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Supplement◆ Editor's Pick
Wegovy® (semaglutide)
GLP-1s help with a lot more than satiation.
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Evidence
5/5
Multiple RCTs demonstrate semaglutide reduces body weight by 10–22% and improves HbA1c (glycated hemoglobin) in people with type 2 diabetes and obesity. The STEP and SUSTAIN trial series show consistent benefit. However, semaglutide is a prescription medication, not a supplement, and carries risks including gastrointestinal side effects, pancreatitis, and thyroid concerns that require medical supervision.
Mechanism
Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist that mimics the GLP-1 hormone, slowing gastric emptying, increasing satiety signaling in the brain, and improving insulin secretion. It reduces appetite and food intake, leading to weight loss and improved glycemic control.
Best evidence type
Randomized trial
Sources
- Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial.JAMA · 2021 · RCT
“Conflict of interest statement: Conflict of Interest Disclosures: Dr Rubino reported being a clinical investigator for Boehringer Ingelheim and AstraZeneca and receiving speaker fees, consulting fees, and honoraria from Novo Nordisk and bei”
- Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension.Diabetes, obesity & metabolism · 2022 · RCT
“Conflict of interest statement: JPHW reports receiving advisory board fees, paid to his institution, from Astellas Pharma, grant support and fees for membership on a data and safety monitoring board, both paid to the University of Liverpool”
- Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial.Lancet (London, England) · 2021 · RCT
“BACKGROUND: This trial assessed the efficacy and safety of the GLP-1 analogue once a week subcutaneous semaglutide 2·4 mg versus semaglutide 1·0 mg (the dose approved for diabetes treatment) and placebo for weight management in adults with ”
- Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials.The lancet. Diabetes & endocrinology · 2019 · Meta-analysis
“BACKGROUND: Glucagon-like peptide-1 (GLP-1) receptor agonists differ in their structure and duration of action and have been studied in trials of varying sizes and with different patient populations, with inconsistent effects on cardiovascu”
Caveats
Semaglutide is FDA-approved as a prescription drug (Ozempic, Wegovy), not marketed as a dietary supplement in the US. Long-term safety data beyond 2–3 years is limited. Gastrointestinal adverse events (nausea, vomiting, diarrhea) are common and sometimes severe. Rare but serious risks include acute pancreatitis and potential thyroid C-cell tumors (based on rodent data). Weight regain occurs after discontinuation. Off-label or compounded versions sold as 'supplements' lack the same manufacturing oversight as FDA-approved formulations.
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