Hello, my name is Jen Limongiello NP and I'm the owner of Scale Down. I've learned a lot about Semaglutide over the last few years and wanted to share some points with you. Overall, most people can tolerate Semaglutide and will lose weight, but it is not for everyone.
First, I screen clients to see if Semaglutide is for them. The first question is what is your height and weight? If their BMI is 27 and over, they can take Semaglutide as long as they have either Hypertension (high blood pressure) or Hyperlipidemia (high cholesterol). If your BMI is 30 and over, then you qualify. This is also the criteria that the insurance companies use to approve Wegovy (brand name Semaglutide) for patients.
Semaglutide does come with some warnings. When they first studied these medications in the lab, they found that rodents developed a rare thyroid cancer, called MEN. This did not happen in any other of the animals they tested it on, and I have not read of any cases of MEN in humans from Semaglutide. They also did not test in people who have had pancreatitis in the past. As far as gallbladder disease goes, anyone can develop gallbladder issues when losing weight quickly. I do not prescribe Semaglutide for anyone with a personal history or first degree relative that has had thyroid cancer. I also do not prescribe for anyone with a history of pancreatitis or normal weight.
Semaglutide is a GLP-1 receptor agonist. We all make GLP-1 when we eat, and it tells our brain that we are full. Maybe in some people, their GLP doesn't work the way it was supposed to. Semaglutide is a weekly injection of the GLP-1 that makes you feel fuller when eating. They think it also works in the reward center of the brain and decreases the cravings. It definitely stops the "food voices". So, for those of us, who know where all of the food is in the house and plotting our next meals, this is for you. Of course, anything that works, does come with some side effects. Nausea is usually the most common side effect. Usually, the day or two after you take the injection, you get some waves of nausea. In some people the nausea is mild and others more pronounced. Usually not enough to make someone vomit but could happen. The person also can get a headache, some heartburn and some with diarrhea. This is why the dose is ramped up over time so that people can tolerate it more easily. I also follow patients closely, once a week in the beginning. I always tell patients to eat "to 80 % full, not more". If you eat more than 80% full, you will feel like you just ate Thanksgiving dinner for 12 hours. Because it slows everything down in your digestive system, you have to be very mindful of constipation. I recommend a bowel regimen for my patients. You still need to eat right, get enough protein in and get some regular exercise. But the medication clears you head of the "food voices" and the person has more mindfulness. They typically make better food choices because they are out of the brain fog.
Wegovy comes in 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, and 2.4 mg. Each dose is done for 4 weeks. Unfortunately, it is difficult to find the beginning doses in the pharmacy. Since the shortage, I have also been offering compounding. Compounding pharmacies are legally allowed to sell generic Semaglutide if put on the FDA shortage list. The pharmacy also can only get the materials from a FDA approved source. Compounding pharmacies can only do this with a legal prescription from a healthcare provider like a physician, nurse practitioner, or physician assistant. If you are buying online without a prescription that is not considered legal.
I have patients on both Wegovy and Semaglutide and both are causing weight loss. I now offer a bridge program. I screen clients to see if eligible, then I obtain some labwork, and see if their insurance will approve. Once approved, I will start them off on compounded Semaglutide and ramp up the dose until they get to the 1.7 mg of Wegovy which is in the local pharmacies. Then the client is able to start, then switch over to the Wegovy at that higher dose. If patient's insurance doesn't cover Wegovy, then I prescribe the compounded version for the client. I also offer other weight loss options.
Not everyone can tolerate or need the higher doses. I have a lot of patients on lower doses because they are losing a few pounds a week and they have little to no side effects. We save the higher doses for hitting plateaus. People that need to lose more weight, may need the max dose to get the full benefit of weight loss. Everyone is different. Please set up a 15-minute free consult to see how I can help you!
