Semaglutide (GLP-1) Therapy: Myth vs Fact

Peptides are a popular topic among conventional and unconventional healthcare channels, and they can be confusing and tough to navigate. Though it's possible you may not be familiar with the term "peptides," I can sure bet you've heard of semaglutide, also known as Ozempic. Perhaps Wegovy? Tirzepatide? Mounjaro? If you haven't, no worries! I am here to explain.

Semaglutide is a peptide known as glucagon-like peptide-1(GLP-1) receptor agonist. By being a receptor agonist, semaglutide mimics the effects of GLP-1 within your body. GLP-1 is a naturally occurring peptide in your body that plays a few rolls. This peptide signals your body to release insulin, which in turn decreases your blood sugar. This is why semaglutide was originally used to type 2 diabetes. GLP-1 also delays stomach emptying, so you stay fuller for a longer amount of time. In higher amounts GLP-1 also interacts with the parts of the brain that suppress your appetite and signal you to feel full. Therefore when paired with a healthy diet and exercise, semaglutide can help with weight loss.

Now, you can see what all the buzz is about! As with anything that is popular, there can be many misconceptions. Thereforem, we've tackled the top 8 misconceptions to help clear the confusion.

Myth 1: Semaglutide is only for people with diabetes.

Fact: Semaglutide was initially developed to manage type 2 diabetes, where it mimics glucagon-like peptide-1 (GLP-1) to improve blood sugar control. However, studies like the STEP trials have demonstrated its effectiveness for weight management in individuals with obesity (BMI ≥30) or overweight (BMI ≥27 with weight-related comorbidities) even without diabetes. It is FDA-approved for both indications (Novo Nordisk, 2021; Wilding et al., 2021).

Myth 2: Semaglutide causes weight loss without lifestyle changes.

Fact: Clinical trials such as STEP 1 and STEP 2 show that semaglutide enhances weight loss when combined with reduced-calorie diets and increased physical activity. While the medication significantly reduces appetite and calorie intake, sustainable results require adherence to a healthy lifestyle (Wilding et al., 2021).

Myth 3: Semaglutide is unsafe and has severe side effects.

Fact: Semaglutide is an FDA-approved medication with a well-established safety profile. Common side effects include nausea, vomiting, and diarrhea, which are often transient and manageable. Serious adverse events, such as pancreatitis or gallbladder disease, are rare. Patients should consult their healthcare provider to evaluate risks and benefits tailored to their medical history (Novo Nordisk, 2021; Nauck & Meier, 2019).

Myth 4: Once you stop semaglutide, the weight stays off.

Fact:Studies, including the STEP 4 trial, indicate that discontinuing semaglutide may result in partial weight regain, especially if lifestyle changes are not maintained. This emphasizes the need for ongoing dietary and physical activity interventions to preserve weight loss (Rubino et al., 2021).

Myth 5: Semaglutide is a quick fix for weight loss.

Fact:Semaglutide is not a rapid solution for weight loss. Clinical studies show gradual weight loss over time, with significant results typically seen at 68 weeks of therapy. The medication supports long-term changes rather than immediate results (Wilding et al., 2021).

Myth 6: Semaglutide is addictive.

Fact: Semaglutide is not classified as addictive. It acts on GLP-1 receptors to regulate appetite and glucose metabolism, and there is no evidence suggesting dependence (Nauck & Meier, 2019).

Myth 7: Semaglutide is only for people who are severely obese.

Fact: Semaglutide is approved for individuals with obesity (BMI ≥30) or overweight (BMI ≥27) who also have at least one weight-related condition, such as hypertension, dyslipidemia, or obstructive sleep apnea. Its use is not restricted to those with severe obesity; it is indicated for a broad range of patients who can benefit from medically assisted weight management (Wilding et al., 2021).

Myth 8: Semaglutide harms the heart.

Fact: Contrary to this misconception, semaglutide has demonstrated cardiovascular benefits in people with type 2 diabetes. The SUSTAIN-6 trial showed a significant reduction in the risk of major adverse cardiovascular events (MACE), including heart attack and stroke, among users of semaglutide. These benefits are being further explored for patients without diabetes (Marso et al., 2016).

Thanks for reading!

Victoria Griffith, DO MPH

References:

• Wilding, J. P., et al. (2021). Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine.

• Marso, S. P., et al. (2016). Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. New England Journal of Medicine.

• Rubino, D., et al. (2021). Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity: The STEP 4 randomized clinical trial. JAMA.

• Nauck, M. A., & Meier, J. J. (2019). Management of endocrine disease: Are all GLP-1 agonists equal in the treatment of type 2 diabetes? European Journal of Endocrinology.