If you're exploring weight loss options, you may have come across semaglutide, a medication gaining popularity for its effectiveness. Semaglutide, known by brand names like Wegovy and Ozempic, is a GLP-1 receptor agonist initially developed for type 2 diabetes. However, its ability to suppress appetite and regulate blood sugar has made it a popular choice for weight loss. This article provides a comprehensive overview of what you can expect when starting semaglutide, particularly during the first week, and how it works over the long term.
Understanding Semaglutide
Semaglutide belongs to a class of medications called GLP-1 receptor agonists. These drugs mimic the glucagon-like peptide-1 (GLP-1) hormone in your body, which plays a crucial role in regulating appetite and blood sugar levels. Semaglutide works by activating GLP-1 receptors, reducing appetite, slowing stomach emptying, and controlling hunger, leading to fewer cravings and smaller portion sizes. This helps create a calorie deficit, essential for weight loss.
FDA Approval and Uses
Wegovy (semaglutide) is approved by the Food and Drug Administration (FDA) for weight management in certain people who are overweight or have obesity. It’s a once-weekly injection. People with overweight also must have at least one weight-related condition, such as high blood pressure, diabetes, or dyslipidemia. Wegovy is also FDA approved to reduce the risk of major cardiovascular (heart and blood vessel) events in adults. Recently, Wegovy received FDA accelerated approval to treat MASH without cirrhosis in adults who have moderate to advanced liver fibrosis. (MASH was formerly known as nonalcoholic steatohepatitis [NASH].) Final approval of the MASH indication may depend on further study.
What to Expect in the First Week of Semaglutide Treatment
Many people want to know what to expect, especially in the first week of treatment. Most patients do not experience dramatic weight loss in the initial 1-2 weeks. The effects of this medication tend to build gradually over the first few months. While initial results may seem small, consistency is key.
Modest Weight Loss
In the first week of semaglutide treatment, it's unlikely you'll see any noticeable changes in your weight. Most patients do not experience dramatic weight loss in the initial 1-2 weeks. The effects of this medication tend to build gradually over the first few months. Expect 1-5 lbs of weight loss in the first 1-2 weeks, primarily due to fluid loss, reduced food intake, and appetite suppression. However, significant fat reduction takes time, and rapid large drops in weight are uncommon in the first week.
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Changes in Health Markers
Even if you don't see a change on the scale, your doctor may notice changes in some of your health markers, such as blood pressure or blood sugar levels.
Potential Side Effects
In their first week of treatment, some people may develop side effects. These might occur within hours to days of their first dose. But the timing and degree of side effects vary widely among people. Semaglutide is administered as a simple, painless weekly injection. The most common include mild to moderate nausea, vomiting, diarrhea, and stomach discomfort.
Common first-week side effects include:
- Nausea and vomiting
- Diarrhea
- Constipation
- Abdominal pain
- Headache
- Fatigue
- Upset stomach
- Dizziness
- Bloating
- Burping
- Gas
- Low blood sugar in people who have type 2 diabetes
Semaglutide Dosage and Administration
Semaglutide is administered as a simple, painless weekly injection. Your dosage will then be gradually increased over the first 5 to 8 weeks until reaching the optimal maintenance dosage of between 0.5 mg to 1.0 mg weekly. The first dose is small (0.25 mg). At Rivas Medical Weight Loss, we understand that it is possible to “out-eat” any weight loss medication. If you were to obtain branded Wegovy, you would receive one month’s worth of injections at a time and increase no faster than one month at a time. In other words, you would receive one month (4 injections) of 0.25 mg, one month (4 injections) of 0.5 mg, and so forth to 1.0 mg, 1.7 mg, and finally 2.4 mg, assuming your side effects are minimal.
It’s crucial to adhere to the prescribed dosage and carefully follow your provider’s instructions when using semaglutide. At Ethos Spa, our medical experts will collaborate with you to determine the ideal customized dosage and provide ongoing monitoring for safety and efficacy. How fast we increase the dose for our patients is individualized and tailored to the needs of each patient. We can accomplish this because we do not use branded Wegovy. Therefore, no two patients have the same rate of increase.
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What Results Can You Expect in the First Month and Later?
It depends. Some people may find that Wegovy is effective for weight loss. Others might not lose much or any weight. Losing weight can take longer for some people, and it may be affected by the dosage of Wegovy and the length of treatment.
Gradual Weight Loss Over Time
While semaglutide promotes weight loss through several mechanisms, it does not magically melt fat away overnight. Most people begin seeing weight loss results within 8-12 weeks. For those who continue using semaglutide for a year or more, total weight loss may reach up to 15% of initial body weight.
A 2021 study compared weight loss in people taking semaglutide and people taking a placebo. (Remember, semaglutide is the active ingredient in Wegovy. A placebo is a substance with no active drug or ingredient.) Researchers found that weight loss measured at the marker of 4 weeks was statistically significant in those taking semaglutide. They also found that weight loss reached its maximum at 60 weeks of treatment.
In other studies, researchers examined weight loss with semaglutide and specific dosages. They found that weight loss was generally greater with higher doses of semaglutide. In summary:
- Weight loss at 12 weeks measured: 4% among people using 1-milligram (mg) injections weekly, 5% among people using 2.4-mg injections weekly
- Weight loss by 28 weeks measured: 7% among people using 1-mg injections weekly, 9.6% among people using 2.4-mg injections weekly
Potential Long-Term Benefits
Semaglutide treatment can lead to several health-related differences in how you feel. These may include:
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- Reduction in overweight or obesity
- Improvement in cardiovascular risk markers
- Lowered blood pressure
- Lowered blood sugar
- Decreased lipid levels (Lipids are chemical elements in the body’s cells.)
- Changes in certain proteins that may reduce inflammation
- Improved overall functioning of the body
Benefits for MASH Patients
With Wegovy treatment for MASH, you could notice reduced liver inflammation, which was noted in the study. Reduced liver inflammation may lead to:
- Less fatigue
- Improvement in skin color
- Less nausea and vomiting
- Reduced pain, especially in the belly area
- Reduction in liver fibrosis (scarring)
Managing Side Effects
It’s not uncommon to experience side effects after your first week of Wegovy treatment. But keep in mind that the timing and degree of side effects vary widely among people. Wegovy side effects generally lessen over time as your body adjusts to the medication. You may be able to reduce some side effects of Wegovy by adjusting your dose. But it’s important not to adjust your dose without first discussing it with your doctor. Some people develop serious side effects. In these cases, your doctor may recommend reducing your dose or stopping the medication.
Tips for Managing Common Side Effects
- Nausea and vomiting: If you develop nausea or vomiting, it’s a good idea to talk with your doctor. Either side effect could be a sign of gallbladder problems or pancreatitis. You might try the following home remedies to help reduce nausea: drinking small sips of cold drinks, avoiding greasy or fatty foods, eating bland foods, such as crackers, rice, or applesauce, and avoiding exercise after eating.
- Constipation: If you have constipation, you may be able to relieve it by drinking more fluids, exercising regularly, and increasing your fiber intake. Your doctor may recommend over-the-counter (OTC) treatments for constipation if home remedies are not effective.
- Diarrhea: When you have persistent diarrhea, stay hydrated to prevent dehydration. It’s also a good idea to avoid caffeine and alcohol (if you drink). Broths or sports drinks can help replenish your levels of electrolytes.
Maximizing Weight Loss with Semaglutide
You can help increase or promote weight loss with Wegovy in several ways. This section discusses a few of those.
Diet and Nutrition
For several of Wegovy’s prescribed uses, doctors also prescribe a diet with fewer calories. To intake fewer calories, you can choose foods that are dense in nutrients. These include fruits, vegetables, whole grains, and healthy protein sources.
- Rightsize your portions: You can help intake fewer calories when you control portion sizes. Try to form the habit of checking serving sizes on nutrition labels to guide your portion sizes. Rather than using a dinner plate, you can select a smaller dish and fill it with one serving.
- Eat slowly: Eat at a slower pace. Enjoy the textures, aromas, and flavors of your food.
Hydration
Water can help you feel full. Plus, it can keep you energized and hydrated. Keep a water bottle nearby and even in several places so you’ll always have one handy.
Physical Activity
Along with prescribing fewer calories, doctors also may prescribe increased physical activity with Wegovy. Some suggestions are:
- Find what’s fun in fitness: Discover ways to stay active that you can enjoy. Explore by walking, dancing, jogging, weightlifting, playing tennis, or doing other activities that keep you moving.
- Go with a buddy: Plan physical activities with family and friends. While you spend time together, you can work toward your weight-management goals.
- Bundle the activity with what interests you: Do your workout or activity with something that makes you want to do it. You could try working out or other physical activity while you: listen to music you love, catch up on your favorite TV program, listen to a podcast, or explore your favorite park.
- Change up activities: Try changing activities here and there to keep your interest high. You could try walking vigorously one day and then running lightly the next. Or use weights while you walk or dance instead of just weightlifting.
The Importance of Lifestyle Changes
Semaglutide, or any other weight loss medication, is a tool to assist in weight loss while the patient makes other lifestyle changes. No magic pill (or injection) will change your relationship with food. Nutrition is an essential factor in weight loss.
The Role of Semaglutide in Appetite Control
It’s believed that Wegovy decreases appetite due to direct and indirect effects on the brain. This causes you to eat less food (thus taking in fewer calories), which results in weight loss. This may help reduce some cardiovascular and other risks associated with obesity, overweight, and MASH.
During Wegovy treatment, you might notice some things in how you feel. You might experience differences in:
- Your appetite: With Wegovy, people generally recognize when they’re full after a snack or a meal. Some also report staying full longer. Others note that they eat less.
- Food cravings: Numerous people find that they have fewer cravings for certain foods. They find that they’re able to ignore cravings to snack or eat more easily.
- Wanting to eat: Some people are familiar with the desire to eat when they’re not hungry. With Wegovy, they may experience that desire less.
- Food choices: Compared with their before-treatment choices, many people report that they choose healthier foods to eat. They also note that they can account for why they made these choices.
- Some day-to-day choices: With Wegovy, people sometimes find that they make different choices about activities. Some make choices that are not centered around food, such as going out but not necessarily going out to eat.
Who is Semaglutide Suitable For?
Semaglutide is suitable for individuals who are looking to lose weight and can commit to the treatment plan. It is not recommended for people with certain health conditions, such as a history of thyroid cancer, pancreatitis, or other severe medical issues. Semaglutide can be an effective tool in your weight loss journey when used in conjunction with a healthy lifestyle.
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