Semaglutide Frequently Asked Questions 2024

GLP-1s, which stands for glucagon-like peptide-1 receptor agonists, are a class of medications developed to manage blood sugar levels in people with Type 2 diabetes. Some of the most common brands of GLP-1 drugs include Trulicity®, Mounjaro®, Ozempic®, Wegovy® Adlyxin®, among others. GLP-1s are often called semaglutide drugs interchangeably.

While originally created for Type 2 diabetes, this class of drugs has exploded in popularity due to its efficacy for weight loss. Multiple studies have found that the use of GLP-1 agonists directly correlate with weight loss, with one study in the New England Journal of Medicine finding that adults lost an average of 15% of their body weight in 15 months.

Dr. Bryce Peterson is a Family Medicine Physician who's board-certified in Obesity Medicine. He has answers to some of the most frequently asked questions about semaglutide in 2024.

Why is semaglutide so popular?

“This medicine is one of the most exciting changes in obesity medicine ever,” says Dr. Peterson. “The gold standard for obesity used to be metabolic surgery. We are now seeing drugs like Mounjaro® that mimic the effect of weight loss surgery with patients losing up to 20% of their body weight.”

Available by injection (most popular) or in a pill form, semaglutide drugs work by mimicking the hormone GLP-1, which serves many functions like triggering insulin release, preventing glucose from entering the bloodstream, slowing digestion, and increasing the feeling of fullness. Patients report feeling much less hungry day-to-do and unable to eat the same volume of food they once did.

Who is eligible to take semaglutide?

The FDA recommends GLP-1s for weight loss if you meet one of the following criteria:

• Have a body mass index (BMI) of 27kg/m2 or greater and at least one weight-related condition, such as high blood pressure, Type 2 diabetes or high cholesterol
• Have a BMI of 30kg/m2 or greater

If you’re thinking about semaglutide for weight loss, your first step should be consulting your primary care physician (PCP) or an obesity specialist such as Dr. Peterson. They will review your medical history and can guide you in the best treatment options. If you have diabetes and already take a different medication, talk to your physician about safe drug combinations.

Is compounded semaglutide effective? Is it safe?

With is massive popularity, it’s now possible to take a compounded version of semaglutide manufactured through a pharmacy. But is compounded semaglutide effective? Is it safe?

“It’s unethical and illegal for an American pharmacy to manufacture something different than what's on it's label,” says Dr. Peterson. “I do not believe, nor have I seen evidence that compounded semaglutide does not have the same active ingredient as name brands. In my practice, I tend to see patients taking compounded semaglutide and having the intended results that we’d expect from brand-name GLP-1 agonists.”

Dr. Peterson adds that he’s thankful to see GLP-1 agonist drugs becoming more accessible. “When first introduced, these name brands could cost $1,000+ per month without insurance. Compounding makes them much more affordable and available for the many people who could benefit from them.”

Is oral semaglutide as effective as injectable semaglutide?

Rybelsus® is the first FDA-approved semaglutide pill which works the same way the injectable. What’s different is the method of delivery and the dosage. “I tend to try oral semaglutide with patients who can’t tolerate injectables very well: if they have severe nausea or feelings of fullness,” says Dr. Peterson. The reason is because Rybelsus® is a low daily dose that tends to be easier on the side effects.

Although data is limited, Rybelsus® and Ozempic® seem to be providing similar results with weight reduction and blood glucose levels. Ozempic® equated to an average of 9.9 pounds lost over 30 days while Rybelsus® averaged 8.2 pounds lost over 30 days according to one study.

Who should not take semaglutide?

There has been a small increased risk of medullary thyroid cancer observed in rats. “This is a rare type of cancer, but if you have a family history, you should not take GLP-1s.”

Dr. Peterson also addresses a social trend called ‘vanity weight loss,’ saying, “These drugs are intended for diabetics, people with risks of heart issues, and overweight people who have struggled to lose or maintain their weight. They are not meant to be used to lose a quick five or ten pounds.”

What side effect(s) should people be aware of?

The side effects of semaglutide are typically mild, especially when compared to the complications associated with overweight and obesity. People taking semaglutide for weight loss may experience:

• Stomach issues like nausea, bloat, or extreme fullness
• Dizziness, headache, or fatigue
• Gastrointestinal issues, such as diarrhea, constipation and gassiness

GI issues are the most common complaint among people just starting semaglutide. “This is a big reason working with a healthcare provider is important. We have the flexibility help patients maintain a dosage of the drug that they can tolerate and gradually increase over time,” says Dr. Peterson.

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Dr. Bryce Peterson is double board-certified in Family Medicine and Obesity Medicine. He practices in Bountiful, Utah at Cope Family Medicine and is accepting new patients for weight loss and metabolic health consultations. Schedule with Dr. Peterson here.