All about Semaglutide

The BBC news article labelled it a “new era” in tackling obesity and Sky News quoting it as “a game changer”.

We have been using this medication for 2 years here at the Liverpool Weight Loss Clinic, so we wanted to share a little bit more about Semaglutide, or to give it its brand name – Ozempic.

What is Semaglutide?

Semaglutide is similar to a naturally occurring hormone (called GLP-1) that is released from the intestine after a meal. It works by acting on receptors in the brain that control your appetite, causing you to feel fuller and less hungry. This may help you eat less food and reduce your body weight.

Why did Semaglutide make the headlines?

A research trial, using a higher dose of Semaglutide than researched previously, published their findings. And in terms of the amount of weight lost – there is very good reason that it made headlines!

Let’s look at the research trial in more detail…

Who took part in the trial?

• 1,961 adults from across 16 countries in Europe, Asia & America
  • 3 out of 4 participants were women
  • The average age was 46 years (ranging from 33 to 59 years)

The average participant weight to start was 105.3kg (16 stone 8pounds), with most people ranging between 83.3kg (13 stone 2lbs) to 127.5kg (20stone 1pound)

• All had a Body Mass Index (BMI) of more than 30kg/m² or a BMI of 27kg/m2 or more with a weight-linked health conditions such as:
  • Hyperlipidaemia (high fat or cholesterol levels in the blood)
  • High blood pressure
  • Obstructive sleep apnoea
  • Cardiovascular disease

What was involved?

This was a randomised, double-blind, placebo-controlled trial. Simply put, everyone on the trial received an injection, some had the active drug Semaglutide in their injection and some did not, – this group took what is referred to as placebo (no active drug).

• Twice as many people received Semaglutide, than the placebo.
• This meant 1,306 participants were taking Semaglutide and 655 people were taking the placebo.
• Importantly neither the participants nor the researchers knew who was on the active medication; this gives better confidence into the effect of Semaglutide

What else was involved in the trial?

All participants received lifestyle support from a dietitian every 4 weeks.

• Each participant had their estimated calorie requirement calculated at the start of the trials and were encouraged to follow a calorie deficit of 500 calories each day
• Physical activity targets of 150 minutes per week were recommended
• Behavioural counselling was provided to encourage and support participants
• Use of a diary or smartphone tracking app was encouraged daily and reviewed as part of support appointments
• Supporting information leaflets were provided

How long were they taking the medication or the placebo?

• In total the study looked at a period of 68 weeks of treatment.
• The first 16 weeks involved gradual increases in the doses from a starting dose of 0.25mg per week; with participants increasing their dose every 4 weeks until they reached the dose of 2.4 mg.
• The 2.4 mg dose was then administered weekly for 52 weeks

Was there any downsides?

The most reported side effects for people who were taking Semaglutide was nausea, diarrhoea, vomiting and constipation; most of these were said to be mild to moderate and temporary. These side effects caused 7% (92 out of the 1,306 participants) to stop taking the medication.

What results did they achieve?

Participants had lost weight as early as 4 weeks after starting the medication – bear in mind they were only taking a small amount (0.25 mg) of the medication at that point.

On average, people who used the medication lost nearly 15% of their body weight (14.9% to be precise)

This is compared to people who were using the placebo who lost just over 2% of their body weight (2.4%).

How much body weight did most people lose?

More people taking Semaglutide, were able to lose bigger amounts of their body weight. A comparison between the two shows:

Percentage body weight lost	Semagluitde	Placebo
5% or more	86.5	31.5
10% or more	69.1	12.0
15% or more	50.5	4.9
20% or more	32.0	1.7

This shows that almost 1 in 3 people lost a fifth of their body weight when taking Semaglutide.

How much weight did they lose?

Average weight loss on the medication was 15.3kg (2 stone 2 pounds)

• Compared to 2.6 kg (6 pounds) lost for those who were taking the placebo
• Waist circumferences/size fell by 13.5 cm (5.3 inches)

Other health benefits were seen in reductions in blood pressure, glycated haemoglobin (measure of blood sugar control) and cholesterol levels.

What about long term results?

At this point, we do not have the research as to what the longer-term outcomes for these participants will be. It is widely accepted that long-term lifestyle changes are required to maintain weight loss.

How does this fit in with what else is available?

Weight loss medications are currently available in the UK and evidence does support the weight loss they help people achieve. Currently licensed weight loss medications available are Orlistat, Mysimba and Saxenda.

Currently, Semaglutide is available by private prescription at a dose of 1.0mg once weekly, if thought appropriate for your weight loss.

What is Liverpool Weight Loss Clinic’s opinion on the research trial?

This adds really strong and positive evidence to what can be achieved for lots of people with the support of this weight loss medication in conjunction with lifestyle changes.

Whilst the dose used in the trials is not currently available; individual needs vary and people we have cared for have been able to achieve significant weight loss even with lower doses of the medication than needed in this trial.

We recognise the importance of robust support and lifestyle changes to support individuals. Our program incorporates medical, psychological and dietetic support to ensure individuals are given every opportunity to identify the right approach for them. We also emphasise long-term changes and our intervention ensures sustainable changes that are suitable for each person on their journey.

 

If you would like to book a free consultation to discuss our programme further, please get in touch.