You’ve probably heard of a new drug called semaglutide. It promotes a variety of benefits, from managing certain types of diabetes to promoting weight loss. From ordinary people to business tycoons like Elon Musk, they’ve been constantly talking about semaglutide’s positive effects on their health. In fact, some even claim it’s a game-changer when it comes to shedding pounds and regulating blood sugar.
Whether it’s your first time hearing about semaglutide or you’re already familiar with it, it’s beneficial to do your research. This holds true especially if you or someone you know is considering taking it.
Want to know more about semaglutide? Read on to learn more about it, how it works, and how it could be beneficial to your body.
What is semaglutide?
The body has a hormone called the GLP-1 hormone in the lower gastrointestinal tract. After eating food, this hormone triggers insulin secretion from the pancreas. Now, insulin is a hormone that reduces the amount of glucose, a kind of sugar, in the bloodstream. It also helps move glucose into the body’s cells to use or store as energy.
Semaglutide is a type of medication that falls under the category of glucagon-like peptide-1 receptor agonists. Interestingly, people also refer to it as GLP-1 Ras, which treat type 2 diabetes and obesity.
Basically, it mimics how the GLP-1 hormone works. Whenever blood sugar levels are high, semaglutide helps the pancreas release just the right amount of insulin. This also applies when other drugs aren’t properly controlling blood sugar levels. Additionally, GLP-1 Ras aid in slowing down the movement of food to weaken appetite and stimulate weight loss.
How was semaglutide developed?
Danish pharmaceutical company Novo Nordisk developed semaglutide in 2012. At the time, it was a weekly therapeutic drug for diabetes because it worked longer than the anti-diabetic medicine liraglutide. They named this once-a-week injectable medication Ozempic.
Examining type 2 diabetes clinical trials, the U.S. Food and Drug Administration (FDA) approved Ozempic in December 2017. Later, in 2018, Novo Nordisk started another clinical trial with semaglutide. This time, it was on its weight loss effects, and Novo Nordisk would sell it under the brand name Wegovy.
In 2019, the FDA approved another semaglutide brand, Rybelsus, also under Novo Nordisk. Whereas you administer Ozempic and Wegovy via injectables, Rybelsus comes in pill format, for treating adults with type 2 diabetes.
Then In 2021, the FDA approved the same semaglutide drug, under the brand name Wegovy. Novo Nordisk promoted it as an anti-obesity medication, and patients inject it once a week at a higher dose than that of Ozempic. Correspondingly, a 2022 review found that semaglutide was a more effective treatment than any other older anti-obesity drugs.
How is semaglutide important in healthcare and treatment of type 2 diabetes and obesity? Apart from controlling blood sugar levels and preventing spikes after meals, semaglutide helps people manage their weight. That’s because when taken in doses higher than those of diabetes patients, it helps curb appetite and promote weight loss.
Studies also suggest semaglutide reduces the chance of a type 2 diabetes patient to suffer from commonly related ailments. One such related ailment are cardiovascular problems. Furthermore, semaglutide helps type 2 diabetes and obesity patients a chance to experience a better quality of life.
What makes semaglutide work?
To have a deeper understanding of semaglutide’s efficacy, it’s worth looking into its design and makeup. Here’s a look at its structure and how it produces its effects against type 2 diabetes and obesity.
Mechanism of action
In pharmacology, “mechanism of action” is the biochemical process by which a molecule, like a drug, works in the body. Accordingly, pharmacology is the study of the properties and effects of drugs and chemicals.
Semaglutide stimulates GLP-1 receptors so that the body’s incretins—metabolic hormones that trigger the decrease in blood sugar levels—work more efficiently. As a result, the stomach takes longer to empty its contents, while appetite and food intake decreases.
In addition, semaglutide inhibits glucagon secretion and reduces hepatic glucose production. Hepatic glucose production or hepatic gluconeogenesis is a process where the body stores glycogen or excess energy for later use. When you need these, the liver breaks down the glycogen into glucose and releases this throughout the body.
Safety and side effects
As with any drug, semaglutide also has its share of potential side effects. In spite of its efficacy in blood sugar control and weight loss, it has also attracted safety concerns. Here are some adverse effects to take note of.
Hypoglycemia
While semaglutide lowers blood glucose, it also possibly triggers hypoglycemia, a condition wherein the blood sugar is lower than normal. Hypoglycemia can cause tremors, perspiration, dizziness, difficulty concentrating, a faster heart rate, as well as feelings of severe hunger.
Gastrointestinal problems
Both oral and injectable semaglutide may also cause gastrointestinal side effects, such as nausea, vomiting, diarrhea, and general abdominal discomfort. People who had just started taking semaglutide typically experienced these side effects. Nevertheless, the symptoms generally improved with extended use.
Acute pancreatitis
One of the less common side effects of semaglutide involves the pancreas. Experts have associated GLP-1 Ras with acute pancreatitis, a condition wherein the pancreas swells over a short period.
Thyroid tumors
In a study, lab rats developed thyroid tumors or medullary thyroid carcinoma (MTC) after semaglutide use. Despite these results, scientists still don’t know whether semaglutide may also potentially cause the same in humans.
Additionally, patients who have had MTC, gallbladder disease, pancreatitis, and multiple endocrine neoplasia syndrome type 2 must avoid semaglutide. This is to prevent the potential occurrence of contraindications. It would also not be advisable for women who are breastfeeding, pregnant, or trying to take semaglutide for safety concerns. Drinking alcohol has also been shown to interfere with blood glucose levels and may make these erratic while taking semaglutide.
Because semaglutide triggers slow gastric emptying, anesthesiologists in the U.S. and Canada have reported an increased risk in certain patients. Specifically, they had a higher risk of developing pulmonary aspiration (accidentally inhaling a foreign substance into the lungs). This was when they would undergo a surgery requiring an empty stomach.
While researchers have recorded these side effects, it’s important to consider that these risks are generally rare. In the meantime, long-term studies are ongoing to gain a better understanding of semaglutide’s safety. As with any medication, people must discuss their medical history in detail with their physician before seeking a prescription.
Semaglutide in the market
While Ozempic and Wegovy have become well-known brands, there are also other key players in the market. Here’s a quick rundown of semaglutide’s key competitors.
Saxenda
Saxenda, a prescription weight loss drug also under Novo Nordisk, uses liraglutide instead of semaglutide. Liraglutide was already existing as an anti-diabetic medication before Novo Nordisk developed semaglutide. It was also slightly less effective than semaglutide. Saxenda helps a person feel full longer. Hence, it reduces appetite and promotes lower food intake, thereby triggering weight loss.
Similar to Ozempic and Wegovy, Saxenda is also in injectable format. In contrast, patients administer it daily while they inject Ozempic and Wegovy weekly. Specifically, it treats patients above 12 years old and over 132 pounds, or with a BMI of 30 and above.
Zepbound
Weight loss drug Zepbound, by American pharmaceutical company Lilly, gained FDA approval in November 2023. Adults aged 18 and above who are obese or overweight can take it.
Zepbound is the first combination peptide (chain of amino acids) with FDA-approval for obesity. It has tirzepatide, which has GLP-1 and glucose-dependent insulinotropic polypeptide (GIP). After eating, the gut produces GIP, a hormone in the small intestines. It triggers insulin secretion and inhibits the release of glucagon. Additionally, it stimulates fat storage for energy through stronger absorption of triglycerides into fat cells or adipose tissue. Triglycerides are a type of fat or lipid.
Zepbound works by curbing appetite, helping the stomach feel fuller, and changing the rate of gastric emptying. Just like Ozempic, Wegovy, and Saxenda, Zepbound is an injectable drug and you administer it once a week.
Mounjaro
Zepbound has a counterpart for diabetes: Mounjaro. This is similar to how Novo Nordisk markets semaglutide differently for weight loss and type 2 diabetes via Wegovy and Ozempic.
Whereas Ozempic and Wegovy stimulate the GLP-1 pathway, Zepbound and Mounjaro stimulate two pathways: the GLP-1 and the GIP pathways. It is an injectable and you should take it once weekly with proper diet and exercise to improve blood sugar levels.
Trulicity
Trulicity is a prescription drug that treats type 2 diabetes. It helps control blood sugar levels in conjunction with diet and exercise and reduces the risk of developing cardiovascular problems.
As Trulicity contains the active drug dulaglutide, experts consider it a GLP-1 receptor agonist, just like Ozempic and Wegovy. It comes in an injection pen and you administer it once a week. Trulicity helps a person feel full after eating and limits how much sugar the liver releases into the bloodstream. Additionally, it aids the pancreas in insulin secretion when blood sugar levels are high.
Buying semaglutide
To be eligible for Ozempic or Wegovy, you must meet certain conditions. You must have a BMI of 27 or above with one weight-related health condition, or a BMI of 30 and above. As long as you have a prescription from your physician, you should easily be able to purchase semaglutide in pharmacies.
According to a November 2024 report, semaglutide brands had the following pharmacy retail prices for one month’s supply:
- Ozempic: $830-870 (list price at $968.52)*
- Wegovy: $1,237-$1,340 (list price at $1,349.02)*
- Rybelsus: $848-$917 (list price at $968.52)*
Health insurance may cover these drugs if you have type 2 diabetes or if you have obesity. Meanwhile, semaglutide’s rival brands cost around $852* to $1,500* a month without insurance.
Now that you’ve had a primer to semaglutide, what it is, how it works, its side effects, and how much it costs, you may be better able to make an informed decision of whether you are eligible to take semaglutide and if it’s the right medication for you. As with any medication, consult your doctor first.
*Price subject to change
Image by Mateus Andre on Freepik
