The buzz around using glucagon-like peptide-1 (GLP-1) receptor agonist drugs like semaglutide and liraglutide for weight loss has been making waves – from Hollywood A-listers to everyday folks. Why the fuss? Well, these little wonders offer a nifty and relatively speedy way to shed those stubborn kilos. Dr. Morris Jammy, a general practitioner, offers some insight: “They were originally designed to manage type 2 Diabetes by helping control blood sugar levels, but their potential for weight management has become increasingly clear.”
These drugs do a fancy dance by imitating the effects of GLP-1, a hormone naturally made in your intestines. It’s the fairy godmother of hormones, making you feel full, curbing your hunger, and slowing down the emptying of your stomach. As a result, folks using these GLP-1 receptor agonists tend to eat less, which can lead to shedding those extra pounds.
Dr. Jammy breaks it down: ” These drugs act on appetite-regulating brain areas, stabilise blood sugar by delaying stomach food release, leading to fewer post-meal sugar spikes and prolonged satiety. They promote insulin production, essential for blood sugar control after meals, while curbing excess liver sugar release into the bloodstream.”
The difference between semaglutide and liraglutide
The most well-known semaglutide drugs currently on the market are Ozempic and Rybelsus (not available in SA), and the liraglutide drug, Victoza. All these drugs are manufactured by pharmaceutical company, Novo Nordisk, and they have been FDA-approved for the treatment of type 2 Diabetes only, and not for weight loss purposes.
Although they have a list of key differences, the main difference is the dosage size. Semaglutide injections, which last for 165 hours, are given weekly, starting at 0.25mg and gradually bumped up to 2.4mg for maximum effectiveness. Liraglutide injections, on the other hand, are daily affairs, lasting 13 to 15 hours. You begin with 0.6mg and and increasing to a maximum daily dosage of 3mg.
In 2022, Novo Nordisk got the green light for Saxenda (liraglutide) and Wegovy (semaglutide – not available in South Africa) as weight management treatments. Although these drugs have been approved to be used for weight management purposes, there has been such an international demand for them, that they are very rarely available, and as such, many people are turning to off-label use of Ozempic, Rybelsus and Victoza instead.
But here’s the hitch: the demand is so off the charts that Dr. Jammy says there’s a shortage for patients who actually need these meds to treat their life-threatening type 2 Diabetes. As such, he recommends that only folks with a body mass index (BMI) of 40+ should use GLP-1 receptor agonist drugs for weight loss.
Does it really work?
GLP-1 receptor agonist drugs act as your trusty sidekick on your weight loss journey, and have shown incredible effectiveness as a weight loss aid. Although Wegovy and Saxenda both belong to the same family of medications, and exhibit similar mechanisms in aiding weight loss, recent research underscores the superior efficacy of Wegovy over Saxenda.
In a comprehensive 68-week study involving 300 adults, Wegovy outperformed Saxenda in terms of weight loss. The Wegovy group achieved a substantial 16% reduction in their initial body weight, coupled with dietary improvements and increased physical activity. In contrast, those using Saxenda experienced a more modest 6% weight loss.
In August 2023, Novo Nordisk issued a statement announcing that Wegovy surpassed expectations in a pivotal late-stage trial. The study, named SELECT, encompassed 17,500 participants and spanned nearly five years. It revealed that Wegovy reduced the risk of major cardiovascular events, such as strokes, by an impressive 20% in overweight or obese individuals with a history of heart disease.
Are there any side effects?
Dr Jammy explains that these aren’t miracle drugs however, and in order to keep the weight off permanently, you also need to make changes to your lifestyle and eating habits: “Studies show that stopping GLP-1 receptor agonist drugs completely will often lead to regaining most of the weight within several months, unless you have made the necessary changes to your diet and exercise regime to ensure that the weight stays off.”
He notes that common side effects of GLP-1 receptor agonists include headaches, dizziness, nausea, diarrhea, vomiting, and constipation: “Most people who take these drugs will experience these symptoms at some point during their treatment, they are usually short-term and should subside over time.”
Some less common, but much more serious side effects, include pancreatitis, vision changes, hypoglycaemia, kidney problems, allergic reactions, gallbladder issues, and thyroid tumors and cancer. Each individual case needs to be evaluated according to family history as well as the pros and cons for each person.
Big results, big costs
While these medications hold substantial potential, their long-term use raises valid affordability concerns. According to an press release from Discovery Health, these weigh loss management drugs are costly: “While these drugs show great promise, they do come at a price tag that raises affordability concerns as they need to be used long-term. Locally, the cost of Saxenda is about R4,184 and the cost of Wegovy, which is not available locally, costs US$1,400 per month in the United States.”
Reading Time: 4 minutesWhat if I told you that you could lose up to 16% of your body weight in a couple of months by …