Introduction
If you’ve been struggling with weight, you might be one of thousands who’ve decided to try their luck with semaglutide brand Ozempic. Given the drug’s massive popularity with celebrities, it’s been on everyone’s lips. Who wouldn’t want to regulate their blood sugar levels while losing weight?
Truthfully, though, Ozempic is not a magic pill. It’s not perfect and just like any drug, it won’t work in the same way in everybody. Factors like your diet, amount of physical activity, quality of sleep, and dosage of semaglutide may affect its efficacy.
So, what do you do when semaglutide is not working and what are the possible reasons behind it? We share steps you can take whenever it’s ineffective.
What is semaglutide?
What exactly is semaglutide and how does it produce the therapeutic benefits of blood sugar regulation and weight loss? Understanding this will complement what we’ll discuss later on about instances of semaglutide’s ineffectiveness.
Semaglutide belongs to a class of drugs called glucagon-like peptide-1 receptor agaonist, which mimic the gut-based hormone GLP-1. Whenever we finish a meal, it triggers the pancreas to release the hormone insulin to lower elevated blood sugar levels.
Another effect of semaglutide is that it delays gastric emptying, causing you to feel fuller for longer. As a result, you don’t crave food as much or think about your next meal, leading you to lose weight.
Oral and subcutaneous semaglutide
You might already know about Ozempic, but have you heard of its fellow semaglutide brands Wegovy and Rybelsus? Just like Ozempic, Rybelsus is FDA-approved to treat type 2 diabetes, while Wegovy has FDA-approval to treat obesity.
Although they may be different brands, they share the same active ingredient, semaglutide, and they work in the same way. Hence, many doctors prescribe Ozempic and Rybelsus off-label for patients who want to lose weight. This is even if they don’t necessarily have type 2 diabetes.
In addition, there have been studies comparing the efficacy of oral and subcutaneous semaglutide. The findings of a 2021 review showed that oral semaglutide may be more, if not as effective as subcutaneous semaglutide. However, research comparing the two formats is still relatively new. More studies will need to be done to conclude whether one is more effective than the other.
Dosage and administration
Ozempic and Rybelsus may both be anti-diabetic drugs, but they come in different formats. Ozempic and Wegovy are subcutaneous semaglutide as they’re in pre-filled injectable dosing pens and administered under the skin. Rybelsus, meanwhile, is a form of oral semaglutide as it is in tablet form and is taken by mouth.
If you’re taking Ozempic or Wegovy, you must inject it once weekly, while you must take Rybelsus once daily. Your healthcare provider will typically start you off on a low dose. He or she will gradually increasing this to a maintenance dose to allow your body to adjust to semaglutide.
In some cases, dosages may play a role in the efficacy of a drug.
Eligibility
Every person is different and may respond differently to a medication. Side effects or a lack of effect may also be a result of a mismatch between a medication and its intended patient.
In the case of semaglutide, it’s not an over-the-counter drug that generally anyone can take. All semaglutide brands are only available via prescription as Ozempic, Wegovy, and Rybelsus all have specific diagnostic criteria.
For Ozempic and Rybelsus, for example, you need to have type 2 diabetes. Healthcare providers may prescribe Ozempic for heart disease patients as it has additional approval for lowering risk of cardiovascular problems. It may at times also be prescribed for those dealing with insulin resistance.
In the case of Wegovy, meanwhile, you will need to have a body mass index (BMI) of 27 or greater. This is in addition to one weight-related health condition (ex: high blood pressure) or a BMI of 30 or greater.
Safety and efficacy of semaglutide
Fortunately, Ozempic, Wegovy, and Rybelsus have undergone extensive studies to receive FDA approval. Hence, you can rest assured of their safety and efficacy. The following are highlights from the research that proves semaglutide’s safety, efficacy, and tolerability.
In the STEP 5 trial, researchers looked at semaglutide’s two-year effects in adults who were overweight or with obesity. 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 taking semaglutide also had greater reductions in their waistline—14.4 centimeters or 5.7 inches, to be exact. Their systolic blood pressure also went down by 5.7 mmHg. These participants also experienced better diastolic blood pressure, blood sugar levels, total cholesterol, and triglycerides (type of fat in blood).
A December 2022 study, meanwhile, found that participants taking semaglutide lost more body fat than body mass. Additionally, they ate less food due to lower appetite, had better control of eating, and less cravings for fatty foods.
When semaglutide is not working
As effective as semaglutide may be, there have still been cases wherein it does not work as expected. Here are some probable causes and steps to take when you don’t see results.
1. It’s too early.
Like many drugs, semaglutide takes time to work and it may be early to expect results in the low-dose phase. As mentioned, you may typically start on small dosages to allow your body to adjust to semaglutide. This entire process can span up to 12 weeks.
According to studies, it takes at least four weeks for you to notice the effects of semaglutide. Given these timings, it’s best to be patient as you await the results.
2. The dosage may be incorrect.
We’ve spoken about gradual dosing and how it takes time for you to reach a maintenance dose. While there’s a standard low dose, there are cases when you may require a higher dosage of semaglutide.
Similar to the severity of semaglutide’s symptoms being directly proportional to its dosage strength, so is its weight-loss effect. You may need to take a higher dose for your body to respond to the drug. Don’t worry about the side effects, though, as these are generally mild and manageable. Use this time to fine-tune your dosage with the help of your healthcare provider.
Ozempic and similar medications have been proven to spur weight loss in conjunction with lifestyle changes like diet and exercise. Without these, it may not be as effective.
3. You have an unhealthy diet and lack exercise.
If you check Ozempic, Wegovy, and Rybelsus’ FDA approvals, you’ll know they must be taken with a healthy lifestyle. In this case, eating a nutritious diet and having plenty of exercise.
You may want to reduce your caloric intake and minimize eating foods high in sugar and refined carbohydrates. Similarly, reduce eating red meat, processed foods, sugar-sweetened beverages, and alcohol as these are linked to weight gain.
As for exercise, you may want to incorporate at least 150 minutes of physical activity per week. You can do low-intensity activities, like walking. Certain forms of exercise, like aerobic exercises with resistance training, also help boost your metabolism.
In conjunction with semaglutide use, you’ll find that you can lose more weight with exercise and reduced caloric intake. With the help of your healthcare provider and nutritionist/dietitian, craft a feasible meal plan and fitness program.
4. You lack proper and adequate sleep.
Sleep plays a big role in how our bodies regulate hormones and how they can pile or keep weight off. When you’re getting low-quality sleep, you may experience hormonal imbalance and this can affect your appetite, cravings, and food preferences. By low-quality sleep, we mean less than six hours or more than eight hours of sleep.
You’ll find that you desire high-calorie, high-carb foods when you don’t have enough or have too much shuteye. Oversleeping has also been linked to obesity and other weight-related conditions like hypertension and diabetes.
5. You’re stressed out.
You may be diligent in taking semaglutide and have a healthy diet, ample physical activity, and quality sleep. But stress can easily impact your willpower and affect how well your body responds to a medication.
Studies show that when you’re constantly stressed because of work or something personal, you’re more likely to pile on pounds. It’s hard to perform simple daily task. Additionally, you end up giving in to food cravings or have trouble sleeping because of all your worries.
6. You may have an underlying condition.
You may be suffering from an underlying condition that is affecting your body’s response to semaglutide. If you have type 2 diabetes, for example, you might find that you lose weight more slowly. Other medications you may be taking apart from semaglutide may also be slowing down your weight loss.
7. You’ve hit a plateau.
Eventually, your body will reach a plateau, or a level wherein a drug’s effect slows down or reaches a ceiling. You may need to switch to stronger medicine or make lifestyle changes to see if you can lose more weight.
Keep things in perspective
It may be discouraging when you don’t experience the results similar to other patients on their first use of semaglutide. But at the end of the day, remember that your body is different.
The treatment must also be approached from a holistic perspective through the application of lifestyle changes.
As with any drug use, discuss any changes or plans with your healthcare provider.
Conclusion
Although studies have proven just how safe and effective semaglutide is, it will not have the same effect on every patient.
Several factors impact its efficacy and the patient may need to actively maintain a certain lifestyle to see results. Eating a reduced-calorie diet, getting plenty of exercise, having quality sleep, and reducing stress levels are just a few approaches.
As with any treatment plan, stay coordinated with your healthcare provider.
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 agonists mimic GLP-1 in the production of insulin to control blood sugar levels.
