How to manage cravings in patients taking Ozempic (semaglutide)?

From the Guidelines

Managing cravings in patients taking Ozempic (semaglutide) involves a combination of dietary strategies, behavioral modifications, and understanding the medication's effects, with a focus on promoting satiety and reducing appetite. To manage cravings, patients should focus on consuming protein-rich foods (20-30g per meal) and high-fiber options (vegetables, whole grains, legumes) to promote satiety, as recommended by the American Gastroenterological Association 1. Small, frequent meals spaced 3-4 hours apart can help maintain stable blood sugar levels and prevent intense hunger. Adequate hydration (at least 64 ounces of water daily) is essential, as thirst can sometimes be mistaken for hunger. When cravings occur, patients should try waiting 10-15 minutes before acting on them, as cravings often pass. Mindful eating practices, including eating slowly and without distractions, can help patients recognize true hunger versus emotional eating. Physical activity, particularly after meals, can reduce cravings by regulating blood sugar and releasing endorphins. Semaglutide works by mimicking GLP-1, a hormone that slows gastric emptying and signals fullness to the brain, so some reduction in appetite is an expected therapeutic effect, as noted in the 2020 expert consensus decision pathway on novel therapies for cardiovascular risk reduction in patients with type 2 diabetes 2. If cravings become severe or disruptive, patients should consult their healthcare provider, as dosage adjustments may be necessary. Keeping a food and craving journal can help identify patterns and triggers that can be addressed with targeted strategies, and behavioral interventions, such as self-monitoring, mindful eating, stimulus control, and stress management, can empower the individual to identify and address factors that promote weight gain, as discussed in the obesity in south and southeast Asia-a new consensus on care and management study 3.

Some key points to consider:

• The importance of a comprehensive approach to managing cravings, including dietary strategies, behavioral modifications, and understanding the medication's effects.
• The role of protein-rich foods and high-fiber options in promoting satiety and reducing appetite.
• The benefits of small, frequent meals and adequate hydration in maintaining stable blood sugar levels and preventing intense hunger.
• The value of mindful eating practices and physical activity in reducing cravings and promoting overall health.
• The potential for dosage adjustments if cravings become severe or disruptive, and the importance of consulting a healthcare provider in such cases.

From the Research

Managing Cravings with Ozempic (Semaglutide)

To manage cravings in patients taking Ozempic (semaglutide), several strategies can be considered based on the available evidence:

• Reduced cravings: Studies have shown that semaglutide can lead to a significant reduction in cravings, including sweet and savory cravings 4, 5.
• Emotional eating: Semaglutide has been found to ameliorate emotional eating and other abnormal eating patterns, which can contribute to cravings 4.
• Food addiction: Semaglutide has been shown to be effective in reducing food addiction symptomatology among people with obesity 5.
• Weight loss: Semaglutide can lead to significant weight loss, which may also help reduce cravings 4, 5, 6, 7, 8.
• Lifestyle interventions: Combining semaglutide with a reduced calorie diet and increased physical activity may enhance its effectiveness in managing cravings and promoting weight loss 6, 8.

Comparison with Other Treatments

When comparing semaglutide with other treatments, such as tirzepatide, it is essential to consider the individual patient's needs and response to treatment:

• Tirzepatide vs. semaglutide: Tirzepatide has been found to be superior to semaglutide in terms of weight loss and reduction in waist circumference 7.
• Individualized treatment: The choice of treatment should be based on the patient's specific characteristics, such as the presence of type 2 diabetes or other comorbidities 6, 7, 8.

Monitoring and Support

Regular monitoring and support are crucial to help patients manage cravings and achieve optimal outcomes with semaglutide:

• Regular follow-ups: Patients should be monitored regularly to assess their response to treatment and adjust their lifestyle interventions as needed 4, 5, 6, 7, 8.
• Support systems: Patients may benefit from support systems, such as counseling or support groups, to help them manage cravings and stay motivated 4, 5, 6, 7, 8.