Semaglutide for weight loss
Semaglutide can help you lose 15% of your body weight when paired with lifestyle change
Written by: Dr. Justin Zaghi
Last updated: February 25, 2024
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Table of contents:
About semaglutide
How to get started
1. What is semaglutide?
Semaglutide is the active ingredient in popular weight loss medications Ozempic and Wegovy. Semaglutide was FDA-approved in 2017 for type 2 diabetes under the brand name Ozempic and was later found to be beneficial for weight loss, achieving about 15% weight loss sustainably1. As a result, semaglutide was FDA-approved in 2021 for weight loss as Wegovy. Ozempic and Wegovy have the same active ingredient (semaglutide) though they are sometimes administered at different doses.
2. How does semaglutide work?
Semaglutide is a GLP-1 agonist, which is a hormone that naturally is made by your intestines. The medicine works by sending signals to the appetite center in your brain to reduce hunger. By slowing down your stomach, it also helps you to feel fuller. In addition, it has hormonal effects to improve your metabolism, specifically triggering insulin and reducing from your pancreas.
3. What are the benefits of semaglutide?
Semaglutide has been shown to lead to sustained weight loss of about 15%2. Weight loss can have significant benefits across many domains of your health, including sleep, mood, energy, and organ function. Studies show benefits including:
1. A 20% reduction in cardiovascular events, including heart attack and stroke, and a decreased risk of death3
2. Reductions in heart failure3
3. Improvements in diabetes and blood sugar control1
4. Improvements in cholesterol and blood pressure control1
5. Improvements in kidney health4
6. Improvements in fatty liver disease5
In short, semaglutide can have an incredible benefit on your health!
1. A 20% reduction in cardiovascular events, including heart attack and stroke, and a decreased risk of death3
2. Reductions in heart failure3
3. Improvements in diabetes and blood sugar control1
4. Improvements in cholesterol and blood pressure control1
5. Improvements in kidney health4
6. Improvements in fatty liver disease5
In short, semaglutide can have an incredible benefit on your health!
4. What side effects should I look out for?
The most common side effects are gastrointestinal in nature, including nausea, vomiting, diarrhea, and constipation. When these gastrointestinal side effects happen, they are typically mild in nature and generally subside over time, usually within 2-3 weeks. Nausea is actually considered an “on target” side effect of semaglutide because the nausea helps you to reduce your caloric intake and lose weight.
Semaglutide may cause other less common, but more serious, side effects. These include:
Semaglutide may cause other less common, but more serious, side effects. These include:
- Gallstones and pancreatitis (inflammation of the pancreas), especially when the weight loss is rapid
- Low blood sugar
- Allergic reactions
- Kidney problems, especially if you’re very dehydrated
- Changes in vision
- Thyroid tumors or cancer (this has been noted in rodents, but not yet humans)
5. Who should avoid semaglutide?
People with any of the following conditions should not take semaglutide:
- A personal or family history of medullary thyroid carcinoma
- A personal history of multiple endocrine neoplasia syndrome type 2
- An allergic reaction to semaglutide or any of its ingredients
- Pregnant women
6. How do I take semaglutide?
Semaglutide is injected under the skin in the abdomen, upper arm, or thigh. When taking semaglutide, make sure you rotate the injection site each week. You can take semaglutide with or without food. You should inject semaglutide once a week — on the same day of the week, every week. It doesn’t matter whether you take it in the morning or at night.
If you need to adjust the day you inject semaglutide, the general rule is to avoid injecting within 2 days of a prior injection. If you forget to take a dose, make sure to take it within 5 days of when you were due.
7. What dose of semaglutide should I take?
Most patients will start at the lowest dose (0.25 mg per week) for 4 weeks, and then increase steadily every 4 weeks until you find the dose that works best for you. Typically, the 1.7 mg and 2.4 mg doses are considered to be maintenance doses, though occasionally patients do perfectly well on the lower doses too! Make sure to attend your regular meeting with your Shapely provider, so that you can find the dose that works best for you. Below is the standard, FDA-approved dosing schedule for semaglutide:
Month 1
0.25 mg
Each week
Month 2
0.5 mg
Each week
Month 3
1 mg
Each week
Month 4
1.7 mg
Each week
Month 5
2.4 mg
Each week (full dose)
8. What should I expect while taking semaglutide?
Because semaglutide slows down gastric emptying and signals your brain to be less hungry, you may also feel fuller and naturally want to consume fewer calories. Many patients describe semaglutide as having an effect of reducing “food noise” or constant chatter/thoughts about food. You may also find a decreased desire to consume alcohol. At the lowest dose of semaglutide, which is 0.25 mg weekly, there may be little to no weight loss. That dose is really intended to see how your body reacts to the medicine. As you increase the doses under the guidance of your Shapely team, you should expect to gradually lose weight. A healthy amount of weight loss is about 0.5-1% of your total body weight per week (usually 1-2/lb for a 200 lb person), though weight gain may be greater when starting on treatment.
9. What foods should I avoid while on semaglutide?
While you don’t need to make any strict dietary changes while taking semaglutide, most people will find that they will naturally want to consume fewer calories. In addition, improving the quality of your diet will only help to accelerate and sustain your weight loss.
Occasionally, semaglutide can increase symptoms of heartburn. If you have a history of heartburn, it’s recommended to avoid high-fat foods, like fried or greasy foods, as well as spicy or acidic foods.
Sometimes, patients will experience constipation while on semaglutide. As a result, it’s recommended to have a diet rich in fiber, as well as to consume plentiful water, as both can help minimize constipation.
Occasionally, semaglutide can increase symptoms of heartburn. If you have a history of heartburn, it’s recommended to avoid high-fat foods, like fried or greasy foods, as well as spicy or acidic foods.
Sometimes, patients will experience constipation while on semaglutide. As a result, it’s recommended to have a diet rich in fiber, as well as to consume plentiful water, as both can help minimize constipation.
10. Am I required to exercise while on semaglutide?
Exercise is not strictly required while on semaglutide, but it is strongly recommended! Many people who lose weight on semaglutide may also lose muscle mass. Doing exercise regularly will help ensure that you retain muscle mass and stay healthy.
We’re excited to help you achieve the best shape of you! For any additional questions on semaglutide, please reach out to your Shapely provider using the chat feature in Healthie. Or feel free to give us a call at 424-600-8360.
We’re excited to help you achieve the best shape of you! For any additional questions on semaglutide, please reach out to your Shapely provider using the chat feature in Healthie. Or feel free to give us a call at 424-600-8360.
References:
- Wilding et al.; STEP 1 Study Group. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021 Mar 18;384(11):989-1002.
- Garvey et al.; STEP 5 Study Group. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial. Nat Med. 2022 Oct;28(10):2083-2091.
- Lincoff et al.; SELECT Trial Investigators. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. N Engl J Med. 2023 Dec 14;389(24):2221-2232.
- Heerspink HJL et al. Effects of Semaglutide on Albuminuria and Kidney Function in People With Overweight or Obesity With or Without Type 2 Diabetes: Exploratory Analysis From the STEP 1, 2, and 3 Trials. Diabetes Care. 2023 Apr 1;46(4):801-810.
- Bandyopadhyay et al. Role of semaglutide in the treatment of nonalcoholic fatty liver disease or non-alcoholic steatohepatitis: A systematic review and meta-analysis. Diabetes Metab Syndr. 2023 Oct;17(10):102849.
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