Semaglutide is a protein that mimics GLP-1.  This protein has at least 2 functions.  First it provides feedback into the brain to tell you that you are full and to stop eating.  The other function is to slow down digestion and the movement of food through the GI tract in order to maximize the absorption of nutrients. 

In simple terms you will feel fuller with less food and longer, decreasing your calorie intake and loosing weight.  The average weight loss is about 15% of body weight.  Some people do lose substantially more and a small percentage will lose nothing at all.  Unfortunately, the only way to see how you will do on Semaglutide is to try it.

Because Semaglutide works in the GI tract the side effects are mostly limited to it.  Some people will have an injection site reaction, some redness or swelling around the location you inject, these are often mild and resolve after a day or two.  The most common side effects are nausea, vomiting, acid reflux, bloating, constipation, and diarrhea.  Most milder side effects will resolve after a couple of weeks of taking the medication. This is why we start at a low dose and increase gradually.  Some people will report feeling nauseated the day or two after their shot that then resolves. 

If you do experience side effects there are medications that can help alleviate them.

When starting semaglutide some people have effects almost immediately others take a little time for the medication to build up.  Usually, the first feeling is a sense of fullness or lack of snacking, with smaller portions being satisfying and noticing that you are not feeling hungry in between meals.  A good rule or thumb is to start with about 1/3 less food than you would normally take and see how you feel.  If you overeat, think thanksgiving dinner that lasts twice as long. 

The short answer is NO.  Weight loss is simply taking in less calories than you use.  It doesn't matter how you get those calories, as long as you are net negative you will lose weight.  However, this is a great time to also make lifestyle changes to improve your overall health.  There is no reason to do fad diets (keto, gluten free, carb limited) or give up food you love.  Simply try to eat a more balanced and well rounded diet higher in fruits, vegetables, and fish.  

My goal is to help you maintain a monthly weight loss of between 5 and 10 pounds. Anything more than that is too fast and can lead to unanticipated consequences such as loose skin or an “Ozempic face.”  You didn’t put the weight on in a couple of months and it doesn’t make sense to try to remove it that fast, either. Furthermore, significant calorie reduction has been associated with the body entering starvation mode, from which it may never recover (think the Biggest Loser).

Remember a 5 pound weight loss per month equates to eating about 500 less calories per day.

No one knows how long someone should be on Semeglutide after achieving their weight loss goal. The medication was initially approved as a lifelong diabetic medication. It has only been used for weight loss for about 18 months. At this point, I would recommend planning to be on Semaglutide for at least one year to allow your body and metabolism a chance to balance and equalize. Your ability to maintain your weight without medication depends on numerous factors, including your exercise regimen, dietary changes, and genetics. Some rebound weight gain is bound to occur if you stop the injections.

A small percentage of people who take Semaglutide find they can no longer get drunk.  What this means is that they will not feel the euphoria that is expected when consuming alcoholic beverages.  The medication is currently being investigated for people with drug and alcohol addictions.  This should not affect marijuana. Be aware that you are still intoxicated even though you may not feel drunk. You should not drive a car or operate heavy machinery and will still have a hangover the next day.

Semaglutide is also finding uses for patients with PCOS and IBS. While not approved for treating these diseases, many patients with them find their symptoms improved or resolved since starting the Semaglutide.