constipation. [5] Most people find they’re more likely to experience side effects temporarily when they start treatment or when their dose increases.

Serious side effects

Other more serious side effects and risks of semaglutide include increased heart rate, pancreatitis and thyroid tumours. It is important to note that these are rare, but you should be aware of warning signs and seek medical attention if you notice anything new that alarms you.

Pancreatitis (swelling of the pancreas) has been noted in clinical trials, and symptoms of this can include persistent and severe abdominal pain, which sometimes radiates to the back, which may or may not present with vomiting. [1] It is important that you stop treatment immediately and seek medical attention if pancreatitis is suspected.

Increases in resting heart rate have also been noted with semaglutide use. You should speak to your healthcare practitioner if you notice a racing heartbeat at rest or heart palpitations while on your treatment. [1]

Studies of semaglutide treatment in rodents have noted the formation of thyroid C-cell tumours. While this effect has not been studied in humans, semaglutide 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). [1]

Lifestyle adjustments

As semaglutide suppresses appetite, it is easier to adhere to a reduced calorie diet. Increasing physical activity levels can ensure the increase or maintenance of muscle mass, which can sometimes be lost during rapid weight loss. 

The implementation of lifestyle changes in addition to semaglutide results in sustainable weight loss and supports an ongoing commitment to healthy eating and exercise.

Maintaining weight loss after treatment

Clinical trials have shown that after stopping semaglutide treatment, weight regain occurs, which can be as much as +6.9% of body weight after 48 weeks after treatment cessation. [6] Semaglutide should be viewed as a long-term treatment plan for either obesity or type 2 diabetes and not as a ‘quick fix’ for weight loss. 

Who should use semaglutide?

Ozempic can be prescribed to treat type 2 diabetes in addition to lifestyle changes. It can also be prescribed to reduce the risk of major cardiovascular events in adults with type 2 diabetes and established cardiovascular disease. [3]

Wegovy can also be prescribed for weight loss in addition to lifestyle changes if your BMI is 30 or over, or if your BMI is 27 or over in the presence of at least one other weight-related health condition (such as prediabetes, high blood pressure or high cholesterol). [1]

At ZipHealth, Compounded Semaglutide is an injectable weight loss drug for people with a BMI over 27. If you have Type 2 diabetes or a BMI less than 27, we can’t prescribe you Compounded Semaglutide for weight loss.

Where to get semaglutide?

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] HIGHLIGHTS OF PRESCRIBING INFORMATION [Internet]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/215256s007lbl.pdf 

[2] 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.

[3] HIGHLIGHTS OF PRESCRIBING INFORMATION [Internet]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/209637s020s021lbl.pdf 

[4] 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.

[5] 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.

[6] Rubino D, Abrahamsson N, Davies M, Hesse D, Greenway FL, Jensen C, Lingvay I, Mosenzon O, Rosenstock J, Rubio MA, Rudofsky G, Tadayon S, Wadden TA, Dicker D; STEP 4 Investigators. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA. 2021 Apr 13;325(14):1414-1425. doi: 10.1001/jama.2021.3224. PMID: 33755728; PMCID: PMC7988425.