What is Semaglutide Therapy?
Semaglutide therapy falls within a class of medications called a glucagon-like-peptide (GLP-1) receptor agonist. GLP is a natural substance that works by stimulating insulin secretion in the body, which helps to reduce blood sugar levels. Semagluatide is very similar in structure to and acts on the same receptors as, GLP. As a result, semaglutide has been approved for the treatment of type 2 diabetes mellitus (ex. Ozempic).
In addition to blood sugar control, semaglutide has also been shown to:
- Decrease Appetite.
- Reduce Feelings of Hunger
- Increase Feelings of Fullness.
As such, semaglutide therapy was recently FDA approved for the treatment of chronic weight management in adults with obesity, especially in combination with appropriate physical activity and dietary regimen.
Who is most appropriate for Semaglutide therapy?
Patients most appropriate for semaglutide typically fall into one of the following categories:
- Body Mass Index (BMI) Of 30 or Greater
- BMI of 27 or Greater in the Presence of at Least One Weight Related Condition
- High Blood Pressure (Hypertension)
- Elevated Cholesterol (Dyslipidemia)
- Heart Disease
Who Is Not Appropriate for Semaglutide Therapy?
- Pregnancy
- Personal history of pancreatitis
- Personal or family history of Medullary thyroid cancer (MTC)
- Personal or family history of Multiple Endocrine Neoplasia type 2 (MEN-2)
- Diabetic Retinopathy
- Severe depression.
During animal studies, MTC and MEN-2 were noted to occur. The human relevance of this however, has not been determined.
What are the benefits of Semaglutide for weight loss?
Semaglutide has been well studied and has consistently shown to induce weight loss when compared to placebo. In addition to weight loss, semaglutide has also appeared to reduce major cardiovascular disease events in adults with type 2 diabetes, heart disease, or kidney disease.
Weight loss in general also has numerous health benefits. These benefits may include:
- Improved blood pressure
- Reduced blood sugar levels in diabetics
- Reduced risk of cardiovascular events (ie, heart attack and stroke)
Are there side effects associated with taking Semaglutide?
- Nausea and/or vomiting.
- Abdominal pain.
- Diarrhea or Constipation.
- Headache.
- Fatigue.
- Indigestion and/or Gastroesophageal reflux.
- Eructation (belching) or flatulence (gas buildup).
- Hypoglycemia (low blood sugar) in diabetic patients on medication.
- Dizziness
Less common side effects also include:
- Pancreatitis
- Cholelithiasis (gallbladder stones)
- Dehydration
- Anaphylaxis
- Rash
- Heart rate increase
- Changes in mood
What if I am pregnant, or looking to become pregnant?
Semaglutide is not recommended in women who are pregnant, as there is potential for fetal harm. Additionally, weight loss in pregnancy offers no benefit and may impose additional harm to the mother and fetus as well.
- Pregnancy must be ruled out in all women under 50 who are looking to initiate semaglutide therapy.
- Semaglutide should be discontinued at least 2 months before attempting to become pregnant.
- If you become pregnant while taking semaglutide, you are required to immediately stop therapy, and refer to your obstetrician for routine prenatal monitoring.
- Semaglutide is not recommended while breastfeeding.
What laboratory testing required before or during treatment?
Routine laboratory monitoring is required both before and during semaglutide therapy. This is done to ensure your safety, and determine any areas of risk that may prevent or delay treatment. The following labs are typically obtained prior to the start of treatment:
- Complete blood count
- Comprehensive metabolic panel
- Hemoglobin A1c
- TSH
- Lipase
- Qualitative hCG, for women under 50.
Patients that are more likely to require lab monitoring include, but are not limited to, those patients with:
- Elevated blood pressure (Hypertension)
- Pre-diabetics/Diabetics
- Age over 50
Additional medical conditions that you have may impact the need to check blood work. Your provider will make these decisions on an individual basis. In all cases blood work may need to be repeated during therapy, to ensure stability.
What type of follow-up is required while taking Semaglutide?
It is important to engage in all telehealth and in-person follow-up appointments, as recommended by Progress Medical. A typical patient engagement schedule includes:
- Telehealth or phone call review on weeks 2, 5, 8, and 13 during the initial ramp-up phase of treatment.
- Monthly telehealth or phone call reviews during the maintenance phase of treatment.
- In-person follow-up on weeks 26 and 52.
Additional follow-up with your provider or dietary counselor will be arranged as needed. Progress Medical staff will always be available to address any questions or concerns that you have during treatment. You are encouraged to reach out to us any time a potential problem arises, so we can help address your needs in the most efficient manner possible.
Do you notify my primary care provider about the semaglutide plan?
If you have a primary care provider, it is important that they are aware of any new medications you may be taking. This includes the use of Semaglutide. We typically do not inform your provider about the new treatments we prescribe but encourage you to do so. If at any point your provider has additional questions about semaglutide, your Progress Medical provider will be happy to discuss it with them.