Obesity medication that’s effective has been a protracted time coming. Enter semaglutide (sold as Ozempic and Wegovy), which helps people improve weight-related health, including lowering the chance of a having a heart attack or stroke, while also silencing “food noise”.
As demand for semaglutide increases, so are claims that taking it’s “cheating” at weight reduction or the “easy way out”.
We don’t tell individuals who need statin medication to treat high cholesterol or drugs to administer hypertension they’re cheating or taking the straightforward way out.
Nor should we shame people taking semaglutide. It’s a drug used to treat diabetes and obesity which must be taken long run and comes with risks and unwanted effects, in addition to advantages. When prescribed for obesity, it’s given alongside advice about weight loss program and exercise.
How does it work?
Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for brief, work higher.
GLP-1 gets secreted by cells in your gut when it detects increased nutrient levels after eating. This stimulates insulin production, which lowers blood sugars.
GLP-1 also slows gastric emptying, which makes you’re feeling full, and reduces hunger and feelings of reward after eating.
GLP-1 receptor agonist (GLP-1RA) medications like Ozempic help the body’s own GLP-1 work higher by mimicking and increasing its motion.
Some studies have found less GLP-1 gets released after meals in adults with obesity or type 2 diabetes mellitus in comparison with adults with normal glucose tolerance. So having less GLP-1 circulating in your blood means you don’t feel as full after eating and get hungry again sooner in comparison with individuals who produce more.
GLP-1 has a really short half-life of about two minutes. So GLP-1RA medications were designed to have a really long half-life of about seven days. That’s why semaglutide is given as a weekly injection.
What can users expect? What does the research say?
Higher doses of semaglutide are prescribed to treat obesity in comparison with type 2 diabetes management (as much as 2.4mg versus 2.0mg weekly).
A big group of randomised controlled trialscalled STEP trials, all tested weekly 2.4mg semaglutide injections versus different interventions or placebo drugs.
Trials lasting 1.3–2 years consistently found weekly 2.4 mg semaglutide injections led to six–12% greater weight reduction in comparison with placebo or alternative interventions. The average weight change trusted how long medication treatment lasted and length of follow-up.
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Weight reduction on account of semaglutide also results in a reduction in systolic and diastolic blood pressure of about 4.8 mmHg and a couple of.5 mmHg respectively, a discount in triglyceride levels (a form of blood fat) and improved physical function.
Another recent trial in adults with pre-existing heart disease and obesity, but without type 2 diabetes, found adults receiving weekly 2.4mg semaglutide injections had a 20% lower risk of specific cardiovascular events, including having a non-fatal heart attack, a stroke or dying from heart problems, after three years follow-up.
Who is eligible for semaglutide?
Australia’s regulator, the Therapeutic Goods Administration (TGA), has approved semaglutide, sold as Ozempic, for treating type 2 diabetes.
However, on account of shortages, the TGA had advised doctors not to start out recent Ozempic prescriptions for “off-label use” corresponding to obesity treatment and the Pharmaceutical Benefits Scheme doesn’t currently subsidise off-label use.
The TGA has approved Wegovy to treat obesity but it surely’s not currently available in Australia.
When it’s available, doctors will have the ability to prescribe semaglutide to treat obesity together with lifestyle interventions (including weight loss program, physical activity and psychological support) in adults with obesity (a BMI of 30 or above) or those with a BMI of 27 or above who even have weight-related medical complications.
What else do you’ll want to do during Ozempic treatment?
Checking details of the STEP trial intervention componentsit’s clear participants invested loads of effort and time. In addition to taking medication, people had temporary lifestyle counselling sessions with dietitians or other health professionals every 4 weeks at least in most trials.
Support sessions were designed to assist people follow consuming 2,000 kilojoules (500 calories) less day by day in comparison with their energy needs, and performing 150 minutes of moderate-to-vigorous physical activitylike brisk walking, dancing and gardening each week.
STEP trials varied in other components, with follow-up time periods various from 68 to 104 weeks. The aim of those trials was to point out the effect of adding the medication on top of other lifestyle counselling.
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A review of obesity medication trials found people reported they needed less cognitive behaviour training to assist them follow the reduced energy intake. This is one aspect where drug treatment may make adherence just a little easier. Not feeling as hungry and having environmental food cues “switched off” may mean less support is required for goal-setting, self-monitoring food intake and avoiding things that trigger eating.
But what are the unwanted effects?
Semaglutide’s side-effects include nausea, diarrhoea, vomiting, constipation, indigestion and abdominal pain.
In on study these led to discontinuation of medication in 6% of individuals, but interestingly also in 3% of individuals taking placebos.
More severe side-effects included gallbladder disease, acute pancreatitis, hypoglycaemia, acute kidney disease and injection site reactions.
To reduce risk or severity of side-effects, medication doses are increased very slowly over months. Once the complete dose and response are achieved, research indicates you’ll want to take it long run.
Given this long-term commitment, and associated high out-of-pocket cost of medicationwith regards to taking semaglutide to treat obesity, there is no such thing as a way it may well be considered “cheating”.