Introduction
So you’ve finally decided to take semaglutide. Whether for type 2 diabetes or weight loss, clinical trials show it’s ]safe and effective in managing blood sugar levels and obesity.
It’s no wonder many people consider it a miracle drug for its therapeutic benefits. You’ve got comedian Chelsea Handler and SpaceX/Tesla business tycoon Elon Musk crediting the drug for their slimmer figures.
Just like any drug, it takes time and repetitive, consistent use to take effect on the body. When to expect results on semaglutide? In this article, we dive into what semaglutide is, how it works, and when you should expect to see results.
What is semaglutide?
In our gut is a hormone, glucagon-like peptide-1, or GLP-1 for short. Whenever we finish eating and blood sugar levels are high, GLP-1 triggers insulin release, which brings these down.
Semaglutide is a glucagon-like peptide-1 receptor agonist, or GLP-1 Ra. Whenever blood sugar levels are high, it responds in the same way, performing the same action.
At the same time, semaglutide delays gastric emptying, that process where food exits the gut and enters the small intestine. Because digestion is slower, you don’t think about food as much and you feel fuller for longer. With fewer food cravings and a weaker appetite, people on semaglutide lose a significant amount of weight. The drug also signals to the brain that you’re already full.
Eligibility: Who can take semaglutide?
To check if you’re eligible to take semaglutide, see if you meet certain diagnostic criteria. For semaglutide brands Ozempic and Rybelsus, patients need to be diagnosed with type 2 diabetes.
Doctors may prescribe Ozempic for heart disease patients, as it has additional approval for lowering the risk of cardiovascular problems. Doctors may also prescribe it for those dealing with insulin resistance.
Wegovy users, meanwhile, need to be overweight or obese and have one weight-related health condition. They must have a BMI of 27 or greater or a BMI of 30 or greater.
Although semaglutide maker Novo Nordisk markets these differently, they offer the same therapeutic benefits of blood sugar regulation and weight management. It’s no wonder many doctors choose to prescribe Ozempic or Rybelsus off-label for weight loss.
Oral and subcutaneous semaglutide
If you prefer taking semaglutide less frequently, you may choose to inject semaglutide. However, if you’re okay with taking it daily, you can drink it in tablet form.
Ozempic and Wegovy are called subcutaneous semaglutide as they come in injectable dosing pens and you inject them under the skin. Rybelsus, meanwhile, is referred to as oral semaglutide because it comes in tablet form and is you take t orally.
Dosage and administration
Your healthcare provider will typically start you on a low dose, gradually increasing to maintenance levels as your body adjusts.
You inject Ozempic and Wegovy once weekly subcutaneously (under the skin) regardless of meals. You can inject them either in the abdomen, the thigh, or the upper arm.
For Rybelsus, meanwhile, you take it orally once daily on an empty stomach and it comes in tablet format.
Safety of semaglutide
Semaglutide has FDA approval to treat type 2 diabetes and obesity after going through extensive clinical studies. The following are highlights from the research that proves semaglutide’s safety, efficacy, and tolerability.
In the STEP 5 trial, researchers looked at the two-year effects of semaglutide in adults who were overweight or obese. Participants lost an average of 15 percent of their body weight with semaglutide. Meanwhile, those in the placebo group lost approximately 2.6 percent of their body weight.
Participants on semaglutide lost 5.7 inches off their waistline and saw systolic blood pressure improvements by 5.7 mmHg. The semaglutide group participants also experienced better diastolic blood pressure, blood sugar levels, total cholesterol, and triglycerides.
A 2022 study found that participants on semaglutide lost more body fat than body mass and ate less.
Side effects
Just like any drug, Ozempic and Wegovy come with potential side effects.
Gastrointestinal reactions account for 10% or more of semaglutide’s side effects. These include nausea, diarrhea, vomiting, constipation, and abdominal pain.
Other less common side effects of semaglutide include indigestion, belching, gassiness, gastroenteritis, or gastritis. Gastroenteritis is a short-term infection and inflammation of the digestive system, while gastritis is inflammation of the stomach lining.
The more serious side effects of semaglutide include allergic reactions, hypoglycemia, pancreatitis, kidney problems, and thyroid c-cell tumors.
When to expect results with semaglutide
Studies show that on average, it takes a person around four weeks on semaglutide to see some weight loss. However, the full effect can take some more time.
In one study, people on weekly semaglutide injections lost 15 pounds after 12 weeks and 27 pounds after 24 weeks. In another study, participants lost as much as 35 pounds or 15.9 kilograms over 68 weeks (17 months).
With Wegovy, you may see weight loss within the first four weeks, but only see the full effects after months. In the same 68-week study, 83% of the participants lost 5% or more of their weight versus 31% on placebo.
With Ozempic, meanwhile, blood sugar levels should fully decline within the first week of use when on the maintenance dose. Patients start with small doses. But the full expect can take as long as eight weeks or even longer, with its once-weekly shots.
Despite these studies, results will vary as the drug’s effect can be affected by a variety of factors.
Non-response to semaglutide use
Sometimes some people do not see effects while on semaglutide. According to Christina Inteso, Pharm.D., clinical pharmacy specialist at Corewell Health in Michigan, patients must still implement lifestyle changes. Here’s an overview of the reasons in case you do not see results with semaglutide.
Non-responders
You may be a non-responder or someone whose body does not respond to semaglutide.
The Endocrine Society, an international medical organization for endocrinology and metabolism, has certain guidelines. A weight loss drug is only effective if patients lose over 5% of their body weight in three months.
In a clinical trial, 86.4% of participants on semaglutide lost over 5% of their body weight throughout 68 weeks. Meanwhile, the remaining participants (13.6%) did not. Obesity specialists and endocrinologists have also observed that a similar percentage didn’t lose weight or lost little weight on semaglutide.
It’s not clear why some people do not respond to semaglutide. However, early response is typically an indicator of how well a drug will work in the long term.
Severe side effects
Another reason why semaglutide may not work for you is when you experience severe side effects while on it.
According to Gitanjali Srivastava, internist and obesity medicine program director at Vanderbilt University Medical Center, non-responders “tend to be sicker.” Co-morbidities like early-onset severe obesity in childhood, endocrine disorders, developmental delays, and early trauma could make a patient less responsive.
More research on such co-morbidities and drugs that may interact with GLP-1 medications is needed to better understand such treatments.
The importance of diet and exercise
“All of the FDA-approved weight loss medications, including semaglutide, are approved as an add-on to a reduced calorie diet and increased physical activity,” Inteso tells Prevention. “These medications were studied with lifestyle changes, plus the medication.”
If you don’t see results while taking Ozempic, you may just need to eat healhy and exercise more regularly. Inteso laments how some people think semaglutide is a magic pill that will promote weight loss without any lifestyle changes.
Incorrect dosage
Another expert, Mir Ali, M.D., a bariatric surgeon and medical director at the MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, thinks it could be a problem with the dosage, which takes several months for any patient.
“Some patients see results right away; others need to be at a higher dose to see results,” he points out.
Inteso thinks it could also be other factors, like genetics, which makes it harder for other people to see the effects.
Improper/inadequate sleep
If semaglutide doesn’t work for you, it may be due to improper/inadequate sleep, stress, or an underlying condition. These all have an effect on how our bodies regulate hormones.
Oversleeping, for example, has been linked to obesity and other weight-related conditions like hypertension and diabetes. Meanwhile, stress can affect how your body responds to medication. Underlying conditions, on the other hand, may be slowing down your weight loss.
Consult your doctor if semaglutide is not giving you the results you want. If you feel the drug is not suitable for you, he/she may prescribe other weight loss drugs.
How to achieve optimal results
With any treatment, it’s important to consult your healthcare provider about what diet or exercise program is best for you. If you follow everything and still don’t see results, it may be time to re-evaluate and speak to a dietitian. Otherwise, consider that you may be better suited with another drug.
Conclusion
Just like any drug, it takes time for semaglutide to take effect on the body. It typically takes around four weeks to see some weight loss, but the full effect takes some more time.
There are cases when semaglutide may not appear to be working. Its efficacy can be affected by various factors like lifestyle and exercise, incorrect dosage, stress, inadequate sleep, and stress. Consult your doctor to review your options.
Glossary of terms:
- GLP-1: Glucagon-like peptide-1 is a gut-based hormone involved in the secretion of insulin to lower blood sugar levels typically elevated after meals.
- GLP-1 Ra: Glucagon-like peptide-1 receptor agonist. It mimics the actions of GLP-1.
