Thursday, March 16, 2023
Semaglutide is a medication used to treat obesity and type 2 diabetes, and it has gained a lot of attention recently due to its effectiveness in helping patients lose weight. Journey Clinic utilizes this medication and prescribes it for medical weight loss treatment when appropriate. However, as with any medication, there are risks and potential side effects associated with semaglutide. In this article, we will do a deep dive into all things semaglutide related with Allison Staley, DNP, APRN, FNP-C, and Brenda Wilson, APRN-FNP-C, two medical weight loss specialists at Journey Clinic.
What is Semaglutide?
Semaglutide, most well known under the brand names Ozempic (approved by the FDA for diabetes patients) and Wegovy (approved by the FDA for weight loss patients), is a medication that belongs to a class of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists. This medication was originally developed to treat type 2 diabetes, but it was later found to have weight-loss benefits. The drug works by regulating the appetite and reducing food intake, leading to weight loss.
Semaglutide comes in the form of an injection, and patients typically take it once a week. This medication is only available with a prescription from a doctor.
There has been controversy recently surrounding these medications as they have been trending on social media and in the news.
“The controversy has a lot to do with the GLP-1s that are approved for type-2 diabetes such as Ozempic because some patients feel that their medication is being used for medical weight loss and isn’t readily available for them for their diagnosis of type 2 diabetes,” said Staley.
“In general most insurance companies don’t pay for weight loss medications, but some of them will cover Ozempic even if you don’t have a diagnosis of type 2 diabetes, it could be for pre-diabetes or other things,” said Staley ”This has kind of created a shortage of the medication and even though the manufacturers say they are stocked, lots of pharmacies are having trouble getting it in.”
Who Qualifies for Semaglutide Medications?
Semaglutide is approved by the U.S. Food and Drug Administration (FDA) for use in adults with a body mass index (BMI) of 30 or higher, or in adults with a BMI of 27 or higher who also have at least one weight-related comorbidity, such as high blood pressure or type 2 diabetes.
However, it's important to note that not everyone who qualifies for semaglutide medications will be prescribed them. Doctors will carefully consider each patient's individual circumstances and medical history before deciding whether semaglutide is the right choice for them.
“Semaglutide is contraindicated in patients with a personal or family history of thyroid cancer or multiple endocrine neoplasia type 2, which is a rare genetic cancer of the adrenal or endocrine glands. So anybody who has that history should not have semaglutide prescribed,” said Staley.
“We use caution in patients with a history of chronic kidney disease as well as patients with a history of gallstones or pancreatitis as it may increase the risk of reoccurrence.” said Wilson.
Risks of Semaglutide Medications
As with any medication, semaglutide comes with potential risks and side effects.
Some of the most common side effects include:
- Stomach pain
More serious side effects of semaglutide include:
- Kidney problems
- Gallbladder problems
- Hypoglycemia (low blood sugar)
- Thyroid tumors
It's important for patients taking semaglutide to be aware of these potential risks and to report any symptoms or side effects to their doctor right away.
It also isn’t uncommon for independent pharmacies to compound their own semaglutide. However, this increases the risks as there is less quality control and patients taking these independently made generics do not always know what they are getting.
“When it comes to injectable medications, if the compounding pharmacy doesn’t have the right equipment to mix the medication, there is a risk for contamination and infection for the patient,” said Staley. “We stay on the side of caution and do not prescribe compounded injectables because we don’t know enough about the source of the medication and the risk is too high.”
Weight Gain After Discontinuing Use
Another important consideration for patients taking semaglutide is the potential for weight gain after discontinuing use. Semaglutide works by reducing appetite and food intake, but these effects may not be permanent. If a patient stops taking semaglutide, they may experience an increase in appetite and weight gain.
This is why it's important for patients taking semaglutide to view it as a long-term treatment for obesity, rather than a short-term fix. It's also important for patients to work with their doctor to develop a plan for maintaining weight loss after discontinuing use of semaglutide.
Understanding Obesity as a Disease
Finally, it's important for candidates for semaglutide medications to understand that obesity is a disease that requires medical treatment. Obesity is associated with a range of health problems, including heart disease, stroke, diabetes, and certain types of cancer. It's not simply a matter of willpower or self-control, and it cannot always be treated through diet and exercise alone.
“Obesity is a disease. It’s a chronic condition like hypertension, so in many cases people will need to be on this medication long-term to treat their disease,” said Staley.
“Our motto at Journey Clinic is ‘wellness is a journey, not a destination’ because you cannot reach your goal and stop. You have to continue lifestyle modifications and potentially medications to keep you on the right path,” said Wilson.
By understanding that obesity is a disease and that medications like semaglutide may be used to treat it long-term, patients can take a more proactive approach to their health and well-being.
Semaglutide is a medication that can be a helpful tool for people struggling with obesity. However, as with any medication, there are potential risks and side effects that should be discussed with a healthcare provider. It is important for people to understand that obesity is a chronic disease that requires long-term management, and semaglutide may be a helpful tool for some people in achieving and maintaining weight loss.
If you are interested in learning more about Journey Clinic and medical weight loss, give us a call at 405-515-2049.