Semaglutide Injection: A Breakthrough in Weight Loss

Semaglutide has rapidly become a household name for people looking to lose weight or manage type 2 diabetes. This medication, originally developed to help with blood sugar control, is used to control blood sugar levels in adults with type 2 diabetes. It has also shown remarkable results in weight loss, making it a dual purpose powerhouse in modern medicine. At Dr. Parangi's office, we aim to educate our patients about cutting edge treatments like semaglutide, which is one of several prescription medicines used for diabetes and weight management, and help them determine if it's the right fit for their health goals.

What is Semaglutide?

Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist used to control blood sugar levels and for weight management in adults with type 2 diabetes. It is available as a subcutaneous injection and oral tablet, with brand names including Ozempic, Wegovy, and Rybelsus. Originally approved by the FDA in 2017 for type 2 diabetes management, semaglutide gained even more attention in 2021 when a higher dose formulation was approved for chronic weight management. Semaglutide is a prescription medicine and should only be used under the supervision of a healthcare provider. Managing blood sugar and weight with semaglutide can help reduce the risk of blood vessel disease, a serious complication of diabetes and obesity. It also helps with weight loss and reducing the risk of worsening kidney disease.

Patients should inform their healthcare provider about all other medicines, including prescription medicines, over-the-counter drugs, herbal supplements and vitamins as interactions may occur.

How Semaglutide Works

Semaglutide works by mimicking the action of the natural hormone GLP-1, which is produced in the gut in response to food intake. GLP-1 plays a crucial role in regulating blood sugar, appetite, and digestion. Here's how semaglutide achieves its effects:

• Appetite Suppression: Semaglutide activates GLP-1 receptors in the brain, particularly in areas that control hunger. This leads to reduced appetite and calorie intake, aiding in weight loss.
• Slowed Gastric Emptying: It slows the rate at which food leaves the stomach, resulting in prolonged feelings of fullness after eating.
• Increased Insulin Secretion: Semaglutide stimulates the pancreas to release more insulin when blood sugar levels are high, helping to lower blood sugar in people with high blood sugar.
• Reduced Glucagon Release: By reducing glucagon (a hormone that raises blood sugar), semaglutide further helps control blood glucose levels.
• Potential Metabolic Benefits: Semaglutide may also increase energy expenditure and promote fat burning, contributing to improved cholesterol and triglyceride levels.

This multifaceted action helps people not only control blood sugar levels and lower high blood sugar, reducing the risk of complications, but also reduce caloric intake and ultimately lose weight.

Semaglutide Brands: Ozempic, Wegovy, and Rybelsus

Semaglutide is available under several brand names, each with different indications and formulations:

Brand	Formulation	Indication	Dosing
Ozempic	Injection (weekly)	Type 2 diabetes, CV risk reduction	0.25–2.0 mg weekly
Wegovy	Injection (weekly)	Weight loss, CV risk reduction	0.25–2.4 mg weekly
Rybelsus	Oral tablet (daily)	Type 2 diabetes	7 mg or 14 mg daily

• Ozempic: Primarily for type 2 diabetes and reducing cardiovascular risk. Not FDA-approved for weight loss, but often used off-label for this purpose.
• Wegovy: Specifically FDA-approved for chronic weight management in adults and adolescents with obesity or overweight and at least one weight-related condition.
• Rybelsus: The only oral form of semaglutide, approved for type 2 diabetes management. It is not approved for weight loss and is less effective for this purpose compared to injectable forms.

Note: Only Novo Nordisk manufactures FDA-approved semaglutide products in the US. There are no generics or other approved brands.

Who Is a Good Candidate for Semaglutide?

• Adults with type 2 diabetes not adequately controlled with other medications
• Individuals with a BMI over 30 (obesity)
• Individuals with a BMI over 27 with at least one weight-related condition such as hypertension or high cholesterol
• Some patients may experience significant weight loss with semaglutide

Contraindications:

• Personal or family history of medullary thyroid carcinoma
• Multiple Endocrine Neoplasia syndrome type 2
• Pregnant or breastfeeding individuals
• Patients with end stage kidney disease should consult their provider before starting semaglutide

Benefits of Semaglutide

• Significant A1C reduction in people with type 2 diabetes
• Average weight loss of 15% or more of body weight in clinical trials
• Potential for significant weight loss in some patients, especially with medications like Ozempic and Wegovy
• Decreased appetite and improved satiety
• Weekly injection (Ozempic, Wegovy) or daily oral option (Rybelsus)

Semaglutide Dosing: How Is It Taken?

Dosing for semaglutide is carefully titrated to minimize side effects, especially gastrointestinal discomfort. The regimen depends on the brand and indication:

Standard Dosing Protocol (Injectable):

• Starting Dose: 0.25 mg once weekly for 4 weeks (to allow the body to adjust)
• Titration: Increase to 0.5 mg once weekly for at least 4 weeks
• Further Increase: Can be increased to 1.0 mg, 1.7 mg, and up to 2.4 mg weekly (Wegovy) for weight loss, or up to 2.0 mg weekly (Ozempic) for diabetes
• Adjustment: Dosing may be adjusted based on individual response and tolerability

Oral Dosing (Rybelsus):

• Initial: 3 mg daily for 30 days, then increase to 7 mg daily; may increase to 14 mg daily if needed

Administration Tips:

• Inject semaglutide subcutaneously (under the skin), usually in the abdomen, thigh, or upper arm
• Rotate injection sites within the same body area (abdomen, thigh, or upper arm) to avoid skin issues
• Take on the same day each week, with or without food

If you have questions about how to inject semaglutide, miss a dose, or experience any issues with administration, call your doctor.

What to Do if You Have a Missed Dose

If a dose is missed, patients should take the missed dose as soon as possible, unless it is more than 5 days late for Ozempic or within 48 hours of the next scheduled dose for Wegovy. It is important to take the next dose as scheduled to maintain a regular dosing routine and ensure the medication's effectiveness. Patients should not double doses or take extra medication to make up for a missed dose. If a patient misses a dose for more than 2 weeks, they should call their doctor for guidance on how to proceed. Patients should always follow the dose escalation schedule and consult their healthcare provider if they have any questions.

Semaglutide for Chronic Weight Management: What to Expect

Semaglutide has been shown in clinical trials and real-world studies to help people lose a significant amount of weight, especially when combined with lifestyle changes like diet and exercise. On average, patients lose about 15% of their body weight over a year or more of treatment.

Key Points:

• Weight loss is gradual and sustained with continued use
• Most people see the greatest weight loss after 6–12 months
• Weight may return if the medication is stopped without lifestyle changes
• Losing weight during pregnancy should be discussed with a healthcare provider to ensure maternal and fetal safety

Semaglutide Side Effects

Like all medications, semaglutide can cause side effects. Most are mild and improve over time, but some may be serious and require medical attention.

Common Side Effects:

• Nausea
• Vomiting
• Diarrhea
• Constipation
• Abdominal pain or discomfort
• Bloating, gas, acid reflux
• Fatigue
• Headache
• Decreased appetite
• Hair loss (less common)
• Symptoms of high blood sugar (increased thirst, frequent urination, blurred vision) – monitor your blood sugar regularly

Serious Side Effects (Rare):

• Pancreatitis (severe abdominal pain, may spread to the back)
• Gallbladder issues (gallstones, cholecystitis)
• Acute kidney injury or worsening kidney problems (decreased urination, swelling in legs/feet)
• Serious allergic reactions (rash, swelling of face/tongue/throat, hoarseness, trouble breathing)
• Vision changes
• Hypoglycemia (especially if used with other diabetes medications)

When to Seek Medical Help:

• Persistent or severe abdominal pain
• Signs of serious allergic reaction (rash, swelling, hoarseness, difficulty breathing)
• Yellowing of skin or eyes (jaundice)
• Severe dehydration (from vomiting/diarrhea)
• Decreased urination or swelling in legs/feet (possible kidney problems)
• If you are scheduled for a procedure involving anesthesia or deep sedation, inform your healthcare provider, as special monitoring may be needed

Tips to Manage Side Effects:

• Start with a low dose and increase gradually
• Eat smaller, more frequent meals
• Stay hydrated
• Avoid high-fat, spicy, or greasy foods during dose escalation
• Treat low blood sugar quickly with fast-acting carbohydrates such as fruit juice
• Discuss alcohol consumption with your provider, as drinking alcohol can affect blood sugar levels and interact with diabetes medications

Semaglutide vs Tirzepatide: A Detailed Comparison

Tirzepatide (brand names: Mounjaro for diabetes, Zepbound for weight loss) is a newer medication that has drawn attention for its even greater weight loss and glucose-lowering effects. Both semaglutide and tirzepatide are prescription medicines and should only be used under medical supervision. Here's how they compare:

Feature	Semaglutide	Tirzepatide
Drug Class	GLP-1 receptor agonist	Dual GLP-1 and GIP receptor agonist
Brands	Ozempic, Wegovy, Rybelsus	Mounjaro, Zepbound
FDA-Approved Uses	Diabetes, weight loss, CV risk, kidney risk	Diabetes, weight loss, OSA
Dosing	0.25–2.4 mg weekly (injectable)	2.5–15 mg weekly (injectable)
Weight Loss (12 mo)	8–15% of body weight	15–20% of body weight
Onset of Action	Gradual, titrated	Gradual, titrated
Side Effects	GI: nausea, vomiting, diarrhea	Similar GI side effects, possibly less nausea
Oral Form Available	Yes (Rybelsus)	No

Is Semaglutide Right for You?

Semaglutide is a powerful tool for weight loss and diabetes management, but it's not for everyone. It's best suited for:

• Adults with a BMI ≥30, or ≥27 with at least one weight-related condition (e.g., hypertension, sleep apnea, type 2 diabetes)
• Adults with type 2 diabetes needing better blood sugar control
• Those at increased cardiovascular risk (per FDA indications)
• Individuals at risk for blood vessel disease, as managing underlying conditions like diabetes and obesity can help reduce the risk of complications such as stroke and heart attack

Semaglutide is Not Recommended For:

• People with a history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2
• Pregnant or breastfeeding women
• Those with a history of severe allergic reaction to semaglutide or its components. Call your doctor if you have experienced serious allergic reactions or have other contraindications before starting this medication

Optimizing Your Semaglutide Results

To get the most out of semaglutide:

• Follow your dosing schedule carefully
• Adopt a balanced, calorie-reduced diet
• Engage in regular physical activity
• Stay hydrated
• Discuss alcohol consumption with your healthcare provider, as drinking alcohol can affect blood sugar levels and weight loss
• Inform your provider about all other medicines you are taking, including prescription, over-the-counter, herbal, and vitamin products, to avoid potential interactions
• Work closely with your healthcare provider to monitor progress and adjust dosing as needed

Semaglutide at Dr. Parangi

At Dr. Parangi's office we offer comprehensive evaluations to determine if semaglutide is right for you. We monitor your progress, adjust dosages as needed, and provide ongoing support with nutrition and lifestyle coaching. Our medically supervised program is designed to help you get the most out of your treatment safely and effectively.

Dr. Parangi is a board certified doctor providing weight loss services from our office located in Paramus, NJ and is conveniently located throughout Bergen County, including: Paramus, Hackensack, Ridgewood, Englewood, Teaneck, Oradell, Saddle River, Westwood and surrounding areas. With an expanding service area, Dr. Parangi is committed to serve a wide audience in Bergen County.

Ready to take the first step? Call (201) 265-7564 or request an appointment online today to speak with Dr. Parangi about semaglutide treatment in New Jersey. Our office is accepting new patients and same day and next day appointments are available for new patients.

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