Weight Loss Program

Adult patients with an initial body mass index (BMI) of 30 kg/m2 or greater (obese) and 27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbid condition (e.g., hypertension, type 2 diabetes mellitus, or dyslipidemia) may be a good candidate for Semaglutide injections.

Some individuals may not be a candidate for Semaglutide injections. If you have any of the following conditions, you cannot take Semaglutide:

• Personal or family history of Medullary Thyroid Carcinoma (MTC)
• Personal or family history of Multiple Endocrine Neoplasia, type 2 (MEN 2)
• Prior allergic reaction to Semaglutide or to any of its ingredients* (serious allergic reactions, including anaphylaxis and angioedema, have been reported with Semaglutide)
• Diabetic retinopathy (diabetic eye disease)
• Pregnant or trying to get pregnant (the estimated background risk of major birth defects is ~3% and the estimated background risk of miscarriage is ~18% – these percentages are increased with use of Semaglutide during pregnancy)
• Breast-feeding (Semaglutide is present in breast milk)
• Less than 18 years old
• Depression with a history of suicidal thoughts

Some individuals require special consideration. You might not be able to take Semaglutide if you have any of the following conditions:

• History of pancreatitis (persistent severe abdominal pain, sometimes radiating to the back with or without vomiting)
• Kidney disease/kidney insufficiency
• Stomach problems (Semaglutide will likely make these problems worse)
• Diabetes (must obtain approval for use from an endocrinologist or primary care physician)

It is recommended that individuals treated with Semaglutide engage in 20-30 minutes a day of walking or other exercises.

Up to 75% of patients have gastrointestinal side effects. These effects are generally mild-to-moderate in severity and are typically temporary. 95% of patients can continue using the medication despite these problems. The most common gastrointestinal side effects are nausea, vomiting, diarrhea, and constipation. The average duration of these symptoms:

• Nausea, 5 days
• Diarrhea, 3 days
• Vomiting, 2 days
• Constipation, 27 days

Semaglutide is administered by injection once a week. It stays in your system for 7-14 days after each injection. It reaches its maximum concentration in the body 1 to 3 days after a dose. If you experience side effects, they will likely be most pronounced during the 1-3 days after each dose.

Patients may also experience abdominal pain, headache, fatigue, indigestion, dizziness, abdominal distension, bloating, burping, flatulence (gas), and gastroesophageal reflux (heartburn).

Things to Consideration Prior to Weight Loss Treatment with Semaglutide:

• Females and Males of Reproductive Potential: Semaglutide can increase the risk of birth defects and miscarriage. Semaglutide must be discontinued at least 2 months before a planned pregnancy.
• Risk of Thyroid C-Cell Tumors: Contact your primary care physician if you develop symptoms of thyroid tumors (e.g., a mass in the neck, difficulty swallowing, difficulty breathing, persistent hoarseness). This has occurred in lab animals given Semaglutide.
• Pancreatitis: Acute and chronic pancreatitis have been reported in clinical studies. Notify your primary care physician if you have signs and symptoms of pancreatitis (persistent severe abdominal pain, sometimes radiating to the back, with or without vomiting). If pancreatitis is suspected, discontinue Semaglutide promptly. If pancreatitis is confirmed, you will no longer be able to take the medication. This occurs in less than 1% of patients taking Semaglutide.
• Diabetic retinopathy: Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy (vision problems).
• Hypoglycemia: Patients receiving Semaglutide in combination with insulin or a medication that increases insulin production (e.g., sulfonylurea) may have increased risk of hypoglycemia (low blood sugar), including severe hypoglycemia. Reducing the dose of insulin or other diabetes medications may be necessary while taking Semaglutide. You will need to tell the doctor that manages your diabetes that you are taking Semaglutide.

In a randomized clinical trial that included 611, either overweight or obese adults, individuals treated with Semaglutide for 68 weeks had the following results on average:

• Decreased body weight (on average, patients lose 26-34 lb. over 68 weeks)
• 70% of patients achieve at least 10% weight loss
• Over 50% achieve at least 15% weight loss
• One-third achieve at least 20% weight loss
• 3 ½ inch reduction in waist circumference
• 4.5 decrease in body-mass index
• 5 mmHg decrease in systolic BP
• Improved physical functioning
• Improved lipid profiles: decreased total cholesterol, VLDL, free fatty acids, and triglycerides
• Lowered fasting blood glucose level (Semaglutide improves blood glucose control in adults with type 2 diabetes and may be used with diabetes medicines)
• Lowered C-reactive protein (a marker of inflammation)
• Semaglutide reduces the risk of heart attack and stroke

Source: Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy on Body Weight in Adults With Overweight or Obesity.  Published in the Journal of American Medicine, February 2021.