From the Guidelines
Ozempic (semaglutide) promotes weight loss by mimicking the hormone GLP-1, which regulates appetite and food intake by increasing feelings of fullness, slowing stomach emptying, and reducing hunger signals in the brain. For weight management, patients typically start with a low dose of 0.25 mg injected subcutaneously once weekly for the first month, then increase to 0.5 mg weekly for another month, with potential further increases to 1 mg and sometimes 2 mg weekly based on response and tolerability, as seen in the STEP trials 1. Common side effects include nausea, vomiting, diarrhea, constipation, and abdominal pain, which often improve over time as the body adjusts to the medication, and are similar to those reported in other studies 1. More serious but rare side effects may include pancreatitis, gallbladder problems, kidney issues, and potential thyroid tumors (based on animal studies) 1. Patients should stay well-hydrated, eat smaller meals, and avoid fatty or spicy foods to help manage gastrointestinal side effects. It's also important to note that while Ozempic is FDA-approved for type 2 diabetes management, its higher-dose version, Wegovy (also semaglutide), is specifically approved for weight management, though they contain the same active ingredient, and semaglutide has been shown to reduce the risk of cardiovascular events in adults with overweight or obesity without diabetes 1. The American Gastroenterological Association recommends using semaglutide 2.4 mg with lifestyle modifications for the long-term treatment of obesity, given its glucoregulatory benefits and association with reduced risk of major adverse cardiovascular events 1. Overall, the use of Ozempic for weight loss should be considered in the context of its potential benefits and risks, and under the guidance of a healthcare professional.
From the Research
Mechanism of Action
- Ozempic (semaglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist that mimics the actions of enteropancreatic hormones to modify central appetite regulation and provide multiple cardiometabolic weight-loss benefits 2.
- It works by regulating appetite in the brain, leading to reduced food intake and increased feelings of fullness 2.
Efficacy in Weight Loss
- Semaglutide has been shown to be effective in promoting weight loss, with a meta-analysis indicating an 11.4% greater weight loss compared to placebo 2.
- Another study found that semaglutide was associated with significant weight loss and improved cardiometabolism when used in combination with lifestyle interventions 3.
Typical Dosing
- The typical dosing of semaglutide for weight loss is not explicitly stated in the provided studies, but it is mentioned that it is administered via injection 2.
- The dosing regimen may vary depending on the individual patient and their response to the medication, and should be determined by a healthcare professional.
Potential Side Effects
- Common side effects of semaglutide include nausea (28%-44%), diarrhea (21%-30%), and constipation (11%-24%) 2.
- Other potential side effects include gastrointestinal discomfort, pancreatitis, and liver impairment, although the risk of these events may vary depending on the individual patient and their medical history 4, 5.
- A stratified analysis of adverse event reports found that semaglutide was associated with a high correlation with non-lethal pancreatitis reports, and that orlistat exhibited a higher reporting rate of gastrointestinal adverse events 5.