Semaglutide is a medication gaining traction in weight management, but what do reviews and research say about its effectiveness, safety, and user experience? This article synthesizes user reviews, clinical trial data, and regulatory information to provide a comprehensive overview of semaglutide for weight loss.
Understanding Semaglutide
Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist. GLP-1 receptor agonists promote satiety, which leads to a reduction in food intake. The bioavailability of semaglutide is 89% when injected subcutaneously. It is designed to protect from natural degradation by dipeptidyl-peptidase 4 (DPP-4). Semaglutide is administered subcutaneously without regard to meals, with administration sites including the abdomen, thigh, and upper arm. When injected once weekly, semaglutide will be present for approximately 5-7 weeks after the last dose. It is eliminated via the urine and feces.
Novo Nordisk manufactures semaglutide under the brand names Ozempic for diabetes and Wegovy for weight loss. While Ozempic is primarily prescribed for managing blood sugar levels in individuals with type 2 diabetes, Wegovy is specifically approved for chronic weight management in overweight or obese adults, with lifestyle changes.
Clinical Evidence of Semaglutide's Effectiveness
Weight Loss Results
Clinical trials have demonstrated the effectiveness of subcutaneous semaglutide for weight loss in individuals with obesity who do not have type 2 diabetes.
A comprehensive search of PubMed/MEDLINE, Cochrane and Google scholar identified trials on the efficacy and safety of subcutaneous semaglutide on patients with obesity without diabetes. The study included 4 randomized controlled trials having a total of 3,613 individuals with obesity without diabetes. The primary outcome was expressed as percent mean weight difference. The mean difference for weight reduction was -11.85%, favoring semaglutide [95% confidence interval (CI) (-12.81,-10.90), p<0.00001].
Read also: Transformations with Ozempic
Across STEP trials to date, patients experienced clinically significant weight loss. Semaglutide 2.4 mg weekly has shown significant results compared to placebo.
- In one study, -14.9% weight change was observed with semaglutide 2.4 mg.
- 86.4% of patients treated with semaglutide 2.4 mg achieved weight loss.
- -16.0% weight change with semaglutide was observed over 68 weeks.
- 86.6% of patients treated with semaglutide achieved weight loss.
- -14.8% weight change was observed (95% CI, -16.0 to -13.5; p<0.001).
- -17.4% weight change with continued semaglutide was observed.
- -15.2% weight change with semaglutide was observed.
- 77.1% of patients treated with semaglutide achieved weight loss.
- Weight loss of 5% or more at 68 weeks was observed.
- -15.8% weight change with semaglutide was observed.
- 87.2% of patients treated with semaglutide achieved weight loss.
- Weight loss of 5% or more was achieved.
STEP Trials
The STEP program included multiple trials evaluating semaglutide 2.4 mg for weight management. These trials involved lifestyle interventions consistent with STEP 1, including increased physical activity and dietary changes. Described lifestyle interventions appear similar to STEP 1.
Comparison with Other Treatments
Semaglutide has also been compared to other weight loss treatments like liraglutide. In one study, semaglutide showed superior weight loss compared to liraglutide (exploratory endpoint).
User Reviews and Experiences
Positive Reviews
Many users have reported positive experiences with semaglutide for weight loss. Some users describe it as "life-changing," noting that it helped them achieve weight loss goals when other methods had failed. For example, one user shared that after their first dose, they lost 7lbs in 5 days.
- One user, Rice, said, "Semaglutide has changed my life and I hope it's around forever."
- Wood found that semaglutide showed her she could lose weight.
Side Effects and Discontinuation
While semaglutide is effective for weight loss, it is associated with several side effects, primarily gastrointestinal adverse events such as nausea, vomiting, constipation, and diarrhea.
Read also: Comprehensive guide: Tirzepatide and Semaglutide for weight management
Clinical trials indicate that the risk of developing gastrointestinal adverse events was 1.59 times more likely with semaglutide (RR 1.59, 95%CI [1.34, 1.88], p<0.00001). The risk for discontinuation due to adverse events was twice as likely in the semaglutide group (RR 2.19, 95%CI [1.36, 3.55], p=0.001), and the risk for serious adverse events was 1.6 times more likely for semaglutide (RR1.60, 95%CI [1.24, 2.07], p=0.0003).
One user reported constipation after the first dose.
Cost Considerations
The cost of semaglutide can be a significant barrier for some individuals. The price of semaglutide is a big con for McCullar, who spends $350 on five doses. Rodriguez pays $200 per shot. One user mentioned paying $365 for a two-month supply through their doctor's office.
- McCullar spends $350 on five doses.
- Rodriguez pays $200 per shot.
Dosage and Administration
Semaglutide treatment typically involves a gradual dose escalation to minimize side effects. A common approach involves a 4-week delay in dose escalation to doses of 0.5 mg, 1 mg, and 1.7 mg, and the maintenance dose of 2.4 mg.
Safety and Precautions
Thyroid C-Cell Tumors
Studies have raised concerns about whether semaglutide causes thyroid C-cell tumors, including MTC.
Read also: Semaglutide Without Diet Changes
Compounded Semaglutide
The FDA has issued warnings regarding compounded versions of semaglutide due to potential safety and quality concerns. Compounded drugs are not FDA approved, meaning they are not reviewed for safety, effectiveness, or quality before being marketed.
Concerns with compounded versions of these drugs:
- Improper storage during shipping may lead to quality issues, as injectable GLP-1 drugs require refrigeration.
- Some products may contain false information on the product label.
- Dosing errors with compounded semaglutide have led to adverse events, some requiring hospitalization.
- Some semaglutide products sold by compounders may be the salt forms, which are different active ingredients than are used in the approved drugs.
Recommendations for consumers:
- Obtain a prescription from a doctor and fill it at a state-licensed pharmacy.
- Carefully check labels for warning signs such as spelling errors or incorrect addresses.
- Contact the pharmacy to verify if the product is genuine.
- Talk to your doctor if you have questions about your medicines.
Counterfeit Drugs and Illegal Online Sales
The FDA monitors the internet for fraudulent or unapproved drugs and has issued warning letters to stop the distribution of illegally marketed semaglutide and tirzepatide. These illegally marketed drugs may be counterfeit, contain the wrong ingredients or harmful ingredients, or contain too little, too much, or no active ingredient at all.
Versions Sold Falsely for Research Purposes
The FDA has warned companies that have illegally sold unapproved drugs containing semaglutide, tirzepatide, or retatrutide that are falsely labeled “for research purposes” or “not for human consumption.”
Regulatory Oversight
The FDA plays a critical role in ensuring the safety and efficacy of drugs like semaglutide. The agency approves medications for chronic weight management based upon the side effects, precautions, and contraindications of a medication.
The FDA is aware that some patients and health care professionals may look to unapproved versions of GLP-1 drugs, including semaglutide and tirzepatide, as an option for weight loss.
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