For individuals struggling to lose weight despite a healthy diet and regular exercise, weight loss injectables offer a potential solution to overcome plateaus. These injections, particularly those involving GLP-1 receptor agonists, have gained popularity for their effectiveness. This article explores the landscape of at-home weight loss shots, their mechanisms, available options, benefits, risks, and considerations for safe and effective use.
Understanding Weight Loss Injections
Weight loss injections are prescription medications designed to aid in weight management. These medications can alter a person’s appetite and metabolism, curbing hunger and reducing calorie intake. They often mimic naturally occurring hormones in the body that are released after eating, promoting feelings of fullness and reducing overall food consumption. Doctors may recommend them to people who have a higher body mass index (BMI).
How Weight Loss Injections Work
Weight loss injections, such as those containing semaglutide, work by mimicking the hormone GLP-1 (glucagon-like peptide-1), which plays a key role in blood sugar regulation and appetite control. These injections lower blood sugar by reducing glucagon levels while increasing insulin production, which helps the body utilize glucose for energy. In addition, they act on the brain’s appetite-regulation centers, promoting feelings of fullness and reducing hunger, which supports sustainable weight loss.
GLP-1 Receptor Agonists: A Key Mechanism
GLP-1 receptor agonists work by mimicking a hormone called glucagon-like peptide-1 (GLP-1), which curbs hunger. GLP-1 also slows down the movement of food from the stomach to the small intestine - hence a feeling of fullness - and increases insulin production, lowering blood sugar. The gist? GLP-1 drugs make you eat less.
Determining Candidacy for Weight Loss Medications
Determining whether someone is a candidate for weight loss medications begins with BMI. The guidelines for tirzepatide (Zepbound) and semaglutide (Wegovy) state that a patient should have a BMI of 30 or a BMI of 27 with weight-related health problems. For each individual case, the doctor and patient should discuss the patient’s current health issues, other medications, and family medical history.
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Available Weight Loss Injection Options
Several brands of weight loss injections are available, each with its unique characteristics and FDA approvals.
Semaglutide (Wegovy, Ozempic)
Semaglutide is a GLP-1 receptor agonist administered weekly via injection. Wegovy is a brand name for semaglutide, a GLP-1 receptor agonist. It was FDA-approved in 2021. It is administered as an injection and approved for use in adults and children aged 12 years or more with obesity (BMI ≥30 for adults, BMI ≥ 95th percentile for age and sex for children) or some adults with excess weight (BMI ≥27) who also have weight-related medical problems. The dose must be increased gradually over 16 to 20 weeks to arrive at the 2.4 mg dosage. This progression can help to alleviate side effects, which include gastrointestinal symptoms, headache, dizziness, and fatigue. It is intended to be used indefinitely, in combination with a healthy diet and exercise.
Ozempic may be a more familiar name to some patients. Semaglutide and Ozempic are related but not identical. Semaglutide is the active ingredient found in several medications and is classified as a glucagon-like peptide-1 receptor agonist (GLP-1 RA), which helps regulate blood sugar levels, suppress appetite, and support weight loss. Ozempic, on the other hand, is a brand name for a medication that contains semaglutide. It is specifically approved for treating Type 2 diabetes and is administered as a weekly injection.
Tirzepatide (Zepbound, Mounjaro)
Zepbound is approved to treat obesity in adults with a BMI of 30 or greater. It is both a GLP-1 and a GIP receptor agonist. Like semaglutide, it works by reducing appetite and is meant to be used in combination with diet and exercise to lose weight. Tirzepatide is a dual GIP and GLP-1 receptor agonist that suppresses appetite, improves satiety, and supports metabolic health.
Mounjaro, which is indicated for type 2 diabetes, and Zepbound, which is indicated for obesity. In the SURMOUNT-1 trial, adults with obesity or overweight (without diabetes) taking tirzepatide achieved up to 22.5% average body weight reduction at 72 weeks.
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Liraglutide (Saxenda, Victoza)
Liraglutide is a daily injectable medication that acts on hormones that send signals from the gut to the brain to make the patient feel full quicker and decrease hunger signals. Doses start at 0.6 mg to 3 mg a day. Some patients may lose 5-10% of body weight, especially with the higher dose of liraglutide. Liraglutide is also approved for Type 2 Diabetes, under the brand name Victoza.
Comparing Semaglutide and Ozempic
Semaglutide and Ozempic are related but not identical.
| Feature | Semaglutide | Ozempic |
|---|---|---|
| What It Is | A medication ingredient (GLP-1 receptor) | A brand name for semaglutide medication |
| Purpose | Used in various drugs for Type 2 diabetes and weight management | Specifically used for Type 2 diabetes management |
| Administration | Available in different formulations (injectable, oral) | Injectable (weekly injection) |
| Brand Examples | Wegovy (for weight loss), Rybelsus (oral for diabetes) | Ozempic (diabetes-focused injectable) |
| FDA Approval | Approved for multiple uses, depending on the brand | Approved for Type 2 diabetes treatment |
| Dosage Frequency | Varies by formulation (daily for Rybelsus, weekly for injectables) | Weekly injection |
| Weight Loss Use | Yes, under brands like Wegovy | Sometimes used off-label for weight loss but not FDA-approved for it |
Benefits of Weight Loss Injections
Weight loss injections offer several potential benefits, including:
- Suppressing appetite, leading to reduced calorie intake.
- Increasing feelings of fullness and satiety.
- Delaying gastric emptying, which can help with blood sugar management.
- Lowering blood sugar levels, particularly for those with type 2 diabetes.
- Helping prevent weight-related conditions such as type 2 diabetes, high blood pressure, or heart disease.
- Supporting adherence to a diet plan.
Research from 2024 shows that, on average, a person loses 8% to 15% more weight with weight loss injections within 12 to 18 months than with diet, exercise, and oral medications alone.
Risks and Side Effects
Like all medications, weight loss injections carry potential risks and side effects. Common side effects include nausea, bloating, diarrhea, and constipation. These side effects can often be prevented by starting with low doses and gradually increasing them as tolerated.
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More serious side effects, though rare, can occur. These include:
- Thyroid cancer (a boxed warning exists for this risk, though studies have primarily shown it in rats).
- Gut issues.
- Severe mental health issues.
- Eating disorders such as anorexia nervosa.
- Gallbladder problems
- Kidney injury
- Pancreatitis
- Thoughts of suicide or self-harm
- Thyroid cancer
It is crucial to consult with a healthcare professional to understand whether weight loss injections are right for you and to discuss any potential risks based on your individual medical history.
Important Considerations
Prescription and Supervision
With prescription medications, a healthcare professional can weigh all factors affecting the patient’s lifestyle and BMI and monitor progress and side effects.
The Importance of Lifestyle Changes
All weight loss medications work best in the context of a healthy eating plan and exercise. A treatment plan for obesity can comprise multiple forms of treatment, including medications, diet, exercise, and/or surgery. Patients taking GLP-1s should prioritize fruits and vegetables; whole grains; lean protein; and the healthy fats found in olive oil, nuts, and seeds.
Insurance Coverage and Cost
Insurance coverage varies and will affect many patients’ choices about going on weight loss medications. GLP-1s are notoriously costly. The Kaiser Family Foundation estimates the annual net price of Wegovy at $13,600.
Potential for Weight Regain
Most people regain weight if AOMs are discontinued. After weight reduction, the body metabolically adapts, often causing an increase in hunger hormones and a decrease in satiety hormones and resting metabolic rate, all of which can contribute to weight regain. AOMs may counter the effects of metabolic adaptation and prevent weight regain.
The Role of Healthcare Professionals
It is important for a person to consult a healthcare professional to understand whether weight loss injections are right for them. A nurse or doctor can teach a person how to use the weight loss injection so they can do it themselves at home.
Addressing the Underlying Reasons for Obesity
It is important to address the underlying reasons for obesity, as weight loss injections may only mask a problem.
Compounded Semaglutide
Compounded versions of medications are made by compounding pharmacies, often to tailor a medication to specific patient needs, like an allergy to an inactive ingredient. Compounded medications are not FDA-approved.
The Future of Weight Loss Medications
With fervent consumer demand for weight loss medications, combined with rising obesity rates, more medications are bound for the market in the coming years. Researchers continue to study hormones that play a role in appetite for other ways to target obesity with medication. Those of interest include not only GLP-1, but also peptide tyrosine-tyrosine (PYY) and cholecystokinin (CCK). With more options available, doctors will be increasingly able to personalize treatments.
Semaglutide: What You Need to Know
Semaglutide promotes weight loss. It may also be used to maintain weight loss. It works by decreasing appetite. It can be used to lower the risk of heart attack and stroke in people affected by excess weight. Changes to diet and exercise are often combined with this medication.
Before Taking Semaglutide
They need to know if you have any of these conditions:
- Diabetes
- Eye disease caused by diabetes
- Gallbladder disease
- Have or have had depression
- Have or have had pancreatitis
- Having surgery
- Kidney disease
- Personal or family history of MEN 2, a condition that causes endocrine gland tumors
- Personal or family history of thyroid cancer
- Stomach or intestine problems, such as problems digesting food
- Suicidal thoughts, plans, or attempt
- An unusual or allergic reaction to semaglutide, other medications, foods, dyes, or preservatives
- Pregnant or trying to get pregnant
- Breastfeeding
How to Use Semaglutide
This medication is injected under the skin. You will be taught how to prepare and give it. Take it as directed on the prescription label. It is given once every week (every 7 days). Keep taking it unless your care team tells you to stop.
It is important that you put your used needles and pens in a special sharps container. Do not put them in a trash can. If you do not have a sharps container, call your pharmacist or care team to get one.
What to Watch for While Using Semaglutide
- Visit your care team for regular checks on your progress. Tell your care team if your condition does not start to get better or if it gets worse.
- Tell your care team if you are taking medication to treat diabetes, such as insulin or glipizide. This may increase your risk of low blood sugar. Know the symptoms of low blood sugar and how to treat it.
- Talk to your care team about your risk of cancer. You may be more at risk for certain types of cancer if you take this medication. Talk to your care team right away if you have a lump or swelling in your neck, hoarseness that does not go away, trouble swallowing, shortness of breath, or trouble breathing.
- Make sure you stay hydrated while taking this medication. Drink water often. Eat fruits and veggies that have a high water content. Drink more water when it is hot or you are active. Talk to your care team right away if you have fever, infection, vomiting, diarrhea, or if you sweat a lot while taking this medication. The loss of too much body fluid may make it dangerous for you to take this medication.
- If you are going to need surgery or a procedure, tell your care team that you are taking this medication.
Potential Side Effects
- Allergic reactions-skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Change in vision
- Dehydration-increased thirst, dry mouth, feeling faint or lightheaded, headache, dark yellow or brown urine
- Fast or irregular heartbeat
- Gallbladder problems-severe stomach pain, nausea, vomiting, fever
- Kidney injury-decrease in the amount of urine, swelling of the ankles, hands, or feet
- Pancreatitis-severe stomach pain that spreads to your back or gets worse after eating or when touched, fever, nausea, vomiting
- Thoughts of suicide or self-harm, worsening mood, feelings of depression
- Thyroid cancer-new mass or lump in the neck, pain or trouble swallowing, trouble breathing, hoarseness