From Diabetes Control to Weight Loss: Advantages And Side Effects Of Semaglutide

If you haven't heard of semaglutide (or Ozempic), are you even keeping up with current health news? In the realm of modern medicine, few drugs have garnered as much attention and acclaim as semaglutide. Originally developed to tackle diabetes, this remarkable medication has emerged as a game-changer in the fight against obesity. However, like any breakthrough, semaglutide’s journey is not without its complexities and considerations. Here’s all you need to know about this innovative drug.

The Trio Of Hormones

When we eat food, a complex interplay of hormones starts playing out.

When food reaches the small intestine, the presence of carbs and fats triggers the intestinal L cells to secrete GLP 1 (Glucagon-Like Peptide-1). GLP 1 enhances the release of insulin from the pancreas in response to increased glucose levels after a meal. It also suppresses the secretion of glucagon. It also slows the emptying of food from the stomach, leading to a slower and more controlled absorption of glucose. GLP 1 also acts on the brain to promote satiety and reduce appetite, which can help control food intake and contribute to weight management. Let’s look at the other two important hormones in relation to our food - insulin and glucagon.

GLP-1 and elevated blood glucose both stimulate insulin release from pancreatic beta cells, facilitating glucose transfer from blood into muscle and fat cells. Insulin inhibits glucagon secretion, preventing excessive glucose production by the liver, thereby maintaining stable post-meal blood glucose levels through coordinated action with glucagon.

Overall, glucagon and insulin work in tandem to maintain blood glucose levels within a narrow range, with insulin lowering blood glucose after meals and glucagon raising it between meals.

Enter Semaglutide

So where does a drug like semaglutide fit into this scheme and how does it work to reduce blood sugar and cause weight loss?

Semaglutide functions similarly to the GLP-1 hormone by activating GLP-1 receptors, thereby enhancing insulin secretion, inhibiting glucagon release, slowing gastric emptying, and reducing appetite.

Semaglutide improves blood glucose control in adults with type 2 diabetes, by mimicking GLP 1 hormone.

It causes weight loss by way of the following mechanisms –

1. It acts on the brain and suppresses appetite, making people feel full faster and with a much lesser quantity of food.
2. Delayed emptying of the stomach prolongs the feeling of fullness after eating and reduces the frequency of hunger signals, contributing to lower food intake.
3. By making individuals feel fuller and less hungry, semaglutide helps reduce the portion sizes and frequency of meals. This behavioural change is crucial for sustained weight loss.
4. Semaglutide helps improve blood sugar control by enhancing insulin secretion and inhibiting glucagon release. Better glycemic control can lead to more stable energy levels and reduce cravings for high-sugar foods.
5. To summarise, it reduces appetite, keeps one full for longer, reduces overall food intake along improves blood sugar control.

Brand Names

• Ozempic (this has become a generic trademark): Typically used for managing type 2 diabetes. (injection only)
• Wegovy: Approved for chronic weight management. (injection only)
• Rybelsus: An oral form for type 2 diabetes (this is the brand available in India presently)

Originally, semaglutide was developed as anti-diabetic therapy. Ozempic was Food and Drug Administration (FDA)-approved in 2017 as a drug to control diabetes. Within a year of its use, researchers found that it was an effective drug against obesity and in 2021, the brand Wegovy was approved by the FDA for weight management in adults with at least one other weight-related condition.

Needless to say, all of these must be taken only when prescribed by a medical professional after analysis of the patient’s condition and if it matches the criteria required for prescribing semaglutide. Injections are usually given once a week and the oral form is taken once daily.

User Insights

I stumbled upon a Reddit thread – Tell me you’re on semaglutide without telling me you’re on semaglutide

• I have my life back I feel relieved and excited to look the way I feel. Finally, something in my metabolism has been corrected.
• Snacks last forever in the house.
• I can't drink anymore.
• Felt great this morning, went out to run some errands, and then out of nowhere, nausea hit me. I may or may not have thrown up in my purse while I was on the highway.
• I used to be a human heater and now I feel like an ice block.
• What do we want to do this weekend? Ummm... Help me think of something that doesn't involve food.

This thread gives great insights into the effects and side effects of this drug.

Side Effects

This so-called ‘miracle drug’ is not without its side effects. Nausea, vomiting, constipation, diarrhoea, and abdominal pain, are the most common ones. The drug has been in the news for lawsuits filed against it for severe side effects like gall bladder disease and gastroparesis (stomach paralysis, which makes it difficult for the stomach to push out food to the small intestine).

Future Direction

Research is ongoing into broader applications of semaglutide, including potential benefits in non-diabetic populations for weight loss and its cardiovascular effects. Ongoing studies are also examining its long-term safety and efficacy.

Semaglutide is changing the game in medicine, bringing new hope for managing diabetes and obesity. Whether you're thinking about it for better blood sugar control or to lose weight, it's important to talk to your doctor first.