Semaglutide: for weight loss, use with caution!

Weight loss has always been a hot topic of great concern to modern people, because obesity will not only affect our appearance and temperament, but may also cause a series of health problems, including hyperlipidemia, hypertension, diabetes, etc. In order to achieve the goal of losing weight, there are endless ways to lose weight such as dieting, exercise, and taking weight loss drugs. What I want to introduce to you today is Semaglutide, a new Internet celebrity weight loss drug that has become very popular on the Internet recently.
Semaglutide has attracted the attention of many people because of its significant weight loss effect, but if you read its drug instructions carefully, you will find that its "job" is actually to control blood sugar. So, how did semaglutide, a hypoglycemic drug, “cross over” into the field of weight loss? Let the pharmacist take you through it.

How does semaglutide help you lose weight?
First of all, it needs to be explained that semaglutide is not a specialized weight-loss drug. It is an incretin-type hypoglycemic drug and is an ultra-long-acting glucagon-like peptide-1 receptor agonist (GLP- 1). The half-life is approximately 1 week, suitable for once-weekly subcutaneous administration, with a 4-week course of treatment. Therefore, some people jokingly call it "liraglutide weekly preparation".

Like other GLP-1RAs, semaglutide can selectively bind to and activate GLP-1 receptors, stimulating insulin secretion and reducing glucagon secretion in a glucose concentration-dependent manner to exert hypoglycemic effects. At the same time, it can also affect weight changes by slightly delaying early postprandial gastric emptying time.

However, good weight loss results cannot be achieved by simply taking injections. According to the mechanism of action, if the drug is stopped or the dose is tolerated, the appetite and stomach will be "liberated", and the possibility of weight regain will definitely increase. The phenomenon of revenge eating can become a major "stumbling block" on the road to weight loss.
How effective is semaglutide for weight loss?
A phase III clinical trial published in the New England Journal in 2020 showed that compared with baseline, the average weight change of semaglutide was reduced by 15.8%. On the basis of diet and exercise control, semaglutide was administered subcutaneously once a week. Injections of semaglutide resulted in significant weight loss at 68 weeks. Based on these clinical data, in June 2021, the U.S. Food and Drug Administration (FDA) approved semaglutide for the treatment of obese or obese patients with one or more weight-related diseases (such as hypertension, type 2 diabetes, or high cholesterol). Overweight adult patients.
Based on clinical research data, the U.S. Food and Drug Administration (FDA) has approved semaglutide as an auxiliary means to reduce dietary calories and increase physical activity for long-term weight management, suitable for patients with an initial body mass index (BMI) ≥30kg/ Obese patients with m2 or overweight patients with a BMI ≥27kg/m2 and at least one weight-related comorbidity (such as hypertension, type 2 diabetes, dyslipidemia).

It can be seen that even if it is used "cross-border" for weight loss, there are strict requirements for the people who are suitable for semaglutide. In many of the successful cases of semaglutide weight loss we have seen on social platforms, a large proportion of them do not meet the definition of obese patients. Many friends who are slightly obese or even "feel fat" use the medication themselves. Risks are unpredictable. At present, semaglutide has not been approved for weight loss treatment in my country. Pharmacists would like to remind you: Do not blindly follow the trend. You must follow the indications in the drug instructions and use the drug under the advice and guidance of professional doctors.
Adverse reactions of semaglutide
Although so far, no major safety issues have arisen with semaglutide. However, the drug is toxic, and the adverse reactions of semaglutide are also very obvious. In addition to the hypoglycemic reaction that occurs with all antidiabetic drugs, gastrointestinal reactions are the most prominent manifestation of this drug.
The incidence of nausea, constipation, vomiting and diarrhea caused by semaglutide is as high as 82.8%, and 7% of people discontinue treatment due to adverse reactions. In addition, semaglutide may increase the risk of pancreatitis, cholelithiasis, diabetic retinopathy, and medullary thyroid cancer. These drug risks are also worthy of attention.

Pharmacist reminder
1. To prevent or slow down gastrointestinal disorders, the dosage of semaglutide should be gradually increased, eating should be done slowly and when you feel full, and you should avoid eating high-fat foods.
2. When used in combination with insulin secretagogues such as insulin or sulfonylureas, consideration should be given to reducing the dose of insulin or insulin secretagogues to reduce the risk of hypoglycemia.
3. Patients with diabetic retinopathy (DRP) need to undergo a fundus examination before using this product, and the risk of deterioration should be closely monitored during use.
4. Patients with risk factors for pancreatitis should use this product with caution; patients with a past or family history of medullary thyroid cancer and patients with multiple endocrine neoplasia syndrome type 2 should not use this drug.