Semaglutide


 

A New Miracle Weight Loss Drug?


UNDERSTANDING SEMAGLUTIDE, WEGOVY, OZEMPIC AND MOUNJARO


Semaglutide is a glucagon-like peptide-1 (GLP-1) agonist medication that’s prescribed under the brand names Wegovy® and Ozempic®. Originally developed to treat diabetes, Semaglutide has been found to be safe and highly effective for long-term weight loss and management.  We have been successfully using GLP-1’s for years at our clinic in conjunction with our four-pillar metabolic health program - focusing on a healthy metabolism: food, sleep, emotional wellness and exercise.




HOW DO SEMAGLUTIDE, WEGOVY, OZEMPIC AND MOUNJARO WORK?


Semaglutide is a GLP-1 agonist, meaning it mimics the peptide hormone GLP-1.  The GLP-1 peptide is a naturally occurring hormone produced by the gut that sends signals to the brain affecting metabolism and appetite. While all of the mechanisms by which GLP-1 agonists assist with weight loss are not yet fully understood, below are the well-established ways in which these injectable medications can contribute to weight loss: 


⦁ They stimulate the secretion of insulin and slow the release of glucagon, influencing blood sugar control. 


⦁ GLP-1 agonists work on leptin and ghrelin, impacting hunger and satiety signaling. Patients generally experience a significant reduction in cravings and find it much easier to manage choices around food (i.e. chronic snacking or obsessive food thoughts that often accompany a calorie-restricted diet).


⦁ GLP-1’s slow stomach emptying, helping patients feel fuller faster & leads them to eat a much lower volume of food.


⦁ Medical publications have suggested that GLP-1 agonists can assist with the conversion of white fat to brown fat - which is the fat we have in greater quantities in our youth - and is more metabolically active and rich in mitochondria. Studies have shown that GLP-1’s - possibly due to the increase in brown fat - can increase one’s metabolic rate. 


GLP-1s may work to lower your set point. Your set point is the weight your body naturally gravitates towards due to the interaction between metabolic health, genetics, and environment. When you restrict calories, your natural biology will resist weight loss in order to defend its set point. Research has shown that overweight patients who have more difficulty losing weight may have a functional deficit in GLP-1 signaling. GLP-1’s may help resist the metabolic slowdown that happens in response to weight loss and calorie restriction.

 



SEMAGLUTIDE BENEFITS AND WHAT TO EXPECT


⦁ Patients taking Semaglutide can expect to lose weight (on average ½ lb to 1 lb a week - some may lose more quickly while others more slowly).


⦁ Food cravings will diminish, making healthy food choices and portion control easier.


⦁ Because GLP-1’s can assist in improving metabolic health and shifting a patient’s set point, this medication not only helps you lose weight but can enable you to maintain weight loss long term. Equipped with tools to maintain the food, exercise, sleep and emotional wellness habits, many of our patients have been able to successfully taper off medication and keep the weight off.  

  
⦁ Semaglutide can help reduce inflammation and has been associated with a reduction in blood pressure.


⦁ GLP-1’s has been shown to regulate cholesterol and triglycerides in Type 2 diabetics by modulating key enzymes of lipid metabolism in the liver.


⦁ Studies have shown that Semaglutide reduces cardiovascular events in Type 2 diabetics and reduces cardiovascular disease. 


so…WHAT’S THE DIFFERENCE BETWEEN THE SOLO ACTION OF SEMAGLUTIDE [WEGOVY & OZEMPIC] AND DUAL ACTION MOUNJARO?


Semaglutide - This is a GLP-1 agonist - and Semaglutide is the active ingredient in Ozempic & also Wegovy [what Elon Musk used].  While it's not available in its generic form at regular pharmacies, weight loss specialists often collaborate with specialty pharmacies to procure its generic variant. One of the benefits of sourcing it from a compounding pharmacy is the flexibility in adjusting doses to specific concentrations. This not only tends to be more cost-effective for patients but can also be combined with other treatments to further aid weight loss. Unlike the prefilled pen-injector format, Semaglutide is administered using an insulin needle. This method permits smaller, more exact dose increments, helping minimize side effects such as nausea. At Optimal Men’s Center, we typically initiate treatment with Semaglutide and adjust the dose over a period of a few months. While some might need a maximum dose of 2.4 mg weekly, we’ve observed that many achieve weight loss success at reduced dosages.


Wegovy – Semaglutide is the active ingredient in Wegovy. This drug was designed & FDA-approved for weight loss. A major limitation of Wegovy is that all the pen-injections are packaged in pre-filled one-time-use-only dosage strengths. Even with the recommended fixed starting doses of 0.25 mg per week, some patients could encounter significant side effects. There is no possibility of tailoring the dose to the unique individual. Eventually you may increase up to 2.4 mg per week to achieve weight loss. For many patients, the maximum dose of 2.4 mg can be overkill.


Ozempic – Semaglutide is also the active ingredient in Ozempic. It has FDA approval for Diabetes and may be prescribed off-label for weight loss. Ozempic suffers from some of the same limitations as Wegovy regarding FDA-specifically approved dosing schedule and strengths. This makes it impossible to tailor the dose for some patients.


Mounjaro – with its active ingredient Tirzepatide, Mounjaro emerged as an innovative medication, simultaneously serving as both a GLP-1 and GIP agonist. In May 2022, the FDA approved its use for treating Type 2 diabetes. The market version is available as a specific pre-filled dosage pen-injector, limiting its adaptability for patients needing personalized dosages. One of Mounjaro's prominent features is its potent ability to promote significant weight loss – resulting in clinicians using it off-label with great success. Although it shares characteristics with other GLP-1 agonists—diabetes medications also renowned for aiding weight reduction — clinical research reveals that Tirzepatide facilitates a more significant weight loss than Semaglutide. This is due to its unique bifunctional/dual role as a GLP-1 and GIP agonist, which enhances its effectiveness, positioning it as a superior therapeutic choice.


Optimal Men’s Center, in its dedication to advancing patients' well-being and offering exceptional patient care, has forged partnerships with specialty compounding pharmacies to prescribe Tirzepatide, further showcasing their unwavering commitment to top-tier patient care.


WHAT DOES THE RESEARCH SAY?


The NIH [National Institute of Health] as well as other organizations have studied this class of medications for close to 20 years. Studies show that there is a direct correlation between GLP-1 agonists and weight loss. In clinical trials of Wegovy as an adjunct to lifestyle modification, participants lost an average of 15 percent of their body weight –up to five times the average weight loss seen with traditional diet and exercise plans.


Other studies concluded that in adults with overweight (with at least one weight-related comorbidity – such as high blood pressure or cholesterol, prediabetes, etc.) or obesity, Semaglutide treatment led to substantial, sustained weight loss.


In another study “stimulation of GLP-1R [the receptor] by the agonist drug… leads to body weight loss independent of reduction in food intake. Instead, this weight loss is caused by the activation of the thermogenic program in BAT (brown adipose tissue).”


Even though Semaglutide is very effective at weight loss, Tirzepatide is still superior in weight reduction.


OUR CLINIC’S PROGRAM


At Optimal Men’s Center, our clinicians have treated countless patients, with a combined 50+ years of experience. There are multiple medications that have been effective for weight loss, but the treatment with either the GLP-1 agonists [Semaglutide] or a combination GIP & GLP-1 agonists [Tirzepatide] has shown to be considerably more successful with the weight reduction.


Semaglutide or Tirzepatide treatment program – We assess every prospective patient prior to determining if a Semaglutide or Tirzepatide program is the right choice for weight loss. We prefer to have *recent laboratory studies available for review prior to your consultation to rule out other possible causes regarding the inability to lose weight. Other potential beneficial treatments could include B12 and Vitamin D3 injections as well as Metformin, a medication used to help stabilize blood sugar.


Optimal Men’s Center also has various PEPTIDE THERAPY treatments that may assist in weight loss, such as:


Sermorelin or CJC-1295/Ipamorelin. These peptides trigger the release of Growth Hormone [GH] from your pituitary gland. GH is a protein hormone that is vital for growth, cellular repair and metabolism, as well as affecting muscle development, fat distribution and sugar processing. Sufficient GH secretion is also closely related to sleep quality - especially the deep, restorative, slow-wave sleep. This can be quite advantageous for not only weight loss but also maintenance.


BPC-157. Promotes tissue healing and reduces inflammation. Studies have shown its potential to heal tendons, ligaments, muscles as well as shown to help repair the gut lining.


FREQUENTLY ASKED QUESTIONS ABOUT WEIGHT LOSS


Q. WHAT IS MY BMI AND DOES MY BMI NEED TO BE OVER 30 TO USE SEMAGLUTIDE/TIRZEPATIDE?
Semaglutide is used on-label and Tirzepatide are used on-label for people with a Body Mass Index [BMI] over 30 or overweight with accompanied co-morbidities (i.e. high blood pressure or cholesterol, etc.). These medications can be used off-label in patients wanting to lose weight without comorbidities based on the clinical judgment of the provider. To compute BMI, use the formula: {weight(lb) / [height (in)]^2 x 703}.

BMI Values for Women and Men 18 and Older
Underweight < 18.5
Normal weight 18.5–24.9
Overweight 25–29.9
Obesity > 30

Q. HOW MUCH DOES THE MEDICATION COST?
A. At a commercial pharmacy, the average cost for Wegovy/Ozempic/Mounjaro is around $900 to $1,400 per month, or about $225 to $350 per week. While it's not available in its generic form at regular pharmacies, we are able to obtain the active ingredients, Semaglutide or Tirzepatide, from a specialty compounding pharmacy. By using a compounding pharmacy, Optimal Men’s Center can tailor dosing & significantly reduce patient costs. (This medication is rarely covered by insurance for patients for weight loss.)


Q. IS THIS MEDICATION APPROVED BY THE FDA?
A. Semaglutide was approved by the FDA to treat weight loss for individuals with a BMI of 30 or higher and individuals with an elevated BMI who also have a weight-related comorbidity (high blood pressure, high cholesterol, fatty liver disease, etc.).  Tirzepatide is only FDA approved for treatment of diabetes.


Q. DOES INSURANCE COVER THIS MEDICATION
A. Most insurance companies will not cover Semaglutide (Wegovy) for weight loss. If a patient has Type 2 Diabetes, they generally need to fail other diabetes medications before being covered for Semaglutide (Ozempic) or Tirzepatide (Mounjaro).


Q. WHAT ARE THE MOST COMMON SIDE EFFECTS?
A. Common side effects include nausea, changes in bowel habits, acid reflux, and more rarely abdominal pain or vomiting. If you are experiencing severe abdominal pain or vomiting, it is important to be evaluated in an urgent care, in severe cases, report to the Emergency Room. That said, very few patients have reported significant side effects.


Q. HOW MUCH WEIGHT CAN I EXPECT TO LOSE?
A. The goal is to lose ½ pound to 1 pound each week. Weight loss might be faster in the beginning. 


Q. DO I HAVE TO SIGNIFICANTLY CHANGE MY DIET?
A. In our experience, a plant or whole foods-heavy diet with at least some consciousness around carbohydrates and varying degrees of intermittent fasting can maximize the effectiveness of the Semaglutide or Tirzepatide program. Additionally, the following dietary recommendations may also help enhance weight loss efforts:
⦁ Eat a fibrous diet. Focus on vegetables that are high in fiber.
⦁ Eat vegetable-centric meals with an adequate amount of high-quality proteins.
⦁ Avoid fried foods or highly processed fatty foods as they take longer to digest.
⦁ Limit alcohol intake as this medication can lower blood pressure.
⦁ Drink at least 64-96 oz of water a day to avoid constipation.


Q. IS EXERCISE NECESSARY?
A. While exercise isn’t as important as what you eat for weight loss, sustainable exercise habits have been proven to keep the pounds off. According to the National Weight Control Registry (a database of people across the U.S. who have lost at least 30 pounds and have kept it off for at least a year), the number one thing these people have in common is a daily exercise routine. Also, remember, while exercise may not be required for weight loss - it is imperative for Optimal health and wellbeing.


Q. CAN I LOSE WEIGHT FAST WITH SEMAGLUTIDE, WEGOVY, OZEMPIC OR MOUNJARO?
A. Most patients lose between a ½ and 1 pound each week with many patients losing weight more rapidly. The speed with which you lose weight will depend on the amount of weight you need to lose as well as the dedication you put into supporting the medication’s effects with healthy lifestyle choices (food, exercise, emotional health and sleep).


Q. WHAT IS THE AVERAGE LENGTH OF THE PROGRAM?
A. The duration of your program will depend on the amount of weight you want to lose as well as how effective the drug and your individual lifestyle changes are. 


Q. WHERE CAN I BUY SEMAGLUTIDE or tirzepatide?
A. Semaglutide and Tirzepatide are not available over the counter and must be prescribed by a clinician. Semaglutide & Tirzepatide are not considered a supplement – they are a prescription medication. We highly recommend you work with a doctor who is familiar with GLP-1’s or GLP-1/GIP combination medication AND understands the intricacies of their use for weight loss.

IF YOU ARE INTERESTED IN LEARNING IF OUR SEMAGLUTIDE OR TIRZEPATIDE PROGRAM IS RIGHT FOR YOU, PLEASE CONTACT OUR OFFICE AT 602.678.4625 or 602-OPTIMAL.

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