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 of weight loss gimmicks, but I am often asked about them and usually always disappointed in my research.  Twenty years ago, when I was in naturopathic medical school, I was confident weight loss would be an easy condition to work with.  Eat this, not that.  Exercise more, eat less.  Get calories in less than calories out... easy.  Fast forward… after years of clinical experience and I have a different perspective.  I do still find weight loss can be straightforward for many.  People often need to figure out the type of approach that is best for them, perhaps how they metabolize carbs or what foods are inflammatory for them.  Some people lack specific nutrients or have an imbalanced relationship with the amount they’re eating and exercising.  Some people have thyroid and/or adrenal issues.  Weight loss, like anything else in nutrition and medicine, is very individualized. 

What has been immensely frustrating over the years is losing the weight that creeps as we age and is often compounded for many as we hit the menopausal transition period.  This is when all of things that have worked before seem to no longer work... frustration and confusion abound for the patient and for us.  Imbalanced hormones and insulin resistance are at the core of this type of weight gain.  While we can balance hormones and work on tightening up glucose control for relief of menopausal symptoms like hot flashes, insomnia and vaginal dryness, stubborn fat cells like to hang around.

Over the years we have incorporated some weight loss solutions that really work like our CleanUP program, Prolon FMD (fasting mimicking diet) and MIC (methionine/ inositol/ choline) with B12 injections.  I have never been a fan of stimulant medications like phentermine for weight loss because we have seen many cases of long-term metabolic issues after prolonged use.  Medications like the diabetes drug, metformin, have their place but weight loss is usually minimal, and you must watch the people with insulin resistance that have glucose regulation issues and not specifically diabetes. 

Now here comes Semaglutide.  Semaglutide, a drug under the brand names Ozempic or Wegovy, is an injectable peptide (building block of protein) that has been FDA-approved for the treatment of type 2 diabetes since 2017 and more recently for weight loss without a diagnosis of diabetes.  While it has been readily used for our diabetic patients, we have recently received so many questions since it has been hyped in the media as the celebrity secret to weight loss.  With a skeptic eye on celebrity weight loss and the pharmaceutical industry's track record here, I expected to find a medication that while natural-ish would likely be something I'd have to discourage my clients from considering.  I was happily surprised when looking at the mechanism of action and hearing from respected colleagues in the field of integrative medicine liking and recommending it.  

While injecting yourself with anything on a weekly basis is clearly not natural, this medication is an analog to a hormone we all produce in the gut, called GLP-1.  This peptide hormone regulates energy use in the body and how we store fat.  It limits glucose spikes after meals, and it helps to limit glucose absorption rate by slowing gastric emptying.  It reduces appetite and creates a feeling of satiety.  This is not a stimulant, and we don't have a risk of lowering glucose too much.  We have a natural process in the body that is happening on a regular basis, and we are encouraging this process.  To me, it is similar to bolstering other hormones in the body, like using bio-identical replacements for thyroid, adrenal or sex hormones.

The bigger implication for this medication beyond weight loss and why we are so excited about it is we can prevent so many potential diseases of aging that are associated with insulin resistance and increased body fat storage like lowering inflammation, improving vascular integrity, decreasing liver fat accumulation and all the symptoms that come with insulin resistance like poor circulation, poor vision, brain fog and sugar cravings.  Think about all the benefits we get from fasting and yet longer fasts are very difficult for most people to do.  There are also so many people with an emotional attachment to food or a situation where the gut microbiota is calling for food and you end up beating yourself up thinking you do not have the willpower to eat differently and the guilt that can follow.  Semaglutide can break this cycle of eating and enhance the cellular benefits we get from fasting.

Another tremendous benefit of using Semaglutide, is in the emerging research for its with managing alcohol consumption.  If you have talked with me recently, I've been sharing one of Huberman's latest podcasts on alcohol intake.  It's a bit sad because if you're like me and love your wine, he really compiles all the data on alcohol intake and the benefits simply are not there.  It's a neurotoxin, period, bottom line.  Having an effective tool to help with cravings for alcohol is huge and it really works.  With Semaglutide our 5pm, end of the day, moderate drinkers find they simply don't want alcohol at all! 

So, what is the catch and why is this a celebrity medication?  Cost and availability, of course.  The unfortunate part of our wacky medical system is that for insurance to cover Semaglutide, you need a diagnosis of type 2 diabetes.  While it is approved for weight loss, insurance companies do not cover it for non-diabetic related weight loss. Ironic, isn't it?  We have a way to reduce the incidence of diabetes by helping with weight loss and it is not covered!  The average cost for this medication out of pocket is $1600/month!  Fortunately, we can get this medication thorough a compounding pharmacy.  It is the same exact medication found in Ozempic and Wegovy, but it does not come in a fancy injectable pen, it must be drawn up in a syringe.  Not a big deal.  It is still pricey though at $350 per month for the lower dosage and $450 for the higher dose, but way better than $1600!

Obviously, I am a big fan of Semaglutide but it is not without side effects like nausea, constipation and fatigue.  Some people have these symptoms for the first day or 2 when they inject.  Some do not have any symptoms.  Everyone is unique as always.  We start low and slowly increase for the body to tolerate the peptide and hopefully not have side effects.  So far, we have not had anyone stop due to side effects but we have had some people stay on the lower dosage. 

Also, we do not offer this for people with a personal or family history of medullary thyroid cancer, multiple endocrine neoplasia type 2, pancreatitis, type 1 diabetes or patients already on glucose lowering medications.  We need to see basic labs within 6 months of starting this medication.

So, reach out to me, Dr. Sherri, if you want to learn more. I am happy to answer questions you might have.  You can email the office at Team@RemedyCharleston.com and the front will forward any clinical questions to me.  If you are not a patient here and want to see if this might be a good fit for you, schedule a free 15-minute call with me and we can discuss in more detail.