Semaglutide is a glucagon like peptide-1 used for the treatment of obesity.  It was first approved in the U.S in 2017 to improve glycemic control in patients with Type 2 diabetes. Recently, once-weekly injections of Semaglutide have been shown to be an effective solution for patients who are having difficulty losing weight, helping them to lose as much as 15% of body fat in 6 months.  Semaglutide now carries an FDA approval indicated as an adjunct to a reduced calorie diet and increased physical activity for chronic weight management in overweight or obese adult patients.  

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With Semaglutide, treatment begins at a low dose in order to allow your body to get used to the molecule and to decrease any potential side effects while titrating dosing up over a period of 12-16 weeks. Once your goal weight is reached, you can consider titration down when ready. 

 

Do not take if you have insulin dependent diabetes. Limit alcohol intake while taking this medication.

Adverse effects: nausea, constipation, elevated liver enzymes 

 

Treatment:

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Initial Consult with Nurse Practitioner includes complete history and physical examination, assessment of health goals and recommendations for improved wellness with Semaglutide.

*The dose increases every four weeks until you reach maintenance dosing, with weight loss increasing the higher the dose*  

 

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Month one: Starting the program, so exciting! You can look forward to losing a few pounds your first month and to start seeing your appetite and cravings decrease. 

~Semaglutide 10 units weekly (0.26 mg) 

 

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Month two: Check in with the office. At this point, you will likely really begin noticing an improvement in how you feel as well as changes to your eating habits based on your decreased appetite.

~Semaglutide, 20 units weekly (0.53 mg)

 

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Month three: Follow up with the office, let us know how you are doing. If you would like to continue, now is the perfect time to place your order for Phase 2. Your weight should be going down and your cravings will have significantly decreased. You're feeling great! 

~Semaglutide 40 units weekly (1.06 mg)

 

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Month four: Check in with office. If you're tolerating the lower doses, keep going and you will see the weight continue to decrease. 

~Semaglutide, 70 units weekly (1.9 mg) 

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Month five and beyond: Follow up in office; weight loss is increased at the higher doses, you should really notice a difference in your overall weight, health, mood, and you can continue until you feel you are at a good weight to be able to continue to eat healthy portions and a well-balanced diet.  Maintenance dose is 90 units-> continue this dose until you reach your goal weight, continue for 2-5 months, then start slow titration down  Semaglutide helps with chronic weight management and can be taken long term under provider's care.

~Semaglutide 90 units weekly (2.4 mg)

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Most people are able to tolerate Semaglutide, if not, Tizepatide will be discussed. This double peptide is actually more effective with less side effects than Semaglutide. It is more expensive, but the results are worth it.