GLP-1 stands for Glucagon-Like Peptide-1, which is a hormone mainly produced by intestinal L cells and belongs to a type of incretin. Many natural foods can promote the production of GLP-1, which can inhibit gastrointestinal motility, delay gastric emptying, and suppress appetite in the human body.
Currently, the latest generation of GLP-1 drugs in the world mainly refer to Semaglutide (also known as Semaglutide) produced by Novo Nordisk in Denmark and Tirzepatide (also known as Tirzepatide) produced by Eli Lilly in the United States.
Does semaglutide have the same weight loss effect on everyone?
The answer to this question is no. Experimental data show that about 15% of people do not achieve significant weight loss effects using semaglutide (for doctors and insurance companies, weight loss effects are defined as weight loss of more than 5% within three months).
“We don’t know why semaglutide can’t help some people lose weight, and there is no scientific basis to predict the weight loss effect of an individual.”
In the Phase 3 clinical trials in which semaglutide was approved for weight loss, there were four studies involving 4,500 people. Among them, the first Phase 3 trial recruited 1,961 obese or overweight patients. After 68 weeks of treatment, the placebo group lost an average of 2.6 kg (about 2.4% of body weight), while the semaglutide group lost an average of 15.3 kg (about 15% of body weight).
Among the subjects who lost 5%, the semaglutide group reached 86.4%, while the placebo group was only 31.5%; among the subjects who lost 15%, the semaglutide group reached 50.5%, while the placebo group was only 4.9%.
From the average weight loss curve, the semaglutide group can lose 9 catties in two months and 30 catties in one year.
However, it should be noted that the average initial weight base of these participants was 105 kg. In addition, they also received a diet plan that restricted calorie intake and health management that increased exercise.
In addition, drugs always have some side effects. Common adverse reactions of semaglutide include nausea, diarrhea, vomiting, constipation, abdominal pain, etc.
Not everyone can successfully lose weight by using semaglutide, and not everyone will experience the above side effects. In clinical trials, 7% (92 people) of the subjects withdrew due to side effects, and 3.1% (20 people) of the subjects in the control group also withdrew.
The clinical trial also found that after using semaglutide to lose weight, if it was replaced with a placebo, the subjects would return to their original weight level after about 20 weeks. This means that although semaglutide can help people lose weight, it needs to be used continuously to maintain the effect.
Early response to semaglutide is a good indicator of long-term effects.
Does it mean that patients who respond to semaglutide can “lose weight while lying down”?
The answer is also no!
“The role of drugs is to help people establish a healthy lifestyle, and it is not encouraged to rely solely on drugs to lose weight.”
Semaglutide simulates a hormone called GLP-1 in the human body to control appetite, enhance satiety, reduce the desire to eat, and help people easily control their diet, thereby achieving the effect of weight loss.
The key to successful weight loss is to create a negative energy balance. By consuming more calories, you can lose weight. However, obesity often stems from bad eating habits, such as overeating, eating a lot after appetite loss, and preferring high-calorie foods, which will affect the weight loss process.
Experts point out that the reason for the poor effect after using semaglutide is simple-the user has not achieved the ideal weight loss effect. Therefore, doctors should scientifically guide patients to set reasonable weight loss goals.
Even if there is no significant change in weight in the short term, taking semaglutide can still bring other benefits, such as improving the risk of cardiovascular disease and lowering blood sugar levels.
Dosage differences for hypoglycemic and weight loss
As a hypoglycemic drug, semaglutide is injected in two stages. The first stage is to inject 0.25 mg per week for 4 consecutive weeks; then upgrade to 0.5 mg per week, also for 4 weeks. If necessary, it can be further increased to a maximum dose of 1 mg per week.
However, in the standard weight loss treatment regimen, the injection dose is 0.25mg in the first week, increased to 0.5mg in the second week, 1mg in the third week, and 1.7mg in the fourth week. From the fifth week, the highest dose of 2.4mg per week can be reached.
Will the drug rebound after stopping?
A large number of studies have shown that without any intervention, patients who stop taking the drug will regain two-thirds of the weight they lost before.
These studies seem to confirm people’s previous concerns: patients need to use GLP-1 drugs for a long time, and may even take them for life to maintain their health benefits. This phenomenon is not unique to weight loss drugs. We are familiar with drugs for chronic diseases such as high blood pressure, high blood sugar and high cholesterol, and patients need to take drugs for life.
Some people are surprised to hear that stopping semaglutide will regain some weight. However, it is actually not much different from any other weight loss intervention.
Think about anyone you know who has successfully lost weight through a healthy diet and exercise regimen. As long as they continue to work hard, their weight loss and weight management results will remain stable. If they return to a sedentary lifestyle and stop watching what they eat, they will quickly regain the weight.
Semaglutide is no exception. It doesn’t permanently change your body structure like some weight loss surgeries, so its weight loss effect will only last as long as you continue to take it.
“All patients who didn’t rebound had one thing in common: they maintained their lifestyle habits during the medication period, sticking to a healthy diet and exercise”