Weight Loss / Semaglutide (GLP-1)

What Is Semaglutide?

Semaglutide is a new medication that was recently approved by the U.S. Food and Drug Administration (FDA) for weight loss. It is sold under the brand name Ozempic, Rybelsus, and Wegovy. It is combined with a low-calorie diet and exercise program to help people lose weight.

It belongs to a class of medications known as incretin mimetics, which cause the pancreas to release insulin when blood sugar levels are high. Another semaglutide medication, sold under the brand name Ozempic, is used to help control blood sugar levels in people with type 2 diabetes.

How Does Semaglutide Work for Weight Loss?

Semaglutide works by mimicking the effects of the hormone glucagon-like peptide-1 (GLP-1). When you eat, GLP-1 is released in the gut, which tells your brain that you are getting full. It can also slow the movement of food through your stomach and small intestine, helping you stay fuller for longer. As a result, you may eat less food, which can lead to weight loss.

GLP-1 also triggers the release of insulin, which lowers your blood sugar and helps your cells use glucose from the food you have eaten. Any glucose that your cells do not use is stored as fat, which is why high blood sugar can lead to weight gain. 

How Much Weight Can You Lose on Semaglutide? 

Before semaglutide was approved by the FDA, four clinical trials were performed to look at the safety and efficacy of the medication. Each trial lasted 68 weeks and more than 2,600 patients received semaglutide, while more than 1,500 received placebo.

One of the clinical trials looked at adult patients without diabetes. The average age of patients in the study was 46 years, and 74 percent of the patients were female. The average body weight at the beginning of the study was 231 pounds. Overall, the patients who took semaglutide lost 12.4 percent of their original body weight compared to those who took the placebo.

Another trial looked at patients with type 2 diabetes. The average age for the study was 55 years, and 51 percent of the patients were female. Overall, the average body weight was 220 pounds. Compared to those who took placebo, the patients that took semaglutide lost 6.2 percent of their initial body weight.

Finally, a study from the New England Journal of Medicine treated 1961 adults with a BMI of 30 or greater with either semaglutide or placebo. Of the 1306 patients taking semaglutide in the study, one third of them lost at least 20 percent of their baseline weight. These results are comparable to those after bariatric surgery (specifically the sleeve gastrectomy). The results of these studies all show promising potential for weight loss when using semaglutide. 

Side Effects of Semaglutide 

The most common side effects of semaglutide are gastrointestinal, and include:

• Nausea
• Vomiting
• Diarrhea or constipation
• Stomach pain
• Indigestion
• Fatigue
• Headache
• Belching
• Intestinal infections, known as gastroenteritis
• Gastroesophageal reflux disease (GERD)

In people with type 2 diabetes, semaglutide can cause a drop in blood sugar levels (known as hypoglycemia), which can become dangerous. Other serious side effects to be aware of include:

• Symptoms of an allergic reaction, including: itching; rash; swelling of the face, eyes, mouth, tongue, or throat; difficulty swallowing or breathing
• Changes in vision
• Dizziness
• Fainting
• Persistent pain in the upper left or middle of the stomach
• Heart palpitations
• Yellowing of the skin and eyes, fever, or clay-colored stools

If you experience any of these side effects, contact your healthcare provider immediately. 

Risks Associated with Semaglutide 

It is important to speak with your doctor about your medical history before beginning semaglutide treatment. The medication should not be prescribed to anyone with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 (MEN 2), because there is an increased risk of developing thyroid C-cell tumors.

There is also an increased risk of other complications, including:

• Gallbladder problems, such as gallstones
• Inflammation of the pancreas, known as pancreatitis
• Suicidal thinking or behavior
• Damage to the retina in the eye, known as diabetic retinopathy
• Kidney damage

How Much Does Semaglutide Cost?

Semaglutide is a relatively new drug that can be quite expensive. It is sold under the brand name Ozempic, Rybelsus, and Wegovy, but it is available as a generic under the name semaglutide. On average, GoodRx lists the retail price at $2,262.84, while the lowest GoodRx price is $1,319.41.

At In Home Infusion, we offer the medication at $185 per dose (once per week), for a monthly total of $740 which includes the nurses visit.