Semaglutide is an injectable medication taken once a week that mimics a hormone in the body to regulate blood sugar and decrease appetite. It has gained so much recognition for its potential to promote significant weight loss, that supply-chain issues have developed a few times in the last year.
Wegovy and Ozempic are virtually the same medication (semaglutide), made by the same pharmaceutical company (Novo Nordisk A/S).
The differences between Wegovy and Ozempic include:
Semaglutide (Wegovy/Ozempic), unlike phentermine/phendimetrazine, is FDA approved for long-term use and is not considered a controlled substance by the DEA. Studies have shown that most people taking semaglutide for weight loss can expect to lose about 15% of their body weight over a 60-week period (just over a year). Because semaglutide is not a controlled substance, monthly visits with Dr. Pastorek are not required, and he typically will see patients on semaglutide for a follow-up visit around 1-3 months after initiating therapy for a weight check and to discuss any side effects or diet challenges.
The most common side effect patients experience on semaglutide (Wegovy/Ozempic) is nausea. Patients usually have mild to moderate nausea 1-2 days after the first injection, and the nausea is usually not as bad after the 2nd, 3rd, and 4th injections. As the dose is titrated up, it’s not uncommon for the nausea to recur briefly, but most patients notice that the nausea isn’t much of an issue once they are stable on the maintenance dose.
There are a handful of patients who cannot tolerate the semaglutide due to severe nausea, but most people notice mild to moderate symptoms that improve over time.
“Gastroparesis” is a buzzword that has come up recently in the news when discussing this relatively new weight loss medication. While gastroparesis literally means “stomach paralysis,” an actual medical definition of the term is:
A disorder characterized by delayed movement of food from the stomach into the small intestine because of impaired stomach motility, resulting in nausea, vomiting, and a feeling of fullness.
The stomach and intestines are constantly moving. Peristalsis is the involuntary constriction and relaxation of the muscles of the stomach and intestines, and the goal of peristalsis is to keep food moving the correct way (down, not up) while your body digests it.
In certain conditions, like diabetes for example, the nerves in the digestive system that allow for normal peristalsis, become damaged over time, and the result is gastroparesis. Gastroparesis is common in people who have been diabetics for years, and it’s managed by eating smaller portions of food to allow for the stomach to have extra time to empty (eating a big meal when dealing with gastroparesis usually results in nausea/vomiting). There are also some medications that can be used to treat gastroparesis.
Semaglutide (Wegovy/Ozempic) has been shown to cause gastroparesis, however the gastroparesis caused by semaglutide is mild for most people and usually, mostly (if not completely) resolves by the 4th month of treatment. For those few patients who have severe nausea/vomiting, they typically stop treatment after a few doses, and their gastroparesis resolves within a week or 2.
Other side effects of semaglutide (Wegovy/Ozempic) reported by some patients include abdominal pain, constipation, and diarrhea. These side effects are usually mild and don’t typically result in discontinuation of treatment.
The biggest issue with Wegovy and Ozempic is the pricing, with supply-chain issues being a close second. In Dr. Pastorek’s experience, insurance covers the cost of the medication for about 1/3 of his patients. If not covered, the cash price can exceed $1500 per month!
As an alternative, compounding pharmacies can offer a significantly less-expensive alternative by combining semaglutide with some sort of vitamin B compound. It is thought that the vitamin B helps mitigate the nausea/gastroparesis symptoms, but by compounding the semaglutide with a vitamin, the compounding pharmacies are able to sell the semaglutide ‘off patent.’ Compounded medications aren’t normally covered by insurance, but the cash price of the starting dose of semaglutide runs around $100 per month up to approximately $250 per month once on the maintenance dose (2.4 or 2.5mg depending on the compounding pharmacy).
Dr. Pastorek typically recommends patients stick to a 1000-1400 Calorie diet while on semaglutide (Wegovy/Ozempic). He also recommends checking your weight daily, logging your food (MyFitnessPal is a popular food-logging app), and walking 20 minutes daily on days you don’t exercise. Semaglutide (Wegovy/Ozempic) can be continued until you feel comfortable stopping or weaning down the dose, and if you start gaining weight after stopping the medication, it can be easily resumed, which makes it a much more versatile option than medications like phentermine.
Contraindications to semaglutide (Wegovy/Ozempic):
To request your appointment, please call (469) 414-9660 or contact us online today!
Pure Medicine
4645 Avon Lane, Suite 200
Frisco, TX 75033
Phone: (469) 414-9660
