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Semaglutide is a weight-loss medication (it’s available by prescription under the brand name Wegovy™), and it is given once a week by self-injection under the skin. It was approved by the FDA for the treatment of overweight and obesity in June 2021 (with similar medications being developed as well). Semaglutide doesn’t work for everyone, but when it’s successful, it can help someone shed 15% of their body weight. (If you weigh 200 pounds, for example, that would be 30 pounds.)
“This medicine helps you feel full earlier,” says Dr. Jastreboff. “It means you will have little desire to reach for ‘seconds’ or a snack later.”
Semaglutide is the first of a new generation of highly effective hormone-based obesity medications. Anti-obesity medications have been around for decades, and there are several currently in use.
This class of GLP-1 analogue medications has been used for over 15 years to treat type 2 diabetes (semaglutide specifically was FDA-approved in 2017 for diabetes). With semaglutide, people are receiving more GLP-1, albeit in a synthetic form,” Dr. Jastreboff says. “They’re essentially getting back more of that hormone, which helps them feel full.”
If your blood sugar levels are too high, semaglutide helps to lower them.
Semaglutide reduces feelings of hunger which means you eat less food. This helps to reduce your body weight, when combined with a healthy diet and exercise.
Semaglutide has been shown to stop the progression of plaques in blood vessels in studies of animals.
Semaglutide mimics a hormone called glucagon-like peptide-1 (GLP-1), which is secreted in the gut and targets receptors throughout the body, including the brain. When a person is eating, GLP-1 sends the brain the “I’m full” signal.
Semaglutide also decreases “gastric emptying,” the process by which stomach contents are moved into the first part of the small intestine as part of the digestive process. “But this effect wanes over time,”. “The main way semaglutide helps treat obesity is through its action in the brain.”
Semaglutide is typically injected just under the skin (subcutaneously) in your abdomen, upper arm, or thigh. Avoid injecting the medication into the same spot every time. But injecting in the same body area (e.g., thigh) is OK as long as you’re rotating sites within the area each time.
The target maintenance dose is 2.4 mg once weekly. Before reaching the target dose, a typical dosing schedule may look like:
| first month | 0.25 mg once weekly |
| second month | 0.5 mg once weekly |
| third month | 1 mg once weekly |
| fourth month | 1.7 mg once weekly |
Since semaglutide slows down how quickly food leaves your stomach, you may experience side effects like nausea and vomiting.
Once you get started on the medication, your provider will slowly raise your dosage every 4 weeks to help make these effects more manageable.
Some people may not be able to reach or tolerate the target dose due to side effects. If this is the case, your provider may wait another month before raising your dose.
However, they may have you discontinue the medication if you’re unable to reach or stay on the target dose.
The common side effects may include (This is not a complete list of side effects and others may occur.):
headache, dizziness, tiredness;
diarrhea, constipation;
upset stomach, heartburn, burping, gas, bloating;
low blood sugar (in people with type 2 diabetes);
nausea, vomiting, stomach pain, loss of appetite;
stomach flu symptoms.