Introduction
So, you’ve decided to take semaglutide. You might probably be thinking about taking Ozempic, given its sheer popularity with Hollywood A-listers and business tycoons. You’ve got the likes of British personality Sharon Osbourne to SpaceX/Tesla mogul Elon Musk, singing their praises for it.
It is practically a wonder drug because it lowers blood sugar levels and promotes weight loss, among other therapeutic benefits.
What happens when you take semaglutide for the first time? From potential side effects to positive outcomes, we share in this article what to expect with semaglutide use.
What is semaglutide?
Before we dive into what happens when you take semaglutide, we must know what semaglutide is and how it works. How is it able to help people manage their blood sugar levels and shed pounds at the same time?
Whenever we finish a meal, a hormone in our gut, glucagon-like peptide-1 (GLP-1) kicks into action. It triggers the pancreas to release the hormone insulin to bring down high blood sugar levels.
Now, semaglutide is a glucagon-like peptide-1 receptor agonist, or GLP-1 Ra, for short. It mimics GLP-1, also prompting the pancreas to do the same when blood sugar levels are high.
At the same time, it also slows down digestion or gastric emptying. As a result, people taking semaglutide tend to feel fuller for a longer period. Since they don’t think about food as much, they have fewer cravings and eat less, leading to weight loss. It’s no wonder the demand is so high for the drug.
Administration of semaglutide
Now that we understand what semaglutide is and how it works, let’s learn about how you should take it.
Semaglutide variants
You have the popular semaglutide brand, Ozempic, that’s been making waves in medicine for its weight loss effects. But surprisingly, it did not receive FDA approval for weight loss. In truth, Ozempic has approval for treating type 2 diabetes.
Ozempic has two other sister brands: Wegovy and Rybelsus. Like Ozempic, Rybelsus is FDA-approved to treat type 2 diabetes, while it’s Wegovy that’s FDA-approved for weight loss.
Essentially, though, they’re still all semaglutide and have the same weight loss effect. Hence, many healthcare providers opt to prescribe Ozempic off-label.
Subcutaneous semaglutide and oral semaglutide
Semaglutide comes in two formats: subcutaneous and oral semaglutide. Subcutaneous means to administer “under the skin,” while oral refers to taking something by mouth.
Ozempic and Wegovy are administered subcutaneously, as they come in injectable dosing pens, while Rybelsus is in tablet form.
Dosages
Your doctor will typically start you off on a low dose, gradually increasing this until you reach a maintenance dose. This is to help your body adjust to semaglutide.
Ozempic comes in 0.5 mg, 1 mg, and 2 mg doses. Meanwhile, Wegovy comes in various dose strengths, from 0.25 mg to 2.4 mg. The different doses come in pens of different colors.
Rybelsus, meanwhile, comes in 3 mg, 7 mg, and 14 mg doses, available in 30-tablet bottles with caps of different colors.
Administration
You must inject Ozempic and Wegovy once weekly, with or without meals. You can inject it in three injection sites, namely the upper arm, thigh, or abdomen. It is best to use a different injection site with every injection. Should you want to use the same injection site, however, just pick a different spot in that general area.
Patients must not inject subcutaneous semaglutide into a muscle or vein. Doing so could cause allergic reactions, erratic blood sugar levels, infection, or even organ damage.
You must take Rybelsus, meanwhile, once daily on an empty stomach the first time you wake up. You should take it the same way every time.
In addition, you typically take Rybelsus at 3mg once per day during the first 30 days of use. After this initial month, your doctor will increase your dose to 7 mg per day. This dose is typically what it takes for your body to regulate its blood sugar levels. After another 30 days on 7 mg, your doctor might increase the dosage to 14 mg per day.
Safety and efficacy of semaglutide
Before taking semaglutide, you should also have a better grasp of just how safe and effective it is. Research points to not just its efficacy in regulating blood sugar levels and promoting weight loss, but other health benefits. The following are examples of studies that provide this evidence.
In the STEP 5 trial, researchers looked at the semaglutide’s two-year effects in overweight or obese adults. Participants lost an average of 15 percent of their body weight with semaglutide. Meanwhile, those in the placebo group just lost around 2.6 percent of their body weight.
Semaglutide promoted greater reductions in waistline circumference—14.4 centimeters or 5.7 inches—and systolic blood pressure, by 5.7 mmHg. Versus the placebo group, participants on semaglutide also experienced improved diastolic blood pressure, blood sugar levels, total cholesterol, and triglycerides.
Another study found that semaglutide participants lost more body fat than body mass and ate less due to weaker appetites. In addition, they had better control of eating, less food cravings, and a lower desire for fatty foods.
Eligibility
Not just anyone can take semaglutide. To be a candidate for Ozempic, you need to have type 2 diabetes. However, because it doesn’t have eligibility weight loss criteria, healthcare providers can prescribe it off-label for its weight management benefit. Note that they will most likely prescribe it, though, if you are overweight or have obesity. The same goes for Rybelsus.
For Wegovy, meanwhile, patients must be overweight or have obesity, along with at least one weight-related condition.
Lifestyle intervention
Remember that for semaglutide to work at its best, you should incorporate lifestyle changes in your treatment plan.
Apart from meeting certain criteria, semaglutide also works alongside a patient’s healthy diet and ample physical activity.
What to expect on semaglutide
Now that we know about the different semaglutide variants and how you must administer them, we can read about potential side effects. What should you expect with semaglutide use? How much weight can you possibly lose and what do you need to eat? How soon can you see the results?
Semaglutide side effects
Although potent, semaglutide is just like any other drug that comes with a host of potential side effects. Knowing its common side effects will help you prepare accordingly.
Common side effects
Gastrointestinal reactions account for 10 percent 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%),
- an increase in the pancreatic enzyme lipase (up to 22%),
- abdominal pain (up to 20%),
- and an increase in the digestive enzyme amylase (up to 13%).
Lipase is an enzyme that breaks down fats in our food so the intestines can absorb them. Meanwhile, the pancreas and salivary glands produce amylase, a digestive enzyme that helps you digest carbohydrates.
An abnormally high level of lipase may indicate that you have a problem with your pancreas such as pancreatitis. It may also suggest kidney failure, cirrhosis, or a bowel problem.
High levels of amylase, meanwhile, may indicate acute pancreatitis or chronic pancreatitis, even pancreatic, breast, colon, ovarian, or lung cancer.
Other side effects
Other common side effects of semaglutide in 1 to 10 percent 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.
It’s worth noting that these common side effects are mild and your healthcare provider can help you manage them. Semaglutide’s more serious adverse effects, meanwhile, are rare.
Managing symptoms
As mentioned, people will have a unique experience with semaglutide, especially in the first few days or weeks of use. Some semaglutide users have been vocal on social media about the symptoms they had. Generally, they expressed a lack of hunger and vomiting.
Fortunately, these side effects are manageable. Here are some tips for managing them:
To manage nausea:
- Eat crackers, apples, mint, and ginger-based drinks 30 minutes after taking or injecting GLP-1 Ra.
- Avoid strong smells.
For vomiting:
- Seek generous hydration.
- Have more frequent meals, in smaller amounts.
To manage diarrhea:
- Seek generous hydration (water, lemon, bicarbonate)
- Steer clear of sports drinks.
- Avoid high-fiber content foods (You will gradually restore these upon improvement). Yes to chicken broth, rice, carrots, ripe fruit, baked fruit. No to dairy products, laxatives, coffee, alcohol, soft drinks, very cold/hot foods, products with “ol” ending sweeteners
Addressing constipation:
- Ensure enough fiber in your diet.
- Increase physical activity.
- Have a healthy, balanced diet
- Seek generous hydration (water, sugar-free liquids)
For any other persistent or severe gastrointestinal adverse effects, contact your doctor as soon as possible.
Frequently asked questions
The following are some typical questions from first-time semaglutide users. Again, remember that the answers to these are more of a general guide. Specific effects on patients will vary.
How quickly do you lose weight on semaglutide?
Although some claim they’ve lost weight in a week, studies show it takes around four weeks on semaglutide. The full effect can take some more time. In one research, participants lost as much as 35 pounds or 15.9 kilograms over 68 weeks.
Can I lose 20 pounds in a month with semaglutide?
It will typically take at least four weeks before you see weight loss. It’s highly likely for patients to lose as much as 20 pounds, but not within a month.
One study found that patients on semaglutide lost an average of approximately 15 pounds three months into their treatment. At the sixth-month mark, they lost around 27 pounds.
Conclusion
Every person will have a different experience as they take semaglutide for the first time. People commonly reported symptoms like nausea, vomiting, and a general lack of hunger. Thankfully, they can manage these side effects by making dietary changes.
Patients should start to lose weight after four weeks. A study shows that they can lose as much as 27 pounds after six months. Remember, though, that these results will vary from one person to another.
Make sure to stay in touch with your healthcare provider throughout your treatment.
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 agonists mimic GLP-1 in the production of insulin to control blood sugar levels.
