Semaglutide for Weight Loss

Semaglutide is a medication originally developed for type 2 diabetes that has gained popularity for its effectiveness in weight loss. It mimics the GLP-1 hormone, which regulates appetite and blood sugar levels, leading to reduced hunger and calorie intake.

Clinical trials have shown significant weight loss results, making it a popular option for individuals struggling with obesity. However, it should be used under medical supervision due to potential side effects like nausea and gastrointestinal discomfort.

As the body gets used to the drug, the first month on semaglutide is a crucial time. This guide addresses common concerns regarding side effects and adjustment periods while examining the typical development of effects, from first changes in appetite to possible weight loss results.

What is Semaglutide?

When paired with a healthy lifestyle, semaglutide for weight loss may be useful in lowering hunger, controlling blood sugar, and encouraging weight loss. Semaglutide is an agonist that mimics the body’s natural glucagon-like peptide-1 (GLP-1) hormone. GLP-1 receptors in the brain, especially those involved in appetite regulation and food intake management, are bound to and activated by this drug.

Multiple routes are involved in the medication’s mechanism of action.

• Helps in the proper release of insulin by the pancreas in response to elevated blood sugar levels.
• Decreases the passage of food through the stomach, resulting in longer-lasting sensations of fullness.
• Acts on the brain regions that regulate hunger to decrease appetite.
• Inhibits the release of glucagon, assisting in the maintenance of appropriate blood sugar levels.

It has shown cardiovascular advantages in addition to its main impact on blood sugar regulation and weight management. The drug has been authorized to lower the risk of adverse cardiovascular events in overweight individuals with cardiovascular disease.

Semaglutide’s 94% similarity to native GLP-1, which helps prevent immunogenicity problems, may be the reason for its efficacy. Improvements in the proinsulin-to-insulin ratio and positive effects on insulin production have been observed with the drug, indicating improved β-cell activity. These processes help GLP-1 be effective in controlling blood sugar and weight during the first month of use.

Although the most popular form of semaglutide is injectable, some people find needle-free options more practical, such as sublingual semaglutide for weight loss. It’s critical to comprehend the safety and efficacy of semaglutide tablets while thinking about oral alternatives. Though their bioavailability is marginally lower than that of injections, these pills work by mimicking the GLP-1 hormone to control blood sugar and reduce appetite.

When taken as directed, both sublingual and tablet forms may be beneficial; nevertheless, to guarantee appropriate dosage and the best possible outcomes, speaking with a healthcare professional is crucial.

What is the purpose of semaglutide?

Wegovy (semaglutide) is used for weight loss.

• Patients 12 years of age and older who suffer from obesity can use Wegovy (semaglutide) to lose weight and keep it off.
• Used in individuals with type 2 diabetes who have known heart disease to lower their risk of significant cardiovascular events (heart attack, stroke, or death).
• Using an autoinjector (pen), the injection is administered once a week beneath the skin of the upper arm, thigh, or stomach (belly).
• This injection ought to be taken in conjunction with a lower-calorie diet and more exercise.

Ozempic injection (semaglutide)

• When used in conjunction with diet and exercise, Ozempic helps adults with type 2 diabetes maintain their blood sugar levels and lowers their risk of significant cardiovascular events, such as heart attacks, strokes, or death, in those who already have heart disease.
• Used to lower the risk of kidney failure, deterioration in kidney function, and cardiovascular disease-related death in persons with type 2 diabetes and chronic kidney disease (CKD).
• Using an autoinjector (pen), the injection is administered once a week beneath the skin of the upper arm, thigh, or stomach (belly).

Rybelsus (semaglutide) oral tablets

• Adults with type 2 diabetes can take Rybelsus to help regulate their blood sugar levels.
• Semaglutide tablets, taken orally once a day, should be used in conjunction with a lower-calorie diet and more exercise.

Semaglutide: How does it work?

The way semaglutide works is by imitating GLP-1, a hormone that the body naturally produces.

• Encourages the pancreas to produce insulin.
• Lowers the synthesis of liver sugar,
• slows down digestion and helps in regulating food intake and appetite.

When we eat, the naturally occurring hormone GLP-1 is released, helping us control how much food we consume. By activating GLP-1 receptors, semaglutide decreases hunger, slows the stomach’s emptying, and boosts insulin production. This makes you feel fuller for longer and encourages you to eat less, which lowers your risk of cardiovascular disease, controls blood sugar levels, and helps you lose weight.

Semaglutide’s mechanism of action for lowering kidney-related risk is not entirely clear.

Semaglutide is a member of the GLP-1 receptor agonist medication class.

Side effects of semaglutide

Common adverse effects of semaglutide

Low blood sugar (in those with type 2 diabetes), problems with digestion, heartburn, burping, gas, bloating, nausea, vomiting, stomach pain, loss of appetite, diarrhea, constipation, symptoms of the stomach flu, headache, dizziness, and fatigue are common adverse effects of semaglutide.

Although gastrointestinal or stomach side effects are frequent, they are usually minor, go away in a few weeks, and don’t normally get in the way of long-term therapy. Higher dosages may increase the risk of adverse stomach effects.

Advice for treating adverse effects in the stomach

The following advice may help you deal with the negative effects of stomach semaglutide:

• Eat more slowly.
• Consume smaller meals.
• Selected more low-fat, bland foods (such as rice, bread, and crackers).
• Avoid eating fatty, fried, or sugary delicacies.
• Consume water-based foods, such as soup or gelatin.
• Avoid lying down immediately after eating.
• Consume ice-cold or clear beverages.
• If you’re feeling nausea, try to get some fresh air outside.
• In individuals with severe gastroparesis, Ryebelsus is not advised.

Tips for Dealing with Hypoglycemia Side Effects

• Check your blood sugar levels frequently when you increase your semaglutide dosage and if you are also taking insulin or sulphonylureas (such as glibenclamide/glyburide, glipizide, and gliclazide) or other diabetic medications.
• If necessary, your doctor may lower your insulin or sulphonylurea dosage to lower your risk of hypoglycemia.
• Hypoglycemia symptoms include feeling hungry, lightheaded, nervous, or agitated, shaking, sweating, and having tingling lips.
• Palpitations in the heart
• feeling weak or fatigued; changes in your vision, such as disorientation or blurred vision

Treatment for low blood sugar

• A tiny glass of fruit juice or a sweet fizzy drink (not diet), glucose or dextrose tablets or gel, or sugary candies are examples of meals or beverages that will cause your blood sugar to rise rapidly.
• After ten to fifteen minutes, check your blood sugar levels.
• After ten minutes, check your blood sugar again and take another sweet drink or food if it’s still low.
• Eat a nutritious snack or supper once your symptoms have subsided to prolong the rise in blood sugar and avoid another decrease.

An injection of glucagon may be necessary for severe hypoglycemia.

Serious adverse effects of semaglutide

If you have any of the following symptoms of an allergic reaction—hives, itching, dizziness, rapid heartbeat, trouble breathing, or swelling of your face, lips, tongue, or throat—get emergency medical attention.

Make an immediate call to your physician if you have:

• Visual changes, strange mood swings, suicidal thoughts, fluttering or hammering heartbeats, dizziness, or a feeling that you might faint;
• Symptoms of a thyroid tumour include a lump or enlargement in the neck, difficulty swallowing, a hoarse voice, and dyspnoea;
• signs of pancreatitis: rapid heartbeat, nausea with or without vomiting, and severe upper abdominal pain that radiates to the back;
• gallbladder issues, such as fever, clay-colored feces, upper abdominal pain, and jaundice (eye or skin yellowing);
• Low blood sugar, which manifests as headache, weakness, hunger, perspiration, disorientation, agitation, lightheadedness, elevated heart rate, or tremors;
• Renal issues, such as oedema, decreased urination, fatigue, or dyspnea; or symptoms of the stomach flu, such as cramping in the stomach, vomiting, appetite loss, and diarrhoea (which can be either watery or bloody).

Expectations for the First Month of Semaglutide Use

Because semaglutide doses usually start low and grow gradually to allow the body to adjust while minimizing side effects, it is crucial to understand the dosage and guidelines for safe and effective use. Since compounded drugs are not FDA-approved and might vary in consistency, the safety of the compounded version of semaglutide depends on the caliber and procedures of the pharmacy making it.

Patients usually see a progression of effects throughout the first month of semaglutide medication, which starts with a carefully planned introduction phase. Knowing this schedule makes it easier to plan for the upcoming changes and set reasonable expectations.

Weight Loss

When used in conjunction with lifestyle modifications, semaglutide for weight loss may decrease hunger and promote noticeable weight loss. Patients may anticipate moderate initial outcomes throughout the first month; studies have shown that weight reduction over the first four weeks might range from 2 to 10 pounds.

Everybody’s weight reduction journey is different, and some people see results sooner than others. Significantly overweight patients typically lose weight more quickly than those who are closer to their target weight, according to clinical research.

This is how a typical weekly progression looks:

• Weeks 1-2: The first stage of adjustment during which there aren’t many weight changes
• Week 3–4: When the medicine reaches therapeutic levels, there is a noticeable start to weight loss.
• Weeks 4-5: Bloodstream concentration reaches a steady condition
• Weeks 8–12: A more noticeable decrease in weight

Appetite

Semaglutide’s influence on appetite is among its initial effects. Within the initial few days to weeks of beginning medication, patients report feeling less hungry. People report severe appetite suppression by weeks 7–12, which results in a 24% reduction in caloric intake.

There are various ways that the drug affects appetite:

• Earlier levels of fullness throughout meals
• Decreased desire for foods high in fat
• Reduced occurrence of hunger cues
• Changing dietary habits

Although appetite suppression has advantages, patients should continue to eat regular, wholesome meals. The objective is to improve control over eating habits rather than completely eradicate hunger.

To guarantee appropriate dosage and handling of any adverse effects, medical professionals advise keeping in close contact throughout this early phase.

Details about Semaglutide Dosing

Ozempic Dosage Details

Recommended Dosage by Ozempic

• For four weeks, administer a 0.25 mg subcutaneous injection (injection beneath the skin) to begin Ozempic. The dosage of 0.25 mg is not useful for glycemic management; rather, it is meant for the start of treatment.
• Increase the dosage to 0.5 mg once weekly after four weeks on the 0.25 mg dosage.
• The dosage may be raised to 1 mg once weekly if further glycaemic management is required after at least 4 weeks on the 0.5 mg dosage.
• The dosage may be raised to 2 mg once weekly if further glycemic control is required after at least 4 weeks on the 1 mg dosage. A weekly dose of no more than 2 mg is advised.
• Once a week, on the same day, at any time of day, with or without meals, administer Ozempic.
• As long as there is a minimum of two days (>48 hours) between doses, the weekly administration day may be altered if needed.
• Ozempic should be taken as quickly as possible, preferably within five days of the missed dosage. Skip the missed dose and give the next dose on the day that is normally planned if more than five days have gone by. Patients can then return to their usual once-weekly dosage schedule in each scenario.

Ozempic is available in:

Dosage pen for Ozempic injection 0.25 mg or 0.5 mg.

• With the pen, doses of 0.25 mg or 0.5 mg can be given.
• 1.34 mg/mL (2 mg/1.5 mL)
• Each 1.5 ml pen contains eight dosages of 0.25 mg or four doses of 0.5 mg.

Ozempic injectable pen, 1 mg dosage.

• One milligram is the dosage from the pen.
• 1.34 mg/mL (4 mg/3mL)
• Each 3ml pen contains four dosages.

The Ozempic injectable pen has a 2 mg dose.

• The dosage from the pen is 2 milligrammes.
• 2.68 mg/mL (8 mg/3 mL)
• Each 3ml pen contains four dosages.

Wegovy Dosage Details

Recommended Dosage for Wegovy

Start Wegovy at a dose of 0.25 mg once weekly, administered subcutaneously, and follow the dose escalation schedule below to minimize gastrointestinal side effects.

• Week 1–4: 0.25 mg each week
• Weeks 5–8: 0.5 mg per week
• Weeks 9–12: 1 mg per week
• Weeks 13–16: 1.7 mg per week
• 2.4 mg weekly starting in week 17.

If patients cannot tolerate a dose during this phase, think about delaying dose escalation for four weeks.
The maintenance dose of Wegovy is 2.4 mg subcutaneously once a week.

• If patients are unable to take the 2.4 mg once weekly maintenance dose, it may be temporarily lowered to 1.7 mg once weekly for a maximum of 4 weeks. After four weeks, increase Wegovy to the maintenance dosage of 2.4 mg once weekly.
• The patient should cease taking Wegovy if the 2.4 mg dosage is intolerable.
• Patients with type 2 diabetes should have their blood glucose levels monitored both before and during the course of taking Wegovy.

Available Wegovy Strengths:

• The Wegovy 0.25 mg pen (0.25 mg/0.5 mL) provides a single 0.25 mg dose.
• The Wegovy 0.5 mg pen provides a single 0.5 mg dose (0.5 mg/0.5 mL).
• The Wegovy 1 mg pen provides a single 1 mg dose (1 mg / 0.5 mL).
• The Wegovy 1.7 mg pen provides a single dosage of 1.7 mg (1.7 mg/0.75 mL).
• The Wegovy 2.4 mg pen provides a single dose of 2.4 mg (2.4 mg/0.75 mL).

Information about Dosing for Rybelsus

Rybelsus should be taken at least half an hour before the first meal, beverage, or oral prescription of the day, and with no more than 4 ounces of plain water. Thirty minutes after taking the tablet, you can eat, drink, or take other oral drugs. Consume the tablets in their whole. It is not recommended to chew, break, or crush tablets.

Recommended Dosage for Rybelsus

• Start taking 3 mg of Rybelsus once daily for 30 days. The 3 mg dosage is intended to start treatment, not to control blood sugar levels.
• After 30 days of taking 3 mg once daily, increase the dosage to 7 mg.
• If more glycaemic control is needed after at least 30 days on the 7 mg dose, the dose may be raised to 14 mg once daily.
• Taking two 7 mg Rybelsus tablets to obtain a 14 mg dosage is not recommended.
• The missing dose should be skipped, and the subsequent dose should be taken the day after the missed one.

Rybelsus pills come in three, seven, and fourteen milligram strengths.

Patients are being moved between Ozempic and Rybelsus.

Patients taking Rybelsus 14 mg daily may utilise an Ozempic subcutaneous injection of 0.5 mg once a week. Patients can begin taking Ozempic the day after their last Rybelsus dosage.

Rybelsus 7 mg or 14 mg may be substituted with Ozempic 0.5 mg weekly subcutaneous injections. Patients can start taking Rybelsus up to seven days after their last Ozempic injection. There is no equivalent dosage for Rybelsus in Ozempic 1 mg.

What occurs if I don’t take my medication?

For Rybelsus, skip the missed dose and take your next one at the appointed time.

Ozempic: Start your regular schedule after taking the prescription as soon as you can. If you are more than five days late for the injection, skip the missed dosage and resume your regular schedule.

Wegovy: Take the drug as soon as you can, and then go back to your regular activities. If your next dose is due in less than two days (48 hours), skip the missing one and resume your regular schedule.

Get in touch with your doctor if you miss more than two Wegovy doses in a row. You may need to resume taking the drug at a reduced dosage to avoid stomach problems.

Avoid taking two semaglutide doses at once.

Which other medications will interact with semaglutide?

Your body may take longer to absorb oral drugs because semaglutide slows down digestion.

You should talk to your doctor about all other prescriptions, including insulin and other diabetic drugs including dulaglutide, exenatide, liraglutide, Byetta, Trulicity, Victoza, and others.

Vitamins, natural treatments, prescription and over-the-counter drugs, and semaglutide may interact with other pharmaceuticals. Tell your doctor about all the other drugs you use.

How is semaglutide to be used or taken?

Instructions for injecting semaglutide

Subcutaneous injections of semaglutide (Ozempic and Wegovy) are given at any time of day, with or without food, and frequently once a week. Give an injection on the same day each week.

All directions should be read and followed. Ask your doctor or pharmacy for help if you need it.

Wait until you’re ready to give an injection before preparing it. Call your chemist if the drug seems unclear, has changed color, or has particles in it.

Where to inject semaglutide will be demonstrated by your healthcare practitioner. Don’t provide two injections in the same spot.

Start your new regimen at least two days after your last injection if you choose to change the weekly injection day.

Avoid using different semaglutide brands concurrently.

Directions for taking semaglutide tablets

Rybelsus oral tablets containing semaglutide are taken once daily with no more than 4 ounces of plain water, at least 30 minutes prior to the first meal, beverage, or oral medication of the day. Thirty minutes after taking the tablet, you can eat, drink, or take other oral drugs. Consume the tablets in their whole. It is not recommended to chew, break, or crush tablets.

Use of semaglutide in general

Stress, disease, surgery, physical activity, alcohol consumption, and meal skipping can all have an impact on blood sugar levels.

Hypoglycemia, or low blood sugar, can cause shakiness, irritability, dizziness, and extreme hunger. Eat or drink hard candy, crackers, raisins, fruit juice, or non-diet cola to promptly correct hypoglycemia. Your physician might recommend glucagon injections if your hypoglycemia is severe.

If you frequently have symptoms of hyperglycemia, such as increased thirst or urination, let your doctor know. Before altering your dosage or drug schedule, see your physician.

Diet, exercise, weight management, medical testing, and specialized medical care may also be part of your treatment.

Dehydration can occur during a protracted disease.

Even if you change out the needle, you should never share an injection pen. A disease or infection can spread from person to person when an injection is shared.

The Ozempic injectable pen has several dosages. Keep the pen at room temperature or in the refrigerator with the needle out after your first use. Protect from heat and light. Keep the cap on while not in use. Throw away the pen 56 days after the first use, or if the dose counter shows less than 0.25 mg.

Never use a needle again. Put it in a “sharps” container that can’t be punctured, then dispose of it according to local or state regulations. Keep out of the reach of pets and kids.

The storage

Ozempic

• Before Ozempic is used for the first time, it should be stored in a refrigerator between 36°F and 46°F (2°C and 8°C). Keep them out of the freezer and away from the refrigerator’s cooling element. It is not recommended to freeze Ozempic or utilise it after freezing.
• For 56 days after first use, the Ozempic pen can be stored in a refrigerator (36°F to 46°F; 2°C to 8°C) or at a regulated room temperature (59°F to 86°F; 15°C to 30°C). Do not freeze.
• Keep the pen cap on while not in use. Ozempic must be protected from intense heat and sunlight.
• Keep the Ozempic pen empty of an injection needle and always remove and discard of the needle after each injection.

Wegovy

In the refrigerator, the single-dose pen should be stored between 2°C and 8°C (36°F and 46°F). The pen can be kept between 8°C and 30°C (46°F and 86°F) for up to 28 days if needed before the cap is taken off. Do not freeze. Don’t let Wegovy see the light. Until the time comes to administer Wegovy, it must be kept in its original container. Throw away the Wegovy pen after using it.

Rybelsus

Store between 68° and 77°F (20° and 25°C); the USP Controlled Room Temperature allows for variations between 59° and 86°F (15° and 30°C). Preserve the original bottle for use and storage.
Tablets should be stored in their original bottle until they are used to protect them from moisture. Keep this medication away from moisture and keep it dry.

Conclusion

According to clinical data, semaglutide is a weight-management breakthrough that gives patients a methodical way to reach their health objectives. Numerous mechanisms, such as appetite management, delayed stomach emptying, and improved metabolic performance, are used in research to validate its efficacy. Many patients who take the medicine as directed experience significant weight loss as a result of these combined effects, and studies have shown that the effects last past the first month of treatment.

Throughout semaglutide treatment, medical supervision is still crucial as medical professionals assist patients in maximizing their outcomes through appropriate dosages and lifestyle changes. Responses from patients vary, underscoring the significance of continuous monitoring and individualized medical advice. Before beginning therapy, medical professionals advise talking about medical history and weight management goals to see if semaglutide is appropriate for a patient’s needs and situation.

FAQs

Reference

• Semaglutide: Uses, dosage, side effects, brands. (n.d.). Drugs.com. https://www.drugs.com/semaglutide.html
• First month on Semaglutide: What to expect (Timeline) | Eden Blog. (n.d.). https://www.tryeden.com/post/first-month-on-semaglutide
• Diet, M. C. (2024, November 22). How fast does semaglutide kick in? Mayo Clinic Diet. https://diet.mayoclinic.org/us/blog/2024/how-fast-does-semaglutide-kick-in/ ‍