August 24, 2022

Ozempic: No 1 Best Medical Treatment of Obesity

Ozempic is a weekly injection of Semaglutide and advisable for the first line treatment option for weightloss.

Obesity is a chronic disease that has become a global problem. Obesity is not just a problem related to the person's appearance; It is known that it can also cause problems such as insulin resistance, diabetes, hypertension and high cholesterol. In addition, a direct relationship between obesity and type 2 diabetes, cardiovascular diseases and fatty liver has been observed. Obesity, which can cause all these problems, can naturally reduce a person's quality of life and life expectancy. 

In fact, we have seen once again in our recent history with Covid-19 that complications from obesity are not only limited to this, but can also be associated with many other diseases. The fact that people with obesity problems suffer from Covid-19 disease more severely and the death rate is higher in this group shows that obesity actually negatively affects the health status of people in general and increases their exposure to diseases more. Adopting a healthy lifestyle is the most important measure in the fight against obesity. It is very important to direct the person to healthier foods, to increase the amount of activity and to take the necessary steps in line with health checks. 

Of course, it is also unrealistic to be able to do all this at once and expect a person to change their whole life within 24 hours. It is always best for patients to set small goals and magnify them reasonably as they reach small goals. For example, it may not be a realistic and sustainable goal to enroll a person who has never exercised in his life to do sports days a week by signing up for the gym. Instead, it would be a better option to start with short 10-minute walks a day.

Although we make a change in our lifestyle, maintaining appetite control is the most difficult step. Even if we do sports and turn to healthier foods, it is only possible to reduce the amount of portions we eat with appetite control. Although the portion amounts are reduced by dieting, the sustainability of the diets and the permanence of the weight lost during the diet can be short-term after the appetite does not decrease. 

Obesity is a treatable disease
Woman's body before and after weight loss.

What is Ozempic?

Ozempic (semaglutide) is a drug that has been recently approved by the American food and drug administration (FDA) for weight loss. Since this drug, which was first released for the treatment of type 2 diabetes and insulin resistance, provides a significant weight loss in patients using it, studies were conducted on the suitability of its use only for weight loss after a while, and as a result of not observing any serious long-term side effects on human subjects, only weight loss was achieved. approved for this purpose. 

Ozempic is a glucagon-like peptide-1 (GLP-1) analogue (a product that mimics the GLP-1). GLP-1 is a natural hormone that has important roles in appetite control and glucose metabolism. Blood sugar and appetite interact with changes between the pancreas and the brain. GLP-1 has a very important role in this interaction. In cases where blood sugar is high, GLP-1, which triggers the necessary insulin secretion, does not have an effect in cases where blood sugar is not high.

That is, the blood sugar in the body must be high for it to trigger the release of insulin. In this way, it does not allow the person to enter a state of hypoglycemia. In addition, it reduces the release of insulin in cases of low blood sugar, allowing the body to recover more easily. GLP-1 also helps prevent high blood sugar levels by reducing glucagon secretion. 

Since the decrease in high blood sugar will also delay the passage of the food that will pass from the stomach to the intestine, it ensures that the feeling of fullness exists for a longer period of time. In this way, it triggers weight loss and a decrease in body fat, along with a decrease in appetite and a decrease in the amount of food eaten. 

What are the effects of Ozempic?

One of the effects of Ozempic is to develop an aversion to foods high in fat. In all studies, a significant decrease has been observed in the consumption of ready-made and high-fat foods that a person craves in normal times. In clinical studies with large participation, it was observed that 86% of people were successful in losing weight with Ozempic injection used once a week, and the weight lost was 14.9% of their body weight on average. 

Step 1, that is, this figure, which emerged as the result of the first study, began to be shaped more clearly with the increasing number of patients with the permission to use after the drug was approved. For example, according to the latest figures, a weight loss of more than 20% of body weight was observed in 32% of patients taking Ozempic. 

In short, the amount of weight to be lost can vary from person to person. But the benefits are not limited to weight loss only. It has been observed that the probability of cardiovascular events such as heart attack and stroke is reduced by 26% in patients treated with Ozempic. With weight and fat loss, repair of insulin resistance, regulation of cholesterol level, and normalization of blood pressure can be observed, and it is seen that these contribute positively to the health of the person in general. 

To Whom Can Ozempic Be Applied? 

Ozempic, which can be applied to people with type 2 diabetes or insulin resistance problems, is also applied to people who do not have such complaints but have chronic weight problems. In June 2021, Ozempic was approved by the FDA for weight loss only. In this way, people who have obesity problems and therefore are exposed to health problems can now lose weight by using Ozempic. 

Who Should Not Be Applied to Ozempic? 

Ozempic should not be used in people with MEN2 syndrome and in people with a family history of Medullary thyroid carcinoma (MTC). No risk has been reported for Papillary, Follicular and Anaplastic thyroid cancers. However, people with a family history of such cancers and active thyroid nodules should not use Ozempic. 

What is the Difference Between Ozempic (Wegovy) and Saxenda? 

The two drugs work by a technically similar mechanism. The purpose of both drugs is to control appetite, reduce portions and provide weight loss. However, there are some differences between these two drugs. The main difference is that Saxenda is a daily injection while Ozempic is a weekly injection.

In the most comprehensive comparative clinical study, it was found that patients using Ozempic lost an average of 13.8% of their initial weight at the end of 26 weeks, while this figure remained at 8% in patients using Saxenda. In addition, a higher incidence of side effects has been reported in patients using Saxenda. As the reason, there are thoughts that side effects may develop depending on the frequency of use because Saxenda is applied every day. 

Ozempic (Semaglutide) injection
GDANSK, POLAND - MAY 2022: obese fat man preparing Semaglutide Ozempic injection control blood sugar levels

What is the Difference Between Ozempic and Trulicity? 

Both injections are administered once a week. The biggest difference between these two preparations, which are similar in this respect, is that Trulicity is not FDA approved. In addition, in clinical studies, it was observed that people using Ozempic lost 2 times more weight than people using Trulicity and had a similarly better decrease in HbA1C rates. 

What Are the Possible Side Effects of Ozempic? 

The most reported side effects during the use of Ozempic are limited to stomach and intestinal problems. These are mainly:

  • Nausea
  • Stomach pain
  • Indigestion Feeling
  • Diarrhea
  • Constipation
  • Fatigue

These effects usually follow a mild to moderate course. It is observed that such side effects decrease as the drug use exceeds a few weeks. Side effects related to the stomach and intestines are generally related to the prolongation of the gastrointestinal transit time of foods. Although there is no such finding in studies related to Ozempic, it has been reported that acute pancreatitis and biliary stone formation are rarely seen in GLP-1 analogues. 

Therefore, if you experience problems such as stomach pain, yellowing of the skin or whites of the eyes, and lightening of the stool color, you should consult your doctor and review the use of medication. At the same time, tests and examinations will be required at certain periods during drug use. Again, although no such case was found in any human study with Ozempic, the possibility of thyroid tumor was reported in mouse experiments. Although unlikely, it is important to control your thyroid functions before and after taking medication. 

How Much Weight Will I Lose With Ozempic? 

In both studies 13% of the patients lost 1-4 kg in the first month. 66% of the patients lost 5-7 kg in the first month. 17% of the patients lost 8-11 kg in the first month. 4% of patients lost more than 12 kg in the first month. Is there a test to be done before starting treatment? Before treatment, certain parameters must be checked. The reason for this is to see if there is another metabolic problem underlying the weight problem and to have information about the cardiovascular risks and general health of the person. 

The tests to be requested before the treatment are as follows: CBC ALT, AST, GGT, Amylase Iron, Ferritin, TIBC Urea, Creatinine FBC, insulin, Homa-IR, HbA1C TSH, fT4 Total cholesterol, HDL, LDL, Triglyceride Vit D, Vit B12, Folic acid CEA, CA 19-9 It is also very important for people with a family history of thyroid cancer to have a thyroid ultrasound and to undergo periodic controls.

References:

1.Wilding, J., Batterham, R., Calanna, S., Davies, M., Van Gaal, L., & Lingvay, I. et al. (2021). Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal Of Medicine384(11), 989-1002. doi: 10.1056/nejmoa2032183

2.Sanchis-Gomar, F., Lavie, C., Mehra, M., Henry, B., & Lippi, G. (2020). Obesity and Outcomes in COVID-19: When an Epidemic and Pandemic Collide. Mayo Clinic Proceedings95(7), 1445-1453. doi: 10.1016/j.mayocp.2020.05.006

3. O’Neil, P., Birkenfeld, A., McGowan, B., Mosenzon, O., Pedersen, S., & Wharton, S. et al. (2018). Efficacy and safety of semaglutide compared with liraglutide and placebo for weight loss in patients with obesity: a randomised, double-blind, placebo and active controlled, dose-ranging, phase 2 trial. The Lancet392(10148), 637-649. doi: 10.1016/s0140-6736(18)31773-2

4. Neeland, I., Poirier, P., & Després, J. (2018). Cardiovascular and Metabolic Heterogeneity of Obesity. Circulation137(13), 1391-1406. doi: 10.1161/circulationaha.117.029617

5. Garvey, W., Mechanick, J., Brett, E., Garber, A., Hurley, D., & Jastreboff, A. et al. (2016). American Association of Clinical Endocrinologists and American College of Endocrinology Comprehensive Clinical Practice Guidelines For Medical Care of Patients with Obesity. Endocrine Practice22, 1-203. doi: 10.4158/ep161365.gl

6. Schaffer, R. (2022). Weekly semaglutide injection associated with substantial weight loss in obesity. Retrieved 15 June 2022, from https://www.healio.com/news/endocrinology/20210211/weekly-semagltide-injection-associated-with-substantial-weight-loss-in-obesity

7.Whitlock, G., Lewington, S., & Sherliker, P. (2009). Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. The Lancet373(9669), 1083-1096. doi: 10.1016/s0140-6736(09)60318-4

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