Introduction
You’ve probably heard of semaglutide brands Ozempic or Wegovy, which are taking the world by storm for their health benefits. Ozempic helps control blood sugar levels, while Wegovy helps promote weight loss. The two brands share the same active ingredient, semaglutide, which triggers insulin release.
While only Wegovy has FDA approval for weight management, some doctors prescribe the anti-diabetic drug Ozempic, as its effects include weight loss.
You may wonder, ‘How long does it take semaglutide to work?’ or ‘How do I know semaglutide is working?’ No matter the reason for semaglutide use, you must know how quickly you can expect results when on the drug.
They may also be concerned about whether using the injectable pen is more effective than taking the drug orally. Semaglutide currently has three brands: Ozempic and Wegovy which come in injectable format and Rybelsus which comes in tablet form. Both Ozempic and Rybelsus address type 2 diabetes while Wegovy addresses obesity.
We explore how semaglutide works, how the body absorbs it, and how long it takes to work. In addition, we discuss the advantages of taking the mediation via injectable or tablet form. We also address why some people may not experience any effects at all.
What is semaglutide?
To understand how semaglutide works, it’s important first to learn what it is.
Semaglutide belongs to a class of medicines called GLP-1 (glucagon-like peptide-1) receptor agonists, or GLP-1 Ras for short. It mimics how the hormone GLP-1 triggers the secretion of insulin, another hormone, to control blood glucose.
The drug also slows down digestion or gastric emptying, causing a person to feel fuller for longer. As a result, there’s weaker appetite and eventually, weight loss.
Semaglutide and it smechanism of action
Now that you know how semaglutide works, let’s look into the biochemical process by which it works in the body. This study is called the “mechanism of action. ” Here’s a deeper explanation of how semaglutide helps people lose weight or regulate their blood sugar levels.
Activating GLP-1 receptors
In the pancreas’ beta cells are GLP-1 receptors. Semaglutide binds to and activates these GLP-1 receptors. When blood sugar levels are high, this prompts the pancreas to release blood insulin to reduce blood glucose after meals.
Inhibiting glucagon
Another process under semaglutide’s mechanism of action is glucagon inhibition. It increases blood sugar levels and prompts the liver to release glucose. As semaglutide prevents the release of glucagon, it controls the body’s overall blood sugar levels.
Delayed gastric emptying
Studies find that semaglutide delayed digestion or gastric emptying, resulting in feeling full longer after eating. Participants retained 37% of a solid meal even if it had already been four hours since they had eaten. Because people taking semaglutide felt full for longer, they were not as frequently hungry, reducing their appetite and food intake.
Reduced appetite and weight management
As GLP-1 receptors are in both the periphery and central nervous system, the binding of semaglutide triggers altered behavior. In particular, semaglutide reduced food cravings, especially fatty foods, in participants with obesity. As semaglutide curbed a desire for food, so did it increase dopamine reward signaling. Dopamine is a kind of neurotransmitter in the brain that triggers feelings of pleasure, satisfaction, motivation, and learning.
Studies supporting semaglutide efficacy
Many studies have illustrated the benefits of taking semaglutide injections for type 2 diabetes and obesity. Moreover, studies have also found that it potentially positively impacts other health conditions.
On obesity
A study looked at the efficacy of semaglutide in treating people who were overweight. 40 percent of the participants on once-weekly semaglutide lost at least 15 percent of their body weight over 68 weeks. Those in the placebo group, meanwhile, lost significantly less weight.
On type 2 diabetes
Another study investigated the effectiveness and safety of semaglutide in treating type 2 diabetes. Some of the participants took semaglutide, while others took other diabetes medications. The study’s results showed that semaglutide was able to reduce blood sugar levels more successfully than other diabetes drugs.
On cardiovascular problems
Clinical studies show how apart from type 2 diabetes, Ozempic reduces the risk of developing cardiovascular issues like heart attack.
Wegovy, meanwhile, appears to help reduce markers of heart disease, from high cholesterol, high blood sugar levels, to hypertension.
Subcutaneous vs. Oral Semaglutide
As we’ve mentioned above, you can take semaglutide in two ways: injecting it under the skin (subcutaneously) or orally.
Some people may prefer one method of administration over another. For instance, not everyone would be comfortable injecting themselves with a medicine. Others, meanwhile, may find the simplicity of drinking a tablet more convenient.
It’s vital that you properly administer semaglutide for the drug to take effect. For example, you can only inject Ozempic and Wegovy in three areas such as the abdomen, thigh, or upper arm. The patient must ensure he or she is not injecting the drug into the muscle or vein. You should take Rybelsus, meanwhile, exactly the same way daily, when you first wake up on an empty stomach.
With these options, others may wonder if there is any difference between the efficacy of subcutaneous versus oral semaglutide. Could the format play a role in how fast the drug takes effect? Or how effective it is?
Pros and cons
From a manufacturing perspective, producing drugs in tablet or pill format can be advantageous where costs are a concern. Taking the oral route is more common and generally safer, more convenient, and the least expensive.
However, food and other medication in the digestive tract could affect how much and how fast your body absorbs oral medicine. This is why you take some medicines specifically with or without food. For Rybelsus, in particular, you must take it on an empty stomach upon first waking up, with four ounces of water.
Taking semaglutide subcutaneously, meanwhile, requires a needle inserted into fatty tissue. Once you inject semaglutide, the drug travels into small blood vessels or capillaries before it travels into the bloodstream. The subcutaneous route protects certain drugs from GI tract destruction if you are administering it orally.
Efficacy
A 2021 review concluded Rybelsus is more effective for weight loss and reducing A1C levels than subcutaneous semaglutide for people with diabetes. A1C is a blood test that shows blood sugar levels over two to three months.
Despite researchers’ findings, it is important to note that research comparing oral and subcutaneous semaglutide is still relatively new. More studies will need to be done to conclude that one form is more effective than the other. There have also been no clinical studies directly comparing the two formats.
It is also worth considering that regardless of which variant a patient prefers, semaglutide comes with a host of side effects. Its most common adverse effects include nausea, vomiting, constipation, diarrhea, or abdominal pain. Serious side effects, meanwhile, such as allergic reactions, hypoglycemia, kidney problems, pancreatitis, and thyroid c-cell tumors, are rare.
So how long does it take semaglutide to work?
Research shows that on average, it takes around four weeks to see some weight loss on semaglutide. However, the full effect can take some more time. In one study, participants lost as much as 35 pounds or 15.9 kilograms over a 68-week period.
With Wegovy, you may see weight loss within the first four weeks, but only see full effects after several months. In the same 68-week study, 83% of the participants lost 5% or more of their weight versus 31% on placebo.
With Ozempic, blood sugar levels should fully decline within the first week of use when already on maintenance dose levels. But the full expect can take as long as eight weeks or even longer, given its once-weekly shots.
Despite these studies, consider that results will vary from person to person. The drugs’ effect can be affected by a variety of factors.
Non-efficacy of Semaglutide
Sometimes there are people who do not see effects while on semaglutide. According to Christina Inteso, Pharm.D., a clinical pharmacy specialist at Corewell Health in Michigan, you still need to implement lifestyle changes to see results.
Diet and exercise still matter
“All of the FDA-approved weight loss medications, including semaglutide, are approved as an add-on to a reduced calorie diet and increased physical activity,” she tells Prevention. “These medications were studied with lifestyle changes, plus the medication.”
Should someone not see results while taking Ozempic, it may be a matter of eating healthy and working out regularly. Inteso laments how some people think semaglutide is a magic pill that will promote weight loss without any lifestyle changes.
Wrong dosage
Mir Ali, M.D., an American bariatric surgeon and medical director, thinks it could be a problem with the dosage. This takes several months for any patient.
“Some patients see results right away; others need to be at a higher dose to see results,” he points out.
Inteso thinks other factors, like genetics, which make it harder for other people to see effects while on semaglutide.
How to get optimal results
As with any treatment, it’s important to consult your healthcare provider about what diet or exercise program is best. If you follow everything to the tee and still don’t see results, it may be time to consult a dietitian. Otherwise, consider that Ozempic may not be the right drug for you.
Conclusion
There are two ways people can administer semaglutide: via injecting it under the skin (subcutaneously) or orally. Each method has its advantages, like how you can self-administer certain drugs and prevent them from being affected through digestion.
Whether you choose subcutaneous or oral semaglutide, a review shows that oral is as effective as subcutaneous semaglutide. Patients are usually started off on low doses before arriving at a maintenance dose. Still, they should be aware of potential side effects.
Generally, patients should see results within the 4-8 weeks of treatment, depending on which semaglutide they are taking. To see the full effect, however, could take several months.
Although patients can lose up to 15% of their body weight, there are still cases wherein semaglutide has no effect. It has to be clear that lifestyle changes must accompany the treatment to see optimal results. Should you be taking the right dose, eating right, and exercising frequently, other factors may be at play. These could bean incorrect dosage, your genetic makeup, or other drugs may be more suitable for you.
