How are the first group of people who used the “magic weight loss drug” doing now?

In the "weight loss circle", I believe everyone must be familiar with the "magic drug" semaglutide, which has become popular in the past two years. As a hypoglycemic drug, it has a significant effect on reducing weight, making it a "magic weapon" for many people to lose weight. Although its indication for weight loss has not been approved in China, many people are currently using it to lose weight.

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Judging from the weight loss effect, the effectiveness of this drug is certainly beyond doubt.

Relevant clinical data show that people who injected semaglutide weekly had an average weight loss of up to 15% after 68.1 weeks of injections, with a median weight loss of 15.3kg. The results of a domestic group control study recently published in The Lancet Diabetes & Endocrinology showed that subjects injected 2.4 mg of semaglutide per week. By the 44th week, the weight of the semaglutide group had decreased by 12.1%, while the placebo group had only decreased by 3.6%.

Seeing this, I'm sure many of you are already excited. However, as long as it is a drug, especially a drug dubbed as a "net celebrity drug" or "miracle drug", we must remember to ask one more question: " What are the risks? "

What we need to remind you here is that in addition to the gratifying and efficient weight loss effect of semaglutide, there are still many hidden dangers in long-term use . If you do not understand the drug safety information and abuse the drug, it will cause health damage to your body, which goes against our original intention of "healthy weight loss". Today's popular science article will summarize the four major health risks that may exist in the long-term use of semaglutide.

Risk of gastrointestinal adverse reactions

From the perspective of drug classification, semaglutide belongs to the GLP-1 receptor agonist drug. GLP-1 is a hormone secreted by the human intestine. It can promote insulin secretion, lower blood sugar, increase the body's sensitivity to insulin, increase satiety, and slow down gastric emptying.

Semaglutide can simulate the effect of GLP-1, thereby further activating the function of GLP-1 in the intestine, thereby exerting multiple effects such as lowering blood sugar and reducing weight.

However, this effect brings about a common adverse reaction, namely gastrointestinal adverse reactions. This situation is different from the adverse reactions of other drugs. It is closely related to the mechanism of action of the drug. Therefore, it can be said that most users of this drug will experience gastrointestinal adverse reactions , which is also confirmed by the results of clinical trials. In the aforementioned clinical trial results, the proportion of gastrointestinal reactions caused by semaglutide was as high as 84.1%, and in the domestic group study, the incidence of this adverse reaction also reached 86%.

Common gastrointestinal side effects of semaglutide include nausea, diarrhea, abdominal pain, decreased appetite, stomach pain, vomiting, constipation, indigestion, etc. The specific circumstances and severity of these side effects vary from person to person. If intolerable gastrointestinal adverse reactions occur during the use of the drug, the drug should be discontinued in time and proper conditioning and improvement should be made to avoid causing more gastrointestinal health problems.

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Risk of muscle and bone loss, facial aging

Semaglutide can help you lose weight quickly, but when you lose weight, you lose not only fat that is not good for your health. The muscle and bone loss caused by rapid weight loss is also one of the important risks of long-term use of semaglutide for weight loss.

Especially for non-obese people (which is not an indication for semaglutide weight loss), and elderly people over 65 years old, the use of semaglutide for weight loss should be particularly cautious . While using this drug to lose weight quickly, it may cause a large amount of muscle loss and even a decrease in bone density. This loss may affect the user's exercise endurance and daily activity ability, and even cause a significant increase in the risk of falls and fractures.

Just imagine, if you lose a lot of muscle in order to lose weight, to the point where you can’t even do daily tasks like going upstairs or taking a shower, then what’s the point of losing weight?

Another issue that needs attention is that using semaglutide for weight loss will cause "Ozempic Face", which refers to a rapid facial aging and sagging appearance that occurs after using drugs to lose weight quickly. This situation is also caused by a large loss of muscle due to rapid weight loss. In addition to the face, other parts of the body may also experience sagging skin and lines similar to "stretch marks".

Some people are not obese, but abuse drugs just to reach their "ideal" weight, but end up with an aged and sagging face and skin. Is it worth it?

Risk of intestinal obstruction

In August 2023, the U.S. FDA updated the safety label of semaglutide, warning that the use of the drug may pose a risk of intestinal obstruction.

It is reported that the US FDA safety reporting system has received more than 6,000 reports of gastrointestinal diseases related to the use of semaglutide. As of June 30, 2023, there have been 34 cases of intestinal obstruction. Although the agency pointed out that it cannot determine the causal relationship between drug exposure and the disease, the drug has the effect of "delaying gastric emptying" and may indeed cause this related adverse reaction risk.

Risk of weight regain after stopping medication

During the use of semaglutide, the weight loss effect is of course clear, but after stopping the drug due to physical intolerance or medication cost issues, the hormone-mimicking effect of the drug will disappear, and its effects on promoting metabolism and suppressing appetite will also disappear. Therefore, the use of semaglutide has a good effect on weight loss, but it is also common for weight to rebound after discontinuation. A study published in April 2022 showed that after stopping the use of semaglutide, weight rebounded, and an average of two-thirds of the weight lost was recovered after one year!

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To sum up, although semaglutide, which is regarded as a "magic drug for weight loss" by many friends, has a clear and efficient weight loss effect, it also has certain medication risks in terms of long-term safety. In order to use this drug safely and rationally, we would like to give you the following suggestions.

First of all, it should be used under the premise of clear indications. At present, semaglutide has not been approved for weight loss indications in China. Its use in weight loss treatment for obese people without diabetes is an off-label application. Therefore, whether the drug can be used and whether it belongs to the user group, it is best to consider the use of the drug after evaluation by professionals before taking the drug.

Secondly, if you use this drug to assist in weight loss, you must pay attention to the reasonable supplementation of nutrition, especially the basic nutrients important for musculoskeletal health , such as high-quality protein and calcium, which should be reasonably supplemented. For example, seafood, dairy products, beans and other foods are all high-quality foods that can be consumed. Arranging dietary supplements can reduce the risk of muscle and bone loss caused by drugs. In addition, you should also pay more attention to increasing water intake, which is also helpful for maintaining skin elasticity.

In addition, the role of exercise cannot be ignored. Exercise is an important means to improve body metabolism, increase calorie consumption, and lose weight healthily . For people using semaglutide, strengthening exercise is even more important. It is an important basic guarantee for healthy weight loss with the drug, and it is also an important intervention method to reduce muscle loss and reduce drug rebound after discontinuation.

We lose weight ultimately for our own "health", so the role of drugs is often only an auxiliary role. Regular healthy diet, long-term exercise and other healthy lifestyles are the real basis for healthy weight loss. On this basis, while ensuring the safety of medication, the rational use of drugs to assist is the correct and reasonable way to lose weight. Don't you agree?

Editor's Note:

In fact, there are several characteristics of current online communications that may affect our choices and bring health risks.

Emotional expressions such as "XXX is so effective for weight loss! Just use it!" leave us no time to think carefully about the pros and cons. "Studies have shown that XXX is effective for weight loss, and even doctors are using it!" Such simplistic expressions allow us to only get part of the truth, but ignore the risks.

In fact, any drug has its indications and contraindications, especially prescription drugs. You should choose the appropriate treatment method according to the specific situation and follow the doctor's advice on medication.

If we see any drug being called a "net celebrity drug" or "miracle drug" in the future, the first thing we should do is to find out what risks it has and what situations it is suitable for, rather than blindly placing an order. At the same time, we also call on all media to seek help from professionals and obtain comprehensive information when reporting on drug-related content, rather than following the hype.

Planning and production

Author: Li Jin, deputy director and pharmacist, deputy leader of the Youth Studies Group of the Medical Committee of the China Science Writers Association

Review丨Liu Guiyang, Chief Pharmacist, Fourth Medical Center, PLA General Hospital

Planning丨Ding Zong

Editor: Ding Zong