Health rarely comes with simple solutions. Weight gain, in particular, can stem from a variety of factors such as injuries, autoimmune conditions and chronic diseases, or a combination of these. Achieving weight loss while managing these conditions can be incredibly challenging. For some, medical weight loss interventions can be a game-changer. Recently, semaglutide (known under the brand names Ozempic and Wegovy) has gained attention as an effective weight loss medication. Initially developed for diabetes management, semaglutide has shown promise in reducing caloric intake and balancing blood sugar levels, leading to significant weight loss. Early studies suggest that this medication helps control blood sugar and may even reverse type 2 diabetes and cardiac diseases, making it a compelling option for weight loss (Hall & Kahn, 2018).
How Does Semaglutide Work?
Semaglutide works by mimicking a hormone called Glucagon-like Peptide 1 (GLP-1). This hormone stimulates insulin release, which helps lower blood glucose levels. For those with diabetes, insufficient insulin or insulin resistance can be a major problem. Semaglutide helps by enhancing insulin effectiveness, reducing appetite, increasing feelings of fullness, and slowing gastric emptying – all of which contribute to weight loss (Wilding et al., 2021).
The Benefits of Semaglutide
The benefits of semaglutide extend beyond blood sugar regulation. It also helps reduce cholesterol, triglycerides, waist circumference, and blood pressure. Notably, about 75% of individuals taking semaglutide for 60 weeks experience a substantial 15% reduction in body weight, and around one-third achieve a 20% weight loss by 100 weeks (Garvey et al., 2022). These results are significantly better than the typical 5-10% weight loss seen with diet, exercise, and behavioral counseling alone (Hall & Kahn, 2018).
Potential Downsides
When considering a new medication, it’s important to thoroughly review all available information. One potential drawback of semaglutide is that much of the research has been conducted by its manufacturer, Novo Nordisk, over a relatively short two-year period, raising questions about the studies' comprehensiveness.
Additionally, the medication’s effects on gut motility and the gut microbiome require further investigation, as any impact on gut motility could have long-term consequences for the body.
Another concern is that semaglutide’s weight loss benefits often diminish once the medication is discontinued, with most users regaining the lost weight. This may be related to lifestyle modifications being stopped along with the medication (Wilding et al., 2022). Therefore, working with a dietitian or other health professional to meet nutritional needs while on the medication and establishing healthy habits in preparation for discontinuation is crucial for long-term health.
Combining Approaches for Better Results
Combining lifestyle changes and nutrition with semaglutide can significantly enhance your results and overall health. It is important to highlight that the STEP Trial, the research trial conducted on semaglutide, included nutrition and lifestyle couseling sessions every four weeks to support adherance to a reduced-calorie diet (500 calorie deficit) and 150 minutes of physical activity per week (Wilding et al., 2021). While semaglutide is an effective tool for weight loss, true health is more than just the number on the scale. It's essential to nourish your body fully by consuming high-quality foods and maintaining the right balance of carbohydrates, fats, and proteins. Managing stress and reducing inflammation are also key factors. Constantly being on the go without stress-relief techniques can disrupt your hormone levels impacting blood sugar and weight loss. Developing lifelong healthy habits and maintaining balance within your body's tolerance can help sustain your results.
Working with a dietitian can help you learn and integrate these healthy habits into your lifestyle. Dietitians can also assist with gut motility by creating strategic ways to nourish your body and get enough fiber even when you are on the go. Whether you choose to use semaglutide or not, connecting with a dietitian can help you achieve your health goals sustainably and realistically.
The Future of Semaglutide
As the use of semaglutide grows, its role in weight loss management continues to evolve. While it offers life-changing benefits, it’s vital to address underlying factors such as blood sugar balance, chronic inflammation, hormone balance, and stress response through diet, exercise, and stress management techniques. These factors are crucial not only for weight loss but also for preventing chronic diseases, whether you take semaglutide or not. The decision to include semaglutide in your regimen is highly personalized and should be discussed with your dietitian or healthcare provider.
Conclusion
Weight loss can be challenging, particularly for those with chronic diseases or autoimmune conditions. While semaglutide can help achieve and maintain weight loss, sustainable results require a comprehensive approach. This includes lifestyle changes potentially combined with medical support. Collaborating with healthcare professionals allows individuals to create a personalized plan that leverages the benefits of semaglutide while addressing overall health.
References:
Garvey, W. T., Batterham, R. L., Bhatta, M., Buscemi, S., Christensen, L. N., Frias, J. P., Jódar, E., Kandler, K., Rigas, G., Wadden, T. A., & Wharton, S. (2022). Two-year effects of semaglutide in adults with overweight or obesity: The step 5 trial. Nature Medicine, 28(10), 2083–2091. https://doi.org/10.1038/s41591-022-02026-4
Hall, K. D., & Kahan, S. (2018). Maintenance of Lost Weight and Long-Term Management of Obesity. The Medical clinics of North America, 102(1), 183–197. https://doi.org/10.1016/j.mcna.2017.08.012
Wilding, J. P. H., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., McGowan, B. M., Rosenstock, J., Tran, M. T. D., Wadden, T. A., Wharton, S., Yokote, K., Zeuthen, N., & Kushner, R. F. (2021). Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine, 384(11), 989–1002. https://doi.org/10.1056/nejmoa2032183
Wilding, J. P., Batterham, R. L., Davies, M., Van Gaal, L. F., Kandler, K., Konakli, K., Lingvay, I., McGowan, B. M., Oral, T. K., Rosenstock, J., Wadden, T. A., Wharton, S., Yokote, K., & Kushner, R. F. (2022). Weight regain and cardiometabolic effects after withdrawal of semaglutide: The step 1 trial extension. Diabetes, Obesity and Metabolism, 24(8), 1553–1564. https://doi.org/10.1111/dom.14725
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