Fast Solutions Can Equal Longterm Problems

Semaglutide - the increasingly popular drug that everyone from movie stars to your neighbor seem to be crazy about.

But what is it and is it safe?

Semaglutide, Saxenda, Wegovy, Ozempic, Rybelsus are all names for the same type of medication. Semaglutide belongs to a class of medications known as glucagon-like peptide-1 receptor agonists, or GLP-1 RAs. It mimics the GLP-1 hormone, released in the gut in response to eating.

One role of GLP-1 is to prompt the body to produce more insulin, which reduces blood sugar (glucose). For that reason, health care providers have used semaglutide since 2017 to treat Type 2 diabetes. GLP-1 in higher amounts also interacts with the parts of your body and brain that suppress your appetite and signal you to feel full. Which is why brand names like Wegovy and Saenda have now been FDA approved for weight loss.

How it works in the body

When semaglutide interacts with the pancreas, it affects insulin production. Insulin is released in response to increased blood sugar, such as when sugar or low complexity carbohydrates/starches are ingested. The pancreas has very specialized cells called ‘beta cells’ that secrete insulin. Semaglutide increases the secretion of insulin from the beta cells.

Additionally, semaglutide improves insulin sensitivity throughout the body (Phillips, 2022). This sounds helpful at first glance, however, increased insulin is extremely inflammatory and if your body is requiring more in order to control your blood sugar within a normal range, it means that your diet is out of control and your pancreas is getting worn out.

Insulin is secreted to help our body utilize sugar for energy. Some sugar and insulin is necessary for cellular functioning and energy production, but too much leads to weight gain, decreased metabolism, increased fat storage, rampant inflammation, and autoimmune disease to name a few.

Without insulin production on a standard American diet (highly processed foods, sugar, seed oils, exposure to glyphosates, less intake of fruits and vegetables), blood sugar levels would soar out of control, causing rapid destruction to our entire body. Insulin isn’t bad, it’s necessary for life, but not at the rate it is being secreted with the standard American diet.

Cutting down on simple carbohydrates, starches, and added sugars is a great way to both lose weight and decrease inflammation while decreasing insulin levels that perpetuate the problem. 

Semaglutide in the GI Tract

Semaglutide works in the GI tract in a few different ways. The most apparent way that semaglutide helps curb hunger is by slowing down gastric motility. In other words, food stays longer in the stomach, making us feel fuller longer. It doesn’t just slow the emptying of the stomach; it slows down gastric motility in general. Semaglutide also increases intestinal mucous production and decreases acid production.

These changes are the primary cause of the gastrointestinal side effects that some patients may experience, including nausea, diarrhea, or constipation (Phillips, 2022). Slowing down gastric motility seems like it could be helpful if it makes you stay full for longer, however, the problem is that studies are now showing that due to food transit in your gut slowing down, constipation can be a big issue. Constipation is dangerous because it destroys normal gut flora and can lead to life threatening blockages, and hemorrhoids. When food sits in the stomach for too long it begins to rot, rather being digested and this can degrade into a host of issues stemming from disruption of your gut microbiome.

Additionally, there have been many reports of a problem called gastroparesis which is where your gut stops moving and can become obstructed with a food impaction requiring emergency treatment and/or surgery.

Decrease in stomach acid is never a good thing and leads to poor digestion of essential nutrients as well as increased chance of Small Intestinal Bacterial Overgrowth (SIBO) and other microbes getting past the acidic barrier of the stomach and affecting the rest of our body. This is one of the reasons why acid reducing medications are so harmful.

The combined affect of GLP-1 agonists on the gut is monumental. The gut controls the majority of our immune system, many neurotransmitters, as well as the primary way we absorb nutrients and water. When this balance is messed up, either through diet, excessive stress, or medications, the side effects can lead to more problems, that in manifest into more medications to address new degrading health, and the problems perpetuate. 

Semaglutide and the Liver

Finally, the liver has the ability to make sugar through a process called gluconeogenesis. This fancy word means “to generate new sugar.” When gluconeogenesis is discouraged, such as when taking semaglutide, there is less circulating blood sugar for the insulin to move into the cells (Phillips, 2022). This seems pretty great at first however, when the liver is blocked from doing its job there can be increased risk of fatty liver issues as well as gallbladder problems. (Ruder, 2023).

Safety

Research is now showing that by taking a medication like Semaglutide, increases the risk of pancreatitis (a serious inflammation of your pancreas) by 9 times greater in comparison to other weight loss medications , increases the greater risk of bowel obstruction by 4 times, and a more than 3 times greater risk of gastroparesis, which causes stomach paralysis and can lead to bowel obstructions (Ruder, 2023).

Studies are finding that increased risk for suicidal ideation and depression are linked with Semaglutide as well as spontaneous vomiting (likely due to the decreased gastric motility) (Ruder, 2023). Data is demonstrating autoimmune reactions manifesting on the skin and to your body’s natural GLP-1 which will make blood sugar control and weight loss much harder than before when you stop taking the medication (Burruss et al., 2021).

Numerous studies have also shown that when patients stop taking a medication like Semaglutide, most if not more of the weight they lost comes back within the first year as well with an increase of cardiac and metabolic risk factors they may have controlled temporarily with the medication. (Wilding et al., 2022).

These adverse reactions are only scratching the surface of the implications of semaglutide use. Not to mention connections to thyroid disorders, messing with brain chemistry and hormone release, loss of critical muscle mass, and more.

Conclusion

All of this may seem overwhelming and you may feel stuck having tried numerous diets in the past to no avail. You may also hear that the benefits of losing weight with this medication outweigh the risks.

While it is absolutely true that obesity is one of the greatest factors in the development of chronic disease, there are a multitude of factors that influence why you may be experiencing weight gain. No one needs a medication in order to lose the weight and become healthy. While it is certainly the easier answer, it comes with long term side effects that you must decide personally if it's worth the risk.

If there are any questions regarding how to lose weight, reduce inflammation, controlling PCOS symptoms, healing autoimmune diseases, reducing brain fog and fatigue, or any other issue you might be struggling with please contact the Wellness Lounge to set up an initial consultation.

We are constantly working on alternatives to conventional medicine’s and the culturally popular way to address health problems. We want to see long term, sustainable healing, rather than compounded health problems and risks.

We want to see you well, whole, healthy and achieving your desired outcomes. We believe it is totally possible for you.

References

Burruss, C. P., Jones, J. M., & Burruss, J. B. (2021). Semaglutide-associated bullous pemphigoid. JAAD case reports, 15, 107–109. https://doi.org/10.1016/j.jdcr.2021.07.027

Phillips A, Clements J. Clinical review of subcutaneous semaglutide for obesity. https://doi.org/10.1111/jcpt.13574. Published 2022. 

Ruder K. As Semaglutide’s Popularity Soars, Rare but Serious Adverse Effects Are Emerging. JAMA. Published online November 15, 2023. doi:10.1001/jama.2023.16620

Wilding, J. P., Batterham, R. L., Davies, M., Van Gaal, L. F., Kandler, K., Konakli, K., Lingvay, I., McGowan, B. M., Oral, T. K., Rosenstock, J., Wadden, T. A., Wharton, S., Yokote, K., & Kushner, R. F. (2022). Weight regain and cardiometabolic effects after withdrawal of semaglutide: The <scp>STEP</scp> 1 trial extension. Diabetes, Obesity and Metabolism, 24(8), 1553-1564. https://doi.org/10.1111/dom.14725