How Does Semaglutide Work for Weight Loss?

Weight loss is a common goal among adults, considering nearly two-thirds of American adults are considered overweight.

Semaglutide is an injectable medication used to treat type 2 diabetes, that can help lower your blood sugar levels, but can it also help you lose weight?

What is semaglutide?

Semaglutide is a generic medication for the brand name Ozempic. Semaglutide is in a class of medications called GLP-1 receptor agonists. 

GLP-1 receptors in your pancreas help increase insulin secretion while reducing glucagon secretion, a hormone that raises blood sugar levels. GLP-1 receptor agonists activate these receptors to help control blood sugar levels.

Semaglutide may promote weight loss because it helps reduce hunger and promotes fullness by slowing stomach emptying. Slowed stomach emptying can also help promote more stable blood sugar levels.

Semaglutide is a non-insulin injectable medication for type 2 diabetes. The typical dose is 0.25 milligrams once weekly for four weeks, then 0.5 milligrams weekly for at least four weeks. If blood sugar targets aren’t being met with 0.5 milligrams weekly, the dose can gradually be increased to a maximum of 2 milligrams weekly.

Does semaglutide cause weight loss? 

Insulin resistance is the primary cause of type 2 diabetes and can make it difficult to lose weight. Losing at least 5% of your initial body weight can improve insulin resistance, which might make achieving weight loss through healthy lifestyle habits easier.

Semaglutide can cause weight loss in some people who take it. In a study of over 1,900 people (without diabetes) considered overweight or obese, taking 2.4 milligrams of semaglutide weekly resulted in an average weight loss of nearly 15% compared to 2.4% with the placebo group.

According to a 40-week trial on people with type 2 diabetes who were also taking metformin, people taking 0.5 milligrams of weekly lost an average of 9.3 pounds (the average starting weight was 213 pounds) or about 4% of their body weight. 

People taking 1 milligram of semaglutide weekly lost an average of 12.8 pounds (average starting weight of 211 pounds) or around 6% of their body weight.

RELATED: Ozempic vs Metformin: Which is Better?

How does semaglutide cause weight loss?

There are a couple of reasons semaglutide may help you lose weight. First, it helps improve insulin sensitivity and reduce insulin resistance. When your body is more sensitive to insulin, your pancreas doesn’t have to produce as much insulin.

Insulin is a fat-storage hormone. If you have lower insulin levels (from improving insulin sensitivity), your body can store less fat.

Semaglutide slows stomach emptying, which can make you feel fuller for longer after you eat. This can result in weight loss due to reduced appetite and increased satiety.

If you experience some of the common side effects of semaglutide, such as nausea, diarrhea, stomach pain, and constipation, you might not have as much of an appetite, which can cause you to lose weight. These side effects might get better as your body gets used to the medication.

How much weight can you lose with semaglutide?

Weight loss with semaglutide varies. According to the studies mentioned above, the average weight loss with semaglutide varied from 4-6% of participants’ initial body weight. 

Weight loss of up to 15% was experienced by some people taking 2.4 milligrams weekly, which is above the maximum recommended weekly dose.

What dosage of semaglutide causes weight loss?

According to the studies mentioned above, dosages of semaglutide for weight loss varied from 0.5 milligrams to 2.4 milligrams weekly. 

The maximum recommended dose is 2 milligrams per week. This means that you might experience weight loss with 0.5-2 milligrams of semaglutide weekly.

The dosage prescribed to you will vary depending on your body weight, other medications, duration of diabetes, and other factors.

How long should you take semaglutide?

There is no specific time frame someone should be on semaglutide and the length prescribed will vary depending on the individual. It is typically prescribed as a long-term treatment for managing blood sugar levels in individuals with type 2 diabetes. It’s important to follow your doctor’s instructions regarding how long you should continue taking the medication. They will consider factors such as your blood sugar control, overall health, and any other medications you may be taking.

When is the best time to take semaglutide?

Semaglutide can be taken at any time of the day. You should take it on the same day each week. If you forget a dose, take it as soon as you remember, as long as your scheduled dose day is two or more days away.

If you want to change the day of the week you take semaglutide, be sure to wait at least two days after your last injection to start injecting on your new day. 

You can take semaglutide with or without food. It is a long-acting medication, so taking it with or without food likely won’t have as much impact as it can with shorter-acting medications.

How long after starting semaglutide do people tend to experience weight loss?

If you are considering starting semaglutide you may be wondering how quickly do you lose weight on semaglutide? The studies on semaglutide for weight loss were done over longer periods, ranging from 40-68 weeks. 

You might experience weight loss sooner than that. How long it takes to lose weight will depend on your dosage of semaglutide. 

If you only take 0.5 milligrams per week as a starting dose, you might not experience as much weight loss as someone whose dosage is bumped up to 2 milligrams per week.

You should give semaglutide at least 6-8 weeks to start taking effect in terms of blood sugar control and weight loss. Remember that the dose is recommended to be increased in four-week increments starting with 0.5 milligrams weekly, so it might take a couple of months to get to your target dose.

It’s important to remember that semaglutide isn’t a weight loss medication. If your blood sugar levels improve after taking it but you aren’t losing weight, you should focus on other ways to lose weight since semaglutide is benefiting your blood sugar, which is what it’s intended to do.

Will your doctor prescribe semaglutide for weight loss?

Ozempic is meant to treat type 2 diabetes and isn’t currently approved by the FDA as a weight-loss drug. However, it is worth discussing ozempic (semaglutide) vs wegovy. Wegovy was approved for weight management in 2021, and it is another brand name of the same medication (semaglutide) as Ozempic.

Some healthcare providers might use semaglutide off-label to treat conditions linked to insulin resistance, such as polycystic ovarian syndrome (PCOS).

Your healthcare provider might not prescribe this medication if you don’t have a history of diabetes or other blood sugar issues. 

If you are prescribed semaglutide for weight loss, your health insurance company might not cover the cost without a diabetes diagnosis, so you should check with your insurance to see what they might cover.

Semaglutide is very expensive without health or prescription insurance coverage. According to GoodRx, a prefilled pen containing 2 milligrams of semaglutide can end up in the $800-$900 range if you’re paying out of pocket.

What are the side effects of semaglutide?

All medications come with potential side effects. Everyone is different, so you might experience different side effects from someone else taking semaglutide for diabetes.

Some side effects are minor and aren’t life-threatening. There is always a chance you might develop a rare but serious side effect or complication while taking medications, including semaglutide. You should speak with your healthcare provider about the potential risks and benefits of this medication.

The most common side effects reported among patients taking semaglutide include:

• Nausea
• Diarrhea
• Vomiting
• Stomach pain
• Constipation

There is a chance that semaglutide may cause thyroid cancer. You shouldn’t take semaglutide if you have a history of thyroid cancer or a thyroid tumor. You should also avoid taking it if anyone in your family has a history of medullary thyroid carcinoma, a type of thyroid cancer.

According to clinical trials, Ozempic may cause pancreatitis, a painful inflammation of your pancreas.

Ozempic may worsen diabetic retinopathy, which is when the nerves in your eyes are damaged from high blood sugar. If you already have retinopathy, Ozempic might not be a good choice for you.

Another side effect you may have heard about is ‘Ozempic face,’ which is characterized by having a saggy, gaunt, or hollow-looking face after weight loss.

Can semaglutide cause weight gain?

Taking semaglutide often results in weight loss, but there is a chance you can gain weight while taking it. According to the manufacturer of semaglutide, some people in clinical trials gained weight while taking it.

Semaglutide isn’t commonly known to cause weight gain. You might gain weight while taking semaglutide due to reasons like diet changes, changes in physical activity, and taking other medications that cause weight gain.

How weight loss can help you manage your diabetes

Insulin is a fat-storage hormone that also helps lower your blood sugar levels. High insulin levels (such as insulin resistance) can cause weight gain. Type 2 diabetes is caused by insulin resistance, which leads to elevated insulin levels as your body tries to lower your blood sugar levels.

Weight loss helps improve your body’s sensitivity to insulin. When your body is more sensitive to insulin, it doesn’t have to produce so much insulin to help keep your blood sugar levels under control. If your insulin levels drop due to improved insulin sensitivity, you might lose weight.

According to a study, a 10% weight loss among patients with type 2 diabetes reduced hemoglobin A1c levels by around 0.8%. That means that your A1c could drop from 8% to almost 7%, which is a sign of improved blood sugar control.

Weight loss can also help improve your cholesterol levels, promote healthy blood pressure levels, and improve your mobility. If you’re able to be more active due to weight loss, you can experience further health benefits from being more physically active.

If you have prediabetes, losing 5-10% of your body weight can reduce your risk of getting diabetes by nearly 60%.

The risk for diabetes complications decreases when your blood sugar control improves. That means that losing weight might help cut your risk of diabetes-related health problems like heart disease, kidney disease, nerve damage, and amputations.

Other ways to lose weight while taking semaglutide

The best way to pursue weight loss is to do it sustainably. Making small and realistic lifestyle changes can add up over time and help you lose weight and keep it off.

Focus on your sleeping habits

Sleep deprivation can wreak havoc on your health, including your blood sugar levels and your weight. People who don’t get enough sleep may be more likely to experience unwanted weight gain. 

Being sleep-deprived can alter hormones that impact your hunger and satiety (fullness) cues. Sleep deprivation can increase ghrelin levels (the hormone responsible for making you feel hungry) and reduce levels of leptin, the hormone that helps make you feel satisfied.

Sleep deprivation can cause fatigue, which might increase your cravings for high-sugar foods to try to get more energy. 

You might be less likely to make healthy eating choices when you’re tired, and you probably won’t feel up for exercise when you’re running low on sleep.

Aim to get more than six hours of sleep but not more than nine hours per night. Getting too little and too much sleep are both associated with insulin resistance and might impact your weight.

Fill up on fiber

Dietary fiber comes from parts of plant foods that your body can’t digest or absorb. Fiber helps make you feel full since it takes longer for your stomach to digest than some lower-fiber foods. Including fiber in your meals and snacks is one method to aid in healthy weight loss.

Plant-based foods vary in fiber content based on their type and how much they’ve been processed. For instance, a whole apple has more fiber than applesauce because the fruit isn’t broken down from its original state and maintains the skin.

Fiber is also found in wheat products, but its amount is dependent on the type of product. 100% whole grain products maintain most of their fiber content because the bran and germ are maintained instead of being removed like they are in refined grain products. 

Some examples of high-fiber foods include:

• Raspberries
• Pears
• Apples
• Bananas
• Oranges
• Strawberries
• Green peas
• Broccoli
• Turnip greens
• Brussels sprouts
• Potatoes
• Cauliflower
• Carrots
• Barley
• Bran flakes
• Quinoa
• Oat bran 
• Oatmeal
• AIr-popped popcorn
• Brown rice
• Whole wheat bread 
• Split peas
• Lentils
• Black beans
• Chia seeds
• Almonds 
• Pistachios
• Sunflower kernels

Eating a high-fiber diet and taking Ozempic might boost your satiety even more and help you achieve your weight loss goals.

Aim to increase your physical activity level

Physical activity plays a major role in losing weight. Unfortunately, most people fall short of the recommendation to get 150 minutes of physical activity per week. Physical inactivity can lead to weight gain and worsen blood sugar control.

In order to achieve sustainable weight loss, it’s best to find an activity that you enjoy. You don’t have to spend hours of your day at a gym or hire a personal trainer to benefit from exercise. Walking, gardening, horseback riding, and other activities can count toward your exercise goals.

If you have a busy schedule, aim to get your physical activity in with three ten-minute segments. A ten-minute walk in the morning before work, a ten-minute walk during your lunch break, and a ten-minute walk after dinner will easily satisfy the 30 minutes per day goal.

Slash added sugar

Added sugar contributes a significant amount of additional calories to your diet. Added sugar is any type of sugar that isn’t naturally present in a food or drink.

Sugary beverages like soda, sweetened coffee, and many other drinks are the leading source of added sugar in the typical Western diet. Added sugar can also be found in foods that seem healthy, like whole-wheat bread, yogurt, and many types of cereal.

The American Heart Association recommends limiting your added sugar intake to fewer than 36 grams of added sugar per day. One 12-ounce can of standard Cola contains 39 grams of added sugar, which is over 100% of the recommendation.

What if you’re worried about your weight loss? 

Weight loss can be beneficial, but it can also be problematic if it’s unintentional or happens very quickly. Weight loss can also be harmful if you were at a bodyweight considered healthy (or even underweight) to begin with. Severe weight loss is a concern among elderly people who can benefit from extra energy reserves in the case of illness.

Rapid, significant weight loss can signify serious underlying health conditions. If you experience rapid, significant weight loss and also have worrying symptoms like pain, extreme fatigue, or other changes in your health, you should consult your healthcare provider for medical advice.

You might experience rapid weight loss if you make dramatic lifestyle changes, including “fad” diets and extreme exercising.  A review of 29 long-term weight loss studies found that “more than half of the lost weight was regained within two years, and by five years, more than 80% of lost weight was regained”.

Weight loss from restrictive and extreme habits can be difficult to sustain. Remember that managing your diabetes and your weight is a lifelong process and that dramatic, short-lived weight loss won’t benefit your health in the long run.

Conclusion

Semaglutide is approved to treat type 2 diabetes, but it might also help you lose weight. For best results, you should practice healthy lifestyle habits to promote sustainable, long-term weight maintenance.

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