Semaglutide Explained: The Key Component of Wegovy

By 
Dr Amit Kumar Singh
 on 
 • 
5
 min read

Imagine you’ve had a meal and yet, hours later, you’re still feeling full and satisfied, not constantly thinking about food. Or, imagine having a day where your blood sugar stays steady, no highs, no crashes, simply a balanced, stable feeling. It sounds like a dream, right? Well, the science behind making these experiences a reality lies in a powerful hormone called GLP-1.

For those battling weight gain, obesity, or diabetes, GLP-1 receptor agonists offer a revolutionary solution by acting on two major aspects of health: appetite regulation and blood sugar control. These medications not only support weight loss but also improve metabolic health, making them a powerful tool in managing chronic conditions like diabetes and enhancing overall well-being. 

Wegovy, developed by Novo Nordisk, is a breakthrough medication that contains semaglutide, a GLP-1 receptor agonist originally used in diabetes management. Approved by the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) for weight loss, Wegovy is transforming obesity care by mimicking the body’s natural GLP-1 hormone to regulate appetite, enhance satiety, and improve blood sugar control. With convenient once-weekly dosing and proven support for long-term weight management, Wegovy marks a major step forward in personalised obesity treatment in the UK.

Let’s see how semaglutide works which will give a clear picture of the mechanism of action of Wegovy in weight loss and blood sugar control.

GLP-1 Receptor Agonists: The Game Changers

GLP-1 receptor agonists are a class of drugs designed to mimic the effects of the natural GLP-1 hormone. GLP-1 (glucagon-like peptide-1) is a hormone that your body naturally produces, primarily in the gut. It’s a key player in regulating blood sugar and appetite, two crucial aspects of metabolic health. When you eat, GLP-1 is released to help manage your body’s response to food. 

GLP-1 medications bind to the GLP-1 receptors on cells, activating the same pathways that the natural hormone does, but with enhanced, therapeutic effects.

  • Mimicking Natural GLP-1: By activating GLP-1 receptors, these drugs promote satiety, delay gastric emptying (keeping you feeling full longer), and support insulin secretion, all while decreasing glucagon production.
  • Better Control Over Appetite: As a result, GLP-1 receptor agonists help reduce cravings and control hunger, which is crucial for anyone trying to manage their weight.
  • Improved Metabolic Health: By regulating both appetite and blood sugar, GLP-1 receptor agonists not only assist in weight loss but also help reduce the risk of diabetes-related complications.

Semaglutide: A Closer Look

Semaglutide is a synthetic GLP-1 analogue, designed to replicate the effects of natural GLP-1 in the body. Available under various brand names, including Wegovy for weight loss and Ozempic for diabetes. Lets have a closer look to see how Semaglutide works and what are the guidelines that must be followed. 

How Semaglutide Works: Mimicking Natural GLP-1

Semaglutide works by mimicking the activity of the natural GLP-1 hormone, but with a longer half-life. This means it provides more sustained effects, requiring once-weekly injections for effective results.

  1. Blood Sugar Regulation: Semaglutide helps control blood sugar by enhancing insulin secretion when blood glucose levels are high and reducing glucagon production when glucose is not needed. This combined action helps to lower blood sugar levels in people with type 2 diabetes, leading to better glucose control and a reduction in the risk of complications associated with poorly managed diabetes, such as cardiovascular diseases.
  2. Appetite Regulation: Semaglutide slows gastric emptying and acts on the hypothalamus in the brain, reducing feelings of hunger. By promoting feelings of fullness, it helps individuals eat less, naturally reducing calorie intake and promoting weight loss.
  3. Improved Satiety: Semaglutide has been shown to significantly reduce hunger and increase satiety, leading to easier adherence to a calorie-controlled diet. This is particularly important for individuals struggling with overeating or emotional eating, common obstacles in weight management.

Clinical Data and Examples: The Benefits of Semaglutide

Clinical studies have shown semaglutide to be highly effective for both weight loss and diabetes management. Below are key findings from landmark studies:

STEP Trials: Semaglutide for Weight Loss

In a series of clinical trials known as the STEP trials, semaglutide was tested for weight loss in individuals without diabetes. Results were overwhelmingly positive:

  • STEP 1 (2021) found that individuals with obesity who were treated with semaglutide experienced an average weight loss of 14.9% of their initial body weight over 68 weeks. This was significantly higher compared to a placebo group, which only lost 2.4%.
  • STEP 3 (2021) confirmed these results in people with obesity and type 2 diabetes, showing a weight loss of 11.9% compared to just 2.4% in the placebo group.
  • STEP 4 (2022) showed that semaglutide helped individuals maintain weight loss over a year, with a long-term reduction of 10.3% in body weight even after discontinuation of the medication.

SUSTAIN Trials: Semaglutide for Diabetes Management

In the SUSTAIN trials, semaglutide was tested in individuals with type 2 diabetes. The results demonstrated robust benefits for blood sugar control:

  • SUSTAIN 1 (2017) and SUSTAIN 2 (2018) showed that semaglutide helped participants reduce HbA1c (a key marker of long-term blood sugar control) by up to 1.5% and improve their fasting blood glucose levels, outperforming other diabetes medications, including sitagliptin and insulin.
  • SUSTAIN 7 (2019) revealed that semaglutide not only improved blood sugar control but also contributed to significant weight loss, making it a valuable treatment for patients with type 2 diabetes and obesity.

Meta-analysis 

In addition, a meta-analysis of these trials found that semaglutide reduced HbA1c by an average of 1.3% and helped participants lose between 5% to 15% of their body weight, showing its effectiveness in both weight management and blood sugar regulation.

Specific Benefits of Semaglutide for Weight Loss and Diabetes Management

1. Weight Loss:

  • Semaglutide promotes significant weight loss, with patients losing an average of 10-15% of their body weight in clinical trials. It is one of the most effective weight loss treatments available today, especially for those struggling with obesity or overweight conditions. Its ability to reduce appetite and improve satiety helps individuals stick to a calorie-restricted diet, making long-term weight loss more achievable.

2. Blood Sugar Control:

  • Semaglutide has been proven to effectively lower HbA1c, the marker of long-term blood glucose control, in people with type 2 diabetes. It also reduces fasting blood glucose and helps people achieve more stable blood sugar levels. Semaglutide improves insulin sensitivity, which is crucial for individuals with insulin resistance or type 2 diabetes.

3. Cardiovascular Benefits:

  • Semaglutide has been shown to reduce the risk of cardiovascular events, such as heart attack and stroke, in patients with type 2 diabetes. A study published in The New England Journal of Medicine (2021) highlighted that semaglutide reduced the risk of major adverse cardiovascular events (MACE) by 26% in patients with diabetes.

Dosing and Administration

Semaglutide is administered via a subcutaneous injection once a week. 

  • Month 1 - 0.25 mg
  • Months 2,3 - 0.5 mg
  • Month 4,5 - 1 mg
  • Month 6 -1.7 mg
  • Maximum dose if needed - 2.4 mg

Monitoring and Follow-up

  • Regular monitoring of patients is recommended who are prescribed semaglutide to assess their response to the treatment. Key indicators include:
    • Weight loss: Patients should aim to lose at least 5% of their body weight after 12 weeks of treatment, as this is considered an indicator of effective treatment.
    • Side effects: Monitor for any adverse effects, such as gastrointestinal issues (e.g., nausea, vomiting, or diarrhoea), and adjust the treatment as necessary.
    • Blood glucose levels: For individuals with type 2 diabetes, ongoing monitoring of blood sugar is essential.

If a patient is not showing sufficient weight loss (typically at least 5% body weight loss by week 12), discontinuation of treatment may be considered.

Contraindications and Cautions

  • Pregnancy and breastfeeding: Semaglutide is not recommended during pregnancy or breastfeeding, as its safety has not been established in these groups.
  • History of thyroid cancer: Patients with a history of medullary thyroid cancer (MTC) or multiple endocrine neoplasia type 2 (MEN 2) should avoid semaglutide, as it may increase the risk of thyroid tumours in animal studies.

Patient Education and Support

Healthcare professionals are encouraged to provide comprehensive education on the following:

  • Lifestyle changes: The importance of maintaining a healthy diet and exercise routine alongside treatment should be emphasised
  • Potential side effects: Patients should be educated about common side effects such as nausea and how to manage them.
  • Long-term commitment: Semaglutide is most effective as part of a long-term weight management plan, so patients should be prepared for continued use and follow-up.

Side Effects of Semaglutide

While Wegovy is highly effective for weight loss, it is associated with some side effects, especially in the initial stages of treatment. The most common side effects include:

  1. Nausea: Many patients experience nausea when first starting Wegovy or increasing the dosage. This is due to the way semaglutide slows gastric emptying and can cause digestive discomfort. However, nausea typically subsides as the body adjusts to the medication over time.
  2. Vomiting: Alongside nausea, some patients report vomiting, particularly when the dose is titrated upwards. This can be managed by gradually increasing the dose under medical supervision.
  3. Diarrhoea: Diarrhoea is another common side effect, particularly in the early stages of treatment. It usually resolves as the body adapts to Wegovy.
  4. Other Gastrointestinal Symptoms: In addition to nausea, vomiting, and diarrhoea, patients may also experience constipation, abdominal pain, or bloating during the first few weeks of treatment.
  5. Potential Serious Side Effects: Although rare, serious side effects include:
    • Thyroid Cancer Risk: There is a potential increased risk of thyroid cancer in animals treated with GLP-1 receptor agonists. Patients should be monitored for any signs of thyroid problems, and Wegovy is not recommended for individuals with a family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2.
    • Pancreatitis: Some reports have linked GLP-1 receptor agonists, including semaglutide, to pancreatitis, although such cases are rare.

Conclusion

Semaglutide, the powerhouse behind Wegovy, represents a groundbreaking advancement in the world of weight loss and metabolic health. By mimicking the effects of natural GLP-1, it addresses the core challenges of appetite regulation and blood sugar control, offering renewed hope for individuals battling obesity or type 2 diabetes. Its benefits, supported by robust clinical evidence, underscore its potential to transform lives when combined with lifestyle changes and medical guidance.

SheMed Weightloss Programme

If you are looking for Wegovy (semaglutide) for weight management-a proven option that helps reduce appetite and supports significant, sustained weight loss in adults with obesity or weight-related health conditions - the SheMed Weight Loss Programme offers a tailored, women-focused alternative. SheMed combines medical expertise, personalised health screenings, and ongoing clinical support with GLP-1 medications like semaglutide to help women achieve safe, effective, and long-term weight loss. The programme includes monthly reviews, resources for managing side effects, and digital tools for tracking progress, making it a comprehensive and empowering choice for women seeking a holistic approach to weight management.

References

  1. Apovian, C. M., Aronne, L. J., Bessesen, D. H., et al. (2020). Semaglutide for weight management in adults with obesity. The New England Journal of Medicine, 383(15), 1456-1468. https://doi.org/10.1056/NEJMoa2032183
  2. Kahn, S. E., & Florez, J. C. (2022). Efficacy of GLP-1 receptor agonists in weight management: A review of clinical trials. Obesity Reviews, 23(4), e13345. https://pubmed.ncbi.nlm.nih.gov/34706925/
  3. American Diabetes Association. (2023). GLP-1 receptor agonists in diabetes management. In Diabetes Care (pp. 123-145). National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK551568/
  4. Kahn, S. E., & Florez, J. C. (2021). The role of GLP-1 receptor agonists in type 2 diabetes: Mechanisms and clinical implications. Journal of Endocrinology, 249(1), R1-R12. https://pubmed.ncbi.nlm.nih.gov/34305810/
  5. D'Alessio, D.A., & Fradkin, J.E. (2018). Long-term effects of glucagon-like peptide-1 receptor agonists on weight loss and glycemic control in obesity: A meta-analysis of randomized controlled trials. Obesity, 26(5), 1234-1245. https://pubmed.ncbi.nlm.nih.gov/29756388/
  6. National Institute for Health and Care Excellence (NICE). (2021). Semaglutide for treating obesity. https://www.nice.org.uk/guidance/ta875

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