Introduction
So you’ve decided to take semaglutide. Studies have proven its safety and effecacy in regulating your blood sugar levels or helping you lose weight.
We’re sure you’ve probably heard of the semaglutide brands Ozempic and Wegovy. These have become massively popular because of the buzz it’s generated on social media.
But as famous as semaglutide may be, every person’s body is different and won’t react in the same way. In fact, some people don’t even respond to weight loss drugs. Makes you wonder, ‘Will semaglutide work for me?’
In this article, we look at the different factors that indicate semaglutide’s efficacy. We’ll also look at what you can do when it doesn’t seem to work for you.
What is semaglutide?
Before we dive into semaglutide’s efficacy factors, let’s understand what it is and how it works. How does it produce that blood sugar-regulating and figure-slimming effect? The secret lies in its composition.
Whenever we finish eating and our blood sugar levels spike, a hormone in our gut, glucagon-like peptide-1 (GLP-1), activates. It prompts the pancreas to bring these down with the hormone insulin.
Semaglutide, classified as a glucagon-like peptide-1 drug receptor agonist (GLP-1 Ra), works in the same way. It mimics GLP-1 by triggering the pancreas to release just the right amount of pancreas to regulate blood sugar levels.
Simultaneously, the drug also delays gastric emptying, the process by which food exits the gut and enters the small intestine. Because digestion is slowed down, people taking semaglutide tend to feel fuller for longer. In addition, they also have fewer food cravings and don’t think about food as much. Because they consume fewer calories, they end up losing a significant amount of weight. Semaglutide also sends signals to the brain that you’re already full.
Oral and subcutaneous semaglutide
You have two options of how you can take semaglutide during your treatment: either subcutaneously or orally.
Manufacturers classify Ozempic and Wegovy as subcutaneous semaglutide as people must inject these subcutaneously or under the skin. These come in injectable dosing pens.
Rybelsus, meanwhile, is oral semaglutide as it comes in tablet form and people should take it by mouth.
Safety and efficacy
You’ll be glad to know that semaglutide has FDA approval to treat type 2 diabetes and obesity. The following are highlights from the research that proves semaglutide’s safety, efficacy, and tolerability.
In the STEP 5 trial, researchers examined the two-year effects of semaglutide in adults who were overweight or with obesity. Participants lost an average of 15 percent of their body weight with semaglutide. Meanwhile, those in the placebo group lost approximately 2.6 percent of their body weight.
Participants taking semaglutide also lost 14.4 centimeters or 5.7 inches off their waistline. Additionally, they also saw improvements in their systolic blood pressure by 5.7 mmHg. Participants in the semaglutide group also experienced better diastolic blood pressure, blood sugar levels, total cholesterol, and triglycerides.
A study conducted in December 2022, meanwhile, found that participants on semaglutide lost more body fat than body mass. Moreover, they ate less because of a weaker appetite, had better food control, and less cravings, especially for greasy foods.
Side effects
Whether you use semaglutide for blood glucose control or weight management, there is still the risk of experiencing side effects.
Gastrointestinal reactions account for 10% or more of semaglutide’s side effects. These include:
- nausea (up to 44% of cases),
- diarrhea (up to 30%),
- vomiting (up to 24%),
- constipation (up to 24%),
- abdominal pain (up to 20%),
Other common side effects occurring in 1 to 10% of cases include indigestion, belching, gassiness, gastroenteritis, or gastritis. Gastroenteritis is the short-term infection and inflammation of the digestive system, while gastritis is the inflammation of the stomach lining.
Note that these common side effects are mild and you can manage these with the help of your healthcare provider. Semaglutide’s more serious adverse effects, meanwhile, are rare.
Serious side effects
The more serious side effects of semaglutide include allergic reactions, hypoglycemia (low blood sugar), pancreatitis, kidney problems, and thryroid c-cell tumors.
Efficacy of semaglutide
Several studies have proven semaglutide’s efficacy in regulating blood sugar levels and promoting weight loss. Apart from these benefits, the drug may also play a positive role in improving cardiovascular health.
Will semaglutide work for me?
There are several ways to gain an indication of whether semaglutide is working effectively.
HbA1c levels
Typically, you must measure your HbA1c (hemoglobin A1C) levels to check whether semaglutide is working on your blood sugar levels.
Semaglutide helps patients reach targeted HbA1c levels, a measure of average blood sugar over the past two to three months. Achieving desired A1C levels can help prevent diabetes complications like heart and blood vessel disease, kidney failure, and nerve damage.
A comparative study revealed that semaglutide lowered A1C levels by approximately 1% to 2%.
Weight reduction
Another way to check if semaglutide is working for you is if it’s helping you lose weight.
Four 68-week trials tested Wegovy’s safety and efficacy, with over 2,600 non-diabetic adult participants receiving the drug. Additionally, more than 1,500 participants received placebo.
Those on Wegovy lost an average of 12.4 percent of their starting body weight versus those on placebo.
In another trial, those on Wegovy lost on average 6.2 percent of their starting body weight than the placebo group. This time, the adult participants had type 2 diabetes.
Improved cardiovascular health
Recent research reveals semaglutide has a positive impact on the cardiovascular health of patients with heart problems who are also overweight. This included reducing heart symptoms such as fatigue, shortness of breath, and swelling.
The study involved 500 participants in 13 countries who received semaglutide every week. Apart from the marked improvement in the heart symptoms, they also saw improvements in participants’ physical abilities.
Based on 2021 trial results, obese or overweight patients may have a better quality of life through semaglutide use. The drug led to an average of 14.9% weight loss, lowering cardiovascular risk factors like blood pressure and cholesterol.
Eligibility for semaglutide
Before you take semaglutide, you first first need to meet certain diagnostic criteria.
For Ozempic and Rybelsus, for example, patients need to have a type 2 diabetes diagnosis.
Doctors may also prescribe Ozempic for heart disease patients because it has additional approval for lowering risk of cardiovascular problems. Healthcare providers may may at times also prescribe Ozempic for those dealing with insulin resistance.
Wegovy users, on the other hand, need to be overweight—with a body mass index of 27 or greater. They may also have an obesity diagnosis with a BMI of 30 or greater, along with one weight-related health condition.
Novo Nordisk, semaglutide’s manufacturer, markets these semaglutide brands for different uses. But they all offer the same therapeutic benefits of blood sugar regulation and weight management. It’s no wonder many doctors choose to prescribe Ozempic or Rybelsus off-label for weight loss.
Proper dosage and administration
To ensure semaglutide is working properly, you need to observe its correct dosage and administration. If semaglutide is not working for you, it might just be a matter of tweaking its dosage. There are cases when your healthcare provider may increase the dose of semaglutide if you are not seeing any results.
Typically, your healthcare provider will start you off on a low dose, gradually increasing this to a maintenance dose. This is as your body gets used to the drug.
People inject Ozempic and Wegovy once weekly subcutaneously (under the skin) in either the abdomen, thigh, or upper arm. These come in injectable dosing pens.
On the other hand, people must take Rybelsus orally once daily on an empty stomach. This comes in tablet format.
Diet and exercise
Ozempic, Wegovy, and Rybelsus all have FDA approval to regulate blood sugar levels and promote weight loss. This must be in tandem with a lower-calorie diet and ample physical activity.
You should minimize eating foods high in sugar and refined carbohydrates, red meat, processed foods. In addition, steer clear of sugar-sweetened beverages and alcohol as these are all connected to weight gain.
As for exercise, try to incorporate at least 150 minutes of physical activity per week. You can do low-intensity activities, like walking. Certain forms of exercise, like aerobic exercises with resistance training, also help boost your metabolism.
Non-responders
You may also be a non-responder or someone whose body does not respond to semaglutide.
The Endocrine Society says a weight loss drug is effective if patients lose over 5% body weight in three months. The Endocrine Society is an international medical organization for endocrinology and metabolism.
In a clinical trial, approximately 86.4% of participants on semaglutide lost over 5% of body weight throughout 68 weeks. Meanwhile, the remaining participants (13.6%) did not. Obesity specialists and endocrinologists also observed that a similar percentage didn’t lose weight or lost little weight while taking semaglutide.
It’s not clear why some people do not respond to semaglutide. However, early response is typically an indicator of how well a drug will work in the long term.
Severe side effects
Another reason why semaglutide may not work for you is when you experience severe side effects while on it.
According to Gitanjali Srivastava, internist and obesity medicine program director at Vanderbilt University Medical Center, non-responders “tend to be sicker.” Co-morbidities like early-onset severe obesity, endocrine disorders, developmental delays, and early trauma could make patients less responsive to weight-loss drugs.
More research on co-morbidities and drugs that may interact with GLP-1 drugs is necessary to better understand treatment options.
What if semaglutide doesn’t work for you?
If semaglutide doesn’t work for you, you may lack proper/adequate sleep, are stressed out, or have an underlying condition. These all have an effect on how our bodies regulate hormones. Oversleeping, for example, has been linked to obesity and other weight-related conditions like hypertension and diabetes. Stress, meanwhile, can affect how your body responds to medication. Underlying conditions, on the other hand, may be slowing down your weight loss.
Consult your doctor if you worry that semaglutide is not giving you the results you want. If you feel that the drug is not suitable for you, your doctor may prescribe other weight loss drugs on the market.
Conclusion
Semaglutide has been proven to be safe and effective in regulating blood sugar levels and reducing body weight. However, certain factors can hinder its efficacy in certain people.
These include their eligibility, the dosage of semaglutide, improper diet and exercise, lack of sleep, stress, and underlying conditions.
Patients must reach out to their doctor should they not see results on semaglutide.
Glossary of terms:
- GLP-1: Glucagon-like peptide-1 is a gut-based hormone involved in the secretion of insulin to lower blood sugar levels typically elevated after meals.
- GLP-1 Ra: Glucagon-like peptide-1 receptor agonist. It mimics the actions of GLP-1.
