Wegovy

What is semaglutide?

It is a long-acting glucagon-like peptide-1 receptor agonist (GLP-1RA), or simply written as a GLP-1 receptor agonist.

The next question is, what is this GLP-1? It was originally a hormone naturally secreted by the gastrointestinal tract. After we eat, it will enter the blood and stimulate insulin secretion and inhibit glucagon secretion, thereby lowering blood sugar levels.

What do you think of when you see these keywords insulin and blood sugar? That's right, diabetes.
This is to simulate the GLP-1 naturally produced by the human body to treat type 2 diabetes. This type of drug also includes exenatide, liraglutide, dulaglutide, etc. And semaglutide is the seventh GLP-1 receptor agonist launched in the world, and its injection preparation was launched in 2017.

So, how did semaglutide go from a drug for treating diabetes to a weight loss drug?

Simply put, doctors and patients found that semaglutide is indeed good for treating diabetes, with few side effects and good clinical effects. But there is also a "side effect" in quotation marks, which is called "benefit effect" in medicine, which is crazy weight loss. In other words, it is very effective for weight loss.

A study in 2021 organized a double-blind trial of 1,961 obese people with a BMI of at least 30. The results showed that the average weight loss of patients taking the drug was 14.9% within 68 weeks. Among them, 50.5% of people lost 15% or more weight. The median weight loss was 15.3 kg, which is equivalent to losing 0.9 kg in 1 month.

In 2022, another team conducted a similar trial with 201 obese adolescents. After 68 weeks, the average BMI of the subjects in the semaglutide group decreased by 16.1% from the baseline, while the average BMI of the placebo group increased by 0.6% from the baseline.

And these, all of which show that semaglutide is really strong at least in terms of weight loss.

Even compared with traditional hypoglycemic drugs such as metformin that have weight loss effects, subcutaneous injection and oral semaglutide are much better in terms of weight loss.

Not to mention comparing it with orlistat, the only chemical weight loss drug approved in my country, which can reduce weight by 5% on average in a year, with a median weight loss of only about 6 kg. Semaglutide is a complete winner.

In short, if we only consider the weight loss efficiency, it can be said that semaglutide has basically achieved the effect of surgical weight loss.

But why can this diabetes drug lose weight?

Studies have long believed that compared with ordinary people, obese people have significantly insufficient GLP-1 in plasma after consuming carbohydrates; other studies have believed that type 2 diabetes is related to the damage of the cell lineage of GLP-1 secretion in the jejunum in human obesity.

In short, the three things of GLP-1 deficiency, obesity and type 2 diabetes are definitely related. But scientists have not yet fully figured out who is the cause and who is the result.

Let's say something certain. Another feature of GLP-1 is that it can act on the central nervous system to suppress appetite and delay gastric emptying, making people feel full.

For example, after using this drug, you used to be full after eating a bowl, but now half a bowl may be enough. I used to feel hungry after a few hours, but now I still feel full and burp.

It's a bit like gastric surgery, after which people feel full very easily. Using this medicine is equivalent to a painless gastric surgery.