An early study of 1,961 obese adults compared people using semaglutide plus a diet and exercise program with people who made the same lifestyle changes without semaglutide. After 68 weeks, half of the participants using semaglutide lost 15% of their body weight, and nearly a third lost 20%.

Participants who incorporated only lifestyle changes lost about 2.4% of their weight.

“The fundamentals of obesity management will always be changes to diet and exercise,” Dr. Surampudi says.

“But having anti-obesity medications is another tool in the toolbox — depending on the person’s clinical history.”

The New England Journey of Medicine

Once-Weekly Semaglutide in Adults with Overweight or Obesity

March 18, 2021N Engl J Med 2021; 384:989-1002

Appetite Reduction

 GLP-1's aid by impacting areas in the brain—to help curb cravings, make you feel full faster, and increase your energy expenditure.

Digestion Regulation 

GLP-1's slow how quickly food moves from the stomach to the intestines. This helps you feel full for longer by regulating sugar absorption in the intestine. 

Inflammation Reduction

 GLP-1's are clinically proven to reduce inflammation markers, leading to decreased inflammatory response and oxidative stress. 

Metabolic Function Improvement
 GLP-1's regulate blood sugar levels by increasing insulin and decreasing glucagon—only when blood sugar levels are high. GLP-1's also improve whole-body energy metabolism by increasing insulin sensitivity of muscle cells and regulating fat cell development. GLP-1 is available as a single-use injection.   You’ll get the injection once a week, on the same day each week. It can be given at any time of day, and you can take it with or without food.   GLP-1 is typically injected just under the skin (subcutaneously) in your abdomen. Avoid injecting the medication into the same spot every time — change your injection site with each dose. But injecting in the same body area (e.g., abdomen) is OK as long as you’re rotating sites within the area each time.  Since GLP-1 slows down how quickly food leaves your stomach, you may experience side effects like nausea and vomiting. Once you get started on the medication, your provider will slowly raise your dosage every 2 weeks to help make these effects more manageable.   Some people may not be able to reach or tolerate the target dose due to side effects. If this is the case, your provider may wait another month before raising your dose. However, they may have you discontinue the medication if you’re unable to reach or stay on the target dose.

The FDA recommends semaglutide for weight loss if you meet one of the following criteria:

Have a body mass index (BMI) of 27kg/m2 or greater and at least one weight-related condition,such as high blood pressure, Type 2 diabetes or high cholesterol. Have a BMI of 30kg/m2 or greater.

GLP-1 is safe and effective with many pre-existing conditions, with the exception of the following: 

- Currently being treated for Cancer

- Type 1 Diabetes

- Currently pregnant, or planning to become pregnant in next 6 months

- Currently Breastfeeding

- Active eating disorder

- Active gallbladder disease-

Active substance abuse or dependency

- Bariatric Surgery (within the past 18 months)

- Pancreatitis within past 6 months, or a history of pancreatitis caused by taking a GLP-1

- History of Medullary thyroid cancer, or MEN syndrome

GLP-1 carries a boxed warning about thyroid C-cell tumors occurring in rodents (with unknown risk in humans), and GLP-1 shouldn’t be used if you or your family have a history of certain thyroid cancers. GLP-1 should not be used in people with type-1 diabetes or a history of pancreatitis. GLP-1 should be used cautiously for people on other blood sugar lowering medications.  Potential side effects:Gastrointestinal (GI) side effects tend to happen most frequently when using this medication — the most common being nausea, diarrhea, and vomiting. You may experience these effects more strongly when your provider raises your dose.Additional common side effects can include:  Constipation, Stomach pain, Headache, Fatigue, Indigestion, Dizziness, Bloating, Burping