Semaglutide, marketed as Ozempic and Wegovy, is also available as compounded Semaglutide. It is a glucagon-like peptide-1 (GLP-1) receptor agonist primarily used as an anti-glycemic drug in type 2 diabetes therapy. However, following its demonstrated efficacy in clinical trials, it has also been approved as a pharmacological agent for the treatment of excessive weight.
Lose Weight
Semaglutide as an agonist
To understand the rationale behind its use as a weight shredder, one has to understand the role of GLP-1 in human physiology.
GLP-1 plays a notable role in glucose metabolism. GLP-1, secreted by intestinal cells in response to food intake, regulates blood glucose levels by stimulating pancreatic insulin release and inhibiting glucagon release from the liver, thereby reducing hyperglycemia without inducing hypoglycemia.
Coupled with its anti-diabetic effect, GLP-1 also acts on the brain to increase the feeling of satiety, decrease appetite, and reduce gastric emptying—all of these work to reduce excessive food intake and ultimately lead to weight loss.
These effects make GLP-1 and its receptor a target for specific medications like semaglutide in treating diabetes and obesity.
Clinical Benefits and Outcome
A study conducted by Blundell J. et al. (2017) shows that after 12 weeks of treatment, weight loss induced by Semaglutide was due to reduced energy intake and appetite. There was also marked improvement in eating control, a lowered preference for fatty, energy-dense food, and fewer cravings. Weight loss post-therapy was more body fat loss than lean body mass.
A meta-analysis of 19 trials showed that at six months, GLP-1 receptor agonists, such as semaglutide, are associated with a significant reduction in Body Mass Index (BMI) compared with placebo and any anti-glycemic agent (Monami et al., 2012).
Life after Semaglutide
Semaglutide for obesity helps individuals lose weight, but continued success requires a commitment to healthy habits.
After exposure to an external stimulus of that magnitude, maintaining weight loss can be quite a hassle with several multifaceted factors, including biological, behavioral, and even environmental factors coming into play.
As the body is no longer subjected to the appetite-suppressing effect of semaglutide, a surge in appetite and reduced satiety occurs, posing a significant risk to the preciously acquired weight loss.
Metabolically, the body also responds to a significant weight loss by decreasing the Basal Metabolic Rate (BMR). BMR is the minimal amount of energy, in calories, required to maintain the body’s physiological functions at rest, such as breathing, digestion, cell production, etcetera. A reduced BMR portends weight gain if calorie intake is not appropriately adjusted; maintaining the same calorie intake while the body’s required expenditure reduces leaves unused calories. These calories will be stored as fat!
One might find adhering to a healthy diet challenging without semaglutide-induced motivation to lose weight. Individuals are prone to reverting to their previous eating habits.
What to do?
Given the challenges mentioned above, maintaining healthy weight loss due to semaglutide therapy requires a comprehensive approach that involves lifestyle modifications, behavioral strategies, and, most invariably, continued medical support.
Dietary approaches
A diet that promotes satiety and is rich in nutrients reduces the likelihood of overeating. Such diets include those rich in vegetables, whole grains, lean meat, fruits, and healthy fats need to be emphasized.
Despite the diet, as mentioned earlier, one has to be mindful of the amount of food one eats. Monitoring portions of food sizes will help reduce excessive calorie intake.
Exercise and physical activity
Pleas J. (1988) stressed that while dieting is a depriving experience, walking and other aerobic activities can be a refreshing experience that restores an obese individual to another degree of freedom.
Simple lifestyle changes, such as walking that extra block, taking the stairs instead of the elevator, standing rather than sitting for long periods, can increase the body’s expenditure (BMR) and ultimately burn stored calories.
Incorporating and engaging in regular physical activity is essential for maintaining weight.
Behavioral modifications
Setting realistic goals is vital to maintaining weight loss. Small, incremental changes are generally more sustainable than large ones. Take baby steps.
Stress has been attributed to some unhealthy engagements, such as stress eating. Incorporation of some healthy stress management techniques, such as yoga and meditation, can help curb this effect.
Continued Medical Support
Support from dieticians, nutritionists, and even mental health professionals can prove valuable to weight maintenance. In some cases, medications such as statins, and bile acids sequestrants, prescribed by healthcare providers, can help address and manage underlying health issues that could impart weight.
Conclusion
To a significant degree, the journey of shedding fat and keeping the fat shed is a strenuous journey that can test the limits of your willpower. There is usually not one solution that fits all sizes. As you gain more experience with using the tools and techniques detailed above, you will find out what exact combination works for you. Don’t give up on the journey. The process may be hard, but the rewards are worthwhile.
References
Blundell, J., Finlayson, G., Axelsen, M., Flint, A., Gibbons, C., Kvist, T., & Hjerpsted, J. B. (2017). Effects of once-weekly semaglutide on appetite, energy intake, control of eating, food preference, and body weight in subjects with obesity. Diabetes, obesity & metabolism, 19(9), 1242–1251. https://doi.org/10.1111/dom.12932
Monami, M., Lamanna, C., Desideri, C. M., & Mannucci, E. (2012). DPP-4 inhibitors and lipids: systematic review and meta-analysis. Advances in therapy, 29(1), 14–25. https://doi.org/10.1007/s12325-011-0088-z
Pleas J. (1988). Long-term effects of a lifestyle-change obesity treatment program with minorities. Journal of the National Medical Association, 80(7), 747–752.
