Semaglutide: Beyond Diabetes - Unveiling Its Additional Benefits

Key Takeaways

• Semaglutide, marketed as Ozempic and Wegovy, was originally developed for type 2 diabetes but is now widely prescribed for weight management.

• It mimics the natural hormone GLP-1 to regulate blood sugar and reduce appetite, leading to significant weight loss when used with lifestyle changes.

• Research shows semaglutide can also improve cardiovascular, kidney, and neurological health, and may have anti-inflammatory benefits.

• Common side effects include nausea, diarrhoea, and constipation, which usually improve over time.

• Wegovy is available on NHS prescription for eligible patients or privately through licensed online pharmacies like Quick Meds.

Semaglutide, also known as Ozempic or Wegovy, is commonly used as a type 2 diabetes medication. However, it's gaining popularity as an injectable weight-loss medication.

In this article, we'll discuss the conditions semaglutide can be used to treat, associated side effects, who it's suitable for, and who can benefit most from including semaglutide in their weight loss programme.

Historical Background

Semaglutide started development in 2012, but it was another 5 years before it was licensed for use in the UK under the brand name Ozempic. At first, the drug was prescribed in patients with type 2 diabetes who could not control their blood sugar using other medications, meaning Ozempic was used to treat diabetes, not for weight management.

But from September 2023, semaglutide was also licensed as a weight loss medication under the brand name Wegovy. Clinical trials show that, alongside lifestyle changes, regular semaglutide injection can have impressive results - up to a 15% reduction of body weight in a year!

With these numbers and plenty of celebrity testimonials, it's no wonder some pharmacies have Wegovy waiting lists of over 20,000 people long. We'll talk about availability later, but let's learn more about how semaglutide works.

Semaglutide: A Quick Review

How Does It Work?

Semaglutide belongs to a medication family called the glucagon-like peptide 1 (GLP 1) agonists. This means they have similar structures to GLP 1, a hormone naturally found in the body that is released after eating. GLP 1 works to increase the amount of insulin in the blood and to reduce hunger cravings. This increase in insulin helps to regulate blood sugar levels.

Other medications in this family include liraglutide and dulaglutide (both used for diabetes).

How Do You Take It?

Semaglutide can be taken as a tablet or injection, but this depends on what you're using it for. For diabetes, a tablet or semaglutide injection can be taken using a regular dosing schedule. Tablets are taken daily, with a starting dose of 3mg that can be increased to 7mg after a month. A semaglutide injection is given weekly, usually starting at 0.25mg and increasing up to 1mg as needed. It's important to change the injection site to avoid build up of fatty tissue in one body area.

Only Wegovy is licensed to treat weight loss, which is available as a four-dose semaglutide pen. This means the only option for weight loss is a semaglutide injection. The dose starts at 0.25 mg, once a week for the first month and goes up in steps: 0.5 mg a week for the second month, 1 mg for the third, and 1.7 mg for the fourth. For the fifth month, the dose may be kept at 1.7 mg or increased to 2.4 mg. Again, it's important to change injection sites.

Regardless of why you're taking semaglutide, it's only available on prescription.

Breaking Down The Benefits

Blood Sugar Control

As we've mentioned, semaglutide was initially only licensed to treat type 2 diabetes. The drug is most commonly used as a diabetes medication, and the brand Ozempic is only licensed for diabetes (not weight loss).

By increasing insulin levels, semaglutide helps reduce blood sugar levels. Ozempic also helps reduce the amount of sugar produced by the liver (1). High blood sugar can have negative effects around the body, so it's important to keep it within normal levels. Low blood sugar, however, can be dangerous and even life-threatening. Luckily, there's no evidence that semaglutide causes low blood sugar alone, although it may be related in people taking insulin alongside semaglutide.

Weight Management

We mentioned that semaglutide works to reduce hunger cravings. As this medication has a similar structure to the natural hormone GLP 1, it has similar effects on the body. These include feeling fuller sooner, feeling less hungry, and eating less as a result.

One study found that people using this medication ate 24% fewer calories at meal times, and 35% fewer high-fat snacks (2). Another study observed 2000 obese adults taking semaglutide once weekly whilst making lifestyle changes in the form of a diet and exercise program (3). It found that more than 50% of people taking this medication lost 15% or more of their body weight after 68 weeks.

It's worth mentioning that some people in this study had to drop out due to side effects like nausea and diarrhoea, although this did get better in time for most people. We'll discuss the side effects in more detail later on.

Alongside the weight loss, this trial showed that people taking semaglutide had larger improvements in cardiovascular risk factors than those who just made lifestyle changes. Let's explore this in more detail.

Cardiovascular Health

Losing weight in general can improve your cardiovascular health. But taking semaglutide seems to have extra benefits at preventing heart attacks and strokes. A clinical trial of over 17,000 people found weekly semaglutide injection reduced the risk of a major cardiovascular event (meaning a heart attack or stroke) by 20% (4).

Another study found that non-diabetic patients taking semaglutide were less likely to need medication for high cholesterol or high blood pressure (5).

Although the evidence suggests this medication has a positive impact on the cardiovascular system, we still don't understand exactly how. It's likely partly due to weight loss, and partly due to how it affects your metabolism.

Effects on Kidney Function

Another body system that semaglutide affects is the kidneys. One study suggests that this medication can improve kidney function in those who already have reduced kidney function or kidney disease (6). In those without kidney problems, semaglutide caused no changes.

Another study found that semaglutide improved chronic kidney disease in diabetic patients - the medication was so successful, that the trial was stopped early to allow more patients to be treated with the drug (7). Currently though, guidelines recommend avoiding semaglutide in patients with end-stage kidney disease (8).

Digestive System Impact

Unfortunately, many of the drug's most common side effects are digestion problems. Nausea and vomiting, abdominal pain, bloating, and constipation/diarrhoea can all occur whilst taking semaglutide. Luckily, these symptoms usually resolve with time, although some people may need to stop treatment.

Neurological Benefits

Alongside the cardiovascular system, semaglutide also has positive effects on the brain and nervous system. Currently, research is being done into the protective effects semaglutide (and other members of the medication family) has on the brain. One study suggests GLP 1 agonists can even lower the risk of developing Alzheimers (9).

Another found that semaglutide increased brain cell uptake of glucose, and improved learning and memory in mice (10). Whilst more evidence is needed, semaglutide seems to have a positive effect on the brain.

Potential Anti-inflammatory Properties

Studies show semaglutide can reduce inflammatory markers in the blood (11, 12). This is great for improving cardiovascular and kidney health, as we've mentioned, but may also help chronic inflammatory conditions like arthritis (13).

There are a few theories as to how semaglutide does this. One is that it reduces the activity of certain immune cells that attack your blood vessels, leading to inflammation. Semaglutide may also reduce inflammation by regulating blood sugar and assisting with weight loss - both high blood sugar and obesity are associated with inflammation.

Comparative Analysis: Semaglutide vs. Other GLP-1 Agonists

Whilst all GLP 1 agonists are similar, and target the same pathway, semaglutide seems to be more effective at treating type 2 diabetes. Evidence suggests it's also more effective for weight loss.

Liraglutide (also known as Saxenda or Nevolat) is also available on prescription for weight loss, and has been on the market for longer. It's often cheaper, but studies suggest semaglutide is more effective.

If you're considering which of these weight loss medications is best for you, check with your doctor or prescriber.

Real-life Testimonies: Experiences with Semaglutide

It's all well and good hearing the statistics, but what about real-life stories of people who've tried Wegovy?

Kenny had been trying to lose weight unsuccessfully for years. He'd tried other weight loss drugs and struggled with the side effects. After starting Wegovy, he lost 6kg in the first month and has now reduced his weight from 181 to 108 kg.

Jamel, a 37-year-old accountant, had struggled to lose weight through diet and exercise alone. After trying Wegovy, she lost 60lb, although she stresses it's been a "gradual process", and that she had to keep up the healthy eating and exercise alongside the medication.

Of course, these are the success stories. Wegovy doesn't work for everyone. It's important to discuss any side effects with a healthcare professional whilst taking the medication. If you're not losing weight, you may need to discuss switching to an alternative.

Costs and Availability

Wegovy has been available on prescription in the UK for weight loss since September 2023. Previously, semaglutide was only available for diabetes, under the brand name Ozempic. Wegovy has been available in the EU and US for longer, though.

To access Wegovy on the NHS, you must have a BMI of over 27 alongside a serious medical condition, like heart disease or hypertension, or have a BMI of over 30. The medication is generally only available through a specialist weight management service, and waiting lists can be long.

If you don't meet the criteria or you'd like to start treatment earlier, Wegovy is also available on private prescription. At Quick Meds, a one-month supply of Wegovy starts at £145. This includes a remote weight loss consultation with a prescriber to make sure it's the best weight loss option for you.

Safety and Side Effects

Common side effects associated with semaglutide include constipation or diarrhoea, nausea and vomiting, burping, dizziness, tiredness, and gallstones. Symptoms usually improve with time, and almost always improve after stopping the medication.

Rarely, people may experience pancreatitis. Other serious side effects are very rare. Speak to your doctor immediately if you're worried you may be experiencing serious side effects.

Wegovy isn't suitable for everyone. For those with a family history of thyroid cancer or multiple endocrine neoplasia syndrome, it's generally best to avoid this medication as it may increase the risk of developing thyroid tumours. If you have diabetic retinopathy or severe heart failure, it's important to discuss the risks vs benefits of Wegovy with a doctor. Semaglutide is not suitable for pregnant or breastfeeding women, or if you are planning on becoming pregnant.

Wegovy must be stopped in the case of diabetic ketoacidosis, which will require hospital admission.

If you experience severe stomach pain, blurred vision, a fast heartbeat, or trouble swallowing then seek medical attention. Serious symptoms like trouble breathing or an unusual or allergic reaction require immediate medical attention.

Conclusion

Semaglutide can be an effective tool to help with weight loss, but it should be combined with a healthy diet and regular exercise. Alongside losing weight, studies suggest semaglutide can improve other areas of your health, including cardiovascular, neurological, and kidney health.

You must consult with a healthcare professional before starting on any weight loss medication. As a GPhC-registered online pharmacy, we offer remote weight-loss consultations to assess your individual needs. Medication is delivered quickly, safely, and discreetly to your door. Start your online consultation today.