Semaglutide: game-changer in weight loss and so much more.

The celebrity secret to weight loss, the reason the Kardashians lose weight so quickly, the "red carpet" weight loss medication. What is Semaglutide?

It's Dr. Sherri here. I don't fall for the media hype around weight loss gimmicks, but I get asked about them constantly, and I'm usually disappointed once I do the research. Twenty years ago, when I was in naturopathic medical school, I was sure weight loss would be an easy thing to work with. Eat this, not that. Exercise more, eat less. Calories in less than calories out. Easy.

Fast forward through all these years of clinical experience and I see it differently now. Weight loss can still be straightforward for plenty of people, depending on where they're starting from. Most people need to figure out the approach that fits them, like how they handle carbs or which foods are inflammatory for their body. Some are low in specific nutrients. Some have an out of balance relationship with how much they eat and move. Some have thyroid or adrenal issues. Weight loss, like everything else in nutrition and medicine, is individual.

What's been frustrating over the years is the weight that creeps on as we age, and it gets worse for a lot of women through the menopause transition. This is when everything that used to work stops working, and it's confusing for the patient and for us. Out of balance hormones and insulin resistance sit at the core of this kind of weight gain. We can balance hormones and tighten up glucose control to ease the hot flashes, insomnia, and vaginal dryness, but those stubborn fat cells still like to hang around.

Over the years we've added weight loss tools that really work, like our CleanUP program, the ProLon fasting mimicking diet, and MIC (methionine, inositol, choline) with B12 injections. I've never been a fan of stimulant medications like phentermine, because we've seen too many people end up with long-term metabolic problems after using them for a while. Drugs like metformin have their place, but the weight loss is usually small, and you have to watch the people who have insulin resistance and glucose issues without a full diabetes diagnosis.

Now here comes Semaglutide.

What Is Semaglutide?

Semaglutide, sold under the brand names Ozempic and Wegovy, is an injectable peptide, which is a building block of protein. It's been FDA approved for type 2 diabetes since 2017, and more recently for weight loss without a diabetes diagnosis. We've used it for our diabetic patients for a while, but the questions really started pouring in once the media called it the celebrity secret to weight loss.

I went in skeptical. Given celebrity weight loss and the pharmaceutical industry's track record, I expected to find something I'd have to talk my patients out of. I was happily surprised. Once I looked at how it actually works and heard respected colleagues in integrative medicine recommending it, my mind changed.

Injecting yourself with anything every week isn't natural, I'll give you that. But this medication is an analog to a hormone we all make in the gut called GLP-1. This peptide hormone regulates how the body uses energy and stores fat. It limits glucose spikes after meals, slows how fast the stomach empties, reduces appetite, and creates a feeling of fullness.

It's not a stimulant, and there's no real risk of dropping glucose too low. We have a natural process that's already happening in the body, and we're encouraging it. To me it's a lot like bolstering other hormones, the way we use bio-identical thyroid, adrenal, or sex hormones.

Beyond Weight Loss

The bigger reason we're excited about this goes well past weight loss. So much of what ages us is tied to insulin resistance and extra body fat. Semaglutide helps lower inflammation, improve blood vessel health, cut down fat in the liver, and ease the symptoms that come with insulin resistance, like poor circulation, poor vision, brain fog, and sugar cravings.

Think about everything we gain from fasting. The problem is that longer fasts are really hard for most people to stick with. A lot of people also have an emotional attachment to food, or their gut bacteria are driving the cravings, and then they beat themselves up over willpower and feel guilty about it. Semaglutide can break that cycle and give you many of the same cellular benefits we get from fasting.

There's another benefit I love, and it's the emerging research on alcohol. If you've talked with me lately, you've heard me bring up one of Huberman's podcasts on drinking. It's honestly a little sad, because if you love your wine like I do, he lays out all the data and the benefits just aren't there. Alcohol is a neurotoxin, bottom line. Having a tool that helps with alcohol cravings is huge, and it really works. Our 5 o'clock, end of the day, moderate drinkers find they simply don't want it anymore.

Cost and Availability

So what's the catch, and why is this a celebrity medication? Cost and availability, of course. In our strange medical system, insurance will only cover Semaglutide if you have a type 2 diabetes diagnosis. It's approved for weight loss, but insurance won't cover it for weight loss on its own. Think about that. We finally have a way to lower the odds of developing diabetes by helping people lose weight, and it's not covered.

Side Effects and Who Should Not Use It

I'm clearly a fan, but Semaglutide isn't without side effects. Some people get nausea, constipation, or fatigue for the first day or two after they inject. Some people get nothing at all. We start low and increase slowly so the body can tolerate the peptide. So far no one has stopped because of side effects, though some people stay on the lower dose.

We don't offer this for anyone with a personal or family history of medullary thyroid cancer, multiple endocrine neoplasia type 2, pancreatitis, or type 1 diabetes, or for anyone already on glucose lowering medications. We also need to see basic labs from within the last 6 months before starting.

I'm happy to answer any questions you have. Email the office at Team@RemedyCharleston.com and the front desk will pass clinical questions along to me. If you're not a patient here and want to find out whether this is a good fit, schedule a free 15 minute call and we'll talk it through.