GLP1A/Semaglutide/B-12 Weight Loss Program Options

Semaglutide is a glucagon-like peptide (GLP-1) analog approved in 2017 as a treatment method for improving glycemic control in patients with Type 2 diabetes. Semaglutide shows great promise for patients who are having difficulty losing weight. Studies have demonstrated that Semaglutide reduced appetite, improved control of eating, and reduced food cravings in addition to improved glycemic control. The greatest weight loss benefits were observed when Semaglutide is used in combination with lifestyle changes, such as improved diet and consistent exercise. **The drug is indicated for chronic weight management in patients with a body mass index (BMI) of 27 or greater who have at least one weight-related ailment or in patients with a BMI of 30 or greater.

Semaglutide works by mimicking a hormone called glucagon-like peptide-1 (GLP-1) that targets areas of the brain that regulate appetite and food intake; it is a powerful appetite suppressant. It also works by increasing the production of insulin and appears to enhance growth of β cells in the pancreas, which are the sites of insulin production. Additionally, it inhibits glucagon, which is a hormone that increases blood sugar. It has been known to aid not only in weight loss but helps to lower glucose levels in those who are pre-diabetic or who have type 2 diabetes.

Delays stomach emptying, leading to a feeling of fullness and smaller meal size

Slows intestinal motility

Lowers blood sugars, in part by reducing the production of sugar in the liver

Stimulates insulin secretion by the pancreas

Patients will begin with the lowest recommended dose titrating up as tolerance grows.

Injections will be administered once weekly.

Originally used for diabetes and sold under the name Ozempic, a higher dose of the same drug was evaluated for weight loss.

The results were dramatic, with the average individual losing 15(+) % of their body weight during the clinic trial.

Semaglutide is a once-weekly subcutaneous injection GLP-1 agonist for weight loss. GLP-1 agonists were initially developed to improve glycemic control with type 2 diabetics as an adjunct to diet and exercise. It works to enhance the growth of beta cells in the pancreas, which are sites of insulin production.

More recently, high-dose (2.4mg) Semaglutide has been studied in non-diabetic patients suffering from obesity. The New England Journal of Medicine’s publication of the STEP trial revealed more than 50 percent of trial participants lost 15 percent of their body weight, and between 33 to 40 percent are losing 20 percent of their body weight. Semaglutide will delay gastric emptying by reducing glucagon secretion in a glucose-dependent manner. The delay in gastric emptying can reduce appetite, improve control of eating, and reduce food cravings.

Reported Benefits:

Weight Loss

Neuroprotective

Improved Fertility

Treatment of PCOS

Smoking Cessation

Cardiovascular Benefits

Possible side effects and contraindications:

The most common side effects seen with Semaglutide during the clinical trials included gastrointestinal events commonly seen with this agent class and included nausea, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, dyspepsia, dizziness, abdominal distension, eructation, hypoglycemia in patients with type 2 diabetes, flatulence, gastroenteritis, and gastroesophageal reflux disease.

**** The risk of serious side effects increases in patients with hypoglycemia, kidney problems, and risk of allergic reactions.

Semaglutide will have a boxed warning on the potential risk of thyroid C-cell tumors — as do all agents in the GLP-1 receptor agonist class. The drug should not be used in patients with a personal or family history of medullary thyroid carcinoma or in patients with a rare condition called multiple endocrine neoplasia syndrome type 2 (MEN 2). Patients with pancreatitis or at an increased risk of pancreatitis should not use Semaglutide.

This medication is not an insulin and should not be used if you have type 1 diabetes or if you develop diabetic ketoacidosis.

For your initial visit, you will need to schedule an appointment with our office. Upon arriving for your appointment, you will have your consultation with our Nurse Practitioner who will use her discretion (based on the FDA recommendations for treating obesity) to determine if Semaglutide is a safe and good option for you. She will carefully screen you by evaluating your past medical history, any current medications you take, your vital signs, and your body mass index (BMI).

If you are a good candidate for this plan, you will be scheduled for follow-up weigh-ins, so we can continue to properly monitor your treatment and refill your Semaglutide prescription.

You are NOT a good candidate for Semaglutide if you have any of the following: diabetic retinopathy, low blood sugar, decreased kidney function, pancreatitis, medullary thyroid cancer (or a family history of medullary thyroid carcinoma), or multiple endocrine neoplasia type 2.