Is semaglutide effective for weight loss if you don't have diabetes?

Semaglutide belongs to the glucagon-like peptide-1 (GLP-1) receptor agonist drug class. 

In the United States, semaglutide is not available as a generic product. Three semaglutide brand names are available, and you need a prescription to obtain all of them. 

Despite sharing the same active ingredient, the three brands are approved for different uses by the Food and Drug Administration (FDA):

• Ozempic: A subcutaneous (under the skin) injection, Ozempic has approval for blood sugar management in adults with type 2 diabetes, alongside exercise and diet modifications. It is also approved for reducing the chance of serious heart events like strokes or heart attacks in adults with type 2 diabetes and heart disease. 
• Rybelsus: An oral tablet, Rybelsus has approval to manage blood sugar in adults with type 2 diabetes, in addition to diet and exercise changes. 
• Wegovy: A subcutaneous injection, Wegovy is approved to complement a reduced calorie diet and exercise for weight management in adults with obesity, adults with overweight and a weight-related disease, or children ages 12 years and over with obesity. 

Despite Wegovy being the only FDA-approved semaglutide drug for weight loss, healthcare professionals also prescribe Ozempic and Rybelsus for the same purpose in some cases.

Semaglutide for weight loss: How does it work?

Semaglutide works by mimicking the action of GLP-1, a hormone that naturally occurs in your body. This causes a range of effects that typically lead to:

• reduced appetite and cravings
• an increase in the production of insulin, a hormone that helps lower blood sugar levels after eating
• a decrease in the production of glucagon, a hormone that raises blood sugar levels between meals
• slower stomach emptying, which makes you feel full for longer

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What happens when someone without diabetes takes semaglutide?

Semaglutide can be a helpful tool if you have difficulty losing weight through diet and exercise alone. 

A 2022 review indicates that semaglutide injections are safe and effective for weight loss in people without type 2 diabetes. The effects of semaglutide on your body are the same whether or not you have type 2 diabetes. The results, however, may vary individually.

Wegovy is approved for use in adults and children who meet the following body mass index (BMI) and health criteria: 

• adults ages 18 years and older with obesity (BMI of 30 or more)
• adults ages 18 years and older with overweight (BMI of 27 or more) and at least one weight-related condition, like high blood pressure
• children ages 12 years and older with obesity (BMI in the 95th percentile or more for their age and sex) 

The Wegovy packet label informs that there have been cases where users without type 2 diabetes experienced low blood sugar (hypoglycemia) when taking other GLP-1 receptor agonist medications. However, this has not been systematically reported in clinical trials for Wegovy and it is considered a rare effect. 

Side effects of semaglutide may occur whether you have diabetes or not. These include:

• nausea
• vomiting
• diarrhea
• stomach pain
• constipation
• headaches
• fatigue
• dizziness

How long do you stay on semaglutide for weight loss?

The length of semaglutide treatment for weight loss varies from person to person. For instance, factors that can affect the duration include:

• side effects and how well you tolerate them
• other medications you may take that cannot be combined with semaglutide
• weight loss progress
• lifestyle habits and how well they support your weight loss goals 

Your prescribing healthcare professional will monitor your progress and help determine the most suitable treatment plan, which may involve a temporary or long-term use of semaglutide for weight loss.

If you do need to use the medication long term, the 2022 review referenced earlier found that semaglutide promotes weight loss beyond 52 weeks of use without plateauing effects.

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Alternative weight loss medications

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) lists alternative FDA-approved medications for weight management. In order of effectiveness, these include: 

• Liraglutide: This is another GLP-1 receptor agonist injection with similar effects to Wegovy. A 2021 and 2022 review note liraglutide may not be as effective as semaglutide for weight loss and that the effects may level off over time. Still, some individuals experience significant weight loss with the drug.
  • You can find it under the brand name Saxenda.
• Phentermine-topiramate: This is an oral medication that reduces your appetite and makes you feel full for longer. It can be preferable if you want to avoid injections. It works in a different way than Wegovy and may have different side effects.
  • You can find it under the brand name Qsymia. 
• Buproprion-naltrexone: This is an oral medication that reduces appetite, cravings, and the rewarding feelings you get when eating. It may also improve mood, reduce depression, and support smoking cessation (if you smoke) since bupropion is also used for these purposes.
  • You can find it under the brand name Contrave. 
• Orlistat: This is an oral medication that reduces the absorption of fat from the food you eat.
  • You can find orlistat as a generic drug, as a prescription-only brand (Xenical), or as an over-the-counter drug (Alli).
• Setmelanotide: This is an injection that, according to a 2023 article, may be used in children as young as 5 years old with specific and very rare genetic conditions.
  • You can find it under the brand name Imcivree. 

Because of their different mechanisms of action, benefits, risks, and side effects, it’s best to discuss with a healthcare professional which option best suits you and your health needs.

Summary

Semaglutide is FDA-approved for both weight loss and type 2 diabetes management. Brand name Wegovy is the only semaglutide product exclusively for weight loss, while Ozempic and Rybelsus are primarily used to treat diabetes.

You can use semaglutide for weight loss whether or not you have type 2 diabetes, though you need to meet certain criteria related to your BMI and health. 

The treatment with semaglutide may be short or long term, depending on factors like tolerance to side effects and your weight loss progress. Your healthcare professional may help you determine what is the best weight management medication for your specific needs. 

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