Analyzing The Effects Of Semaglutide (Ozempic/Wegovy) On Metabolism: Investigating Correlations With Weight Reduction

Abstract

Background: Ozempic and Wegovy are brand names of Semaglutide, a GLP1 receptor agonist.  Semaglutide mimics the actions of the incretin hormone GLP-1 found in the body resulting in  increased release of insulin from pancreatic beta cells postprandially, inhibition of glucagon release, and prolongation of gastric emptying. While the FDA approved Wegovy for weight loss, Ozempic is FDA approved for managing blood glucose in patients diagnosed with Type 2 Diabetes Mellitus. In the years following approval of Ozempic for glycemic control, various trials utilizing differing dosage regimens demonstrated consistent weight loss in patients regardless of their diabetic status. From this data, chronic weight management was added as an approved indication for Ozempic. Hereinafter, both Ozempic and Wegovy will be referenced as Semaglutide, the primary active ingredient in both drugs.  

Objective: This study aims to conduct a network meta-analysis and systematic literature review to assess the efficacy of subcutaneous Semaglutide injection in promoting weight loss and improving metabolism in obese patients with and without comorbidities.

Methods: Relevant research studies published between 2018 to 2023 were collected from the Pubmed database using a keyword search. Results were streamlined to focus on clinical studies including patient populations suffering from obesity with or without the diagnosis of Type 2 Diabetes Mellitus and use of subcutaneous Semaglutide only. A total of twenty-one studies including randomized control trials, retrospective cohort studies, and clinical trials were chosen and the outcomes were analyzed such as weight management from baseline, hemoglobin A1c, blood glucose levels, and other associated biomarkers.

Findings: In numerous studies reviewed, a positive correlation was observed between weight loss and overweight/obese patients receiving scheduled Semaglutide. Semaglutide demonstrated efficacy in reducing HbA1c levels, making it a powerful tool for practitioners in glycemic control (De Lucas et. al., 2022). Comparative analysis of HbA1c and weight loss results between oral and subcutaneous Semaglutide administration routes revealed little difference. Patients without prior GLP-1 receptor agonist treatment showed greater effects in HbA1c, weight, and insulin reduction. Continuous treatment with Semaglutide over 48 weeks led to greater weight loss compared to patients who switched to a placebo part way through treatment (Rubino et. al., 2021). In adolescents, weekly 2.4mg Semaglutide injections demonstrated greater weight loss of 5% of their body weight compared to the placebo group (odds ratio, 14.0; 95% CI, 6.3 to 31.0; P<0.001) (Weghuber et. al., 2022). In patients with obesity and PCOS who faced challenges in losing weight with lifestyle modifications, weekly Semaglutide injections were able to help them lose weight; the overall mean weight loss after 6 months was 11.5 kg with 80% of responsive patients resulting in normalized menstrual cycles with minimal side effects (Carmina et. al., 2023). In addition, Semaglutide significantly reduced perceived hyperglycemia with no perceived hypoglycemia between treatments. Semaglutide further aids weight loss by decreasing patients’ food cravings (Wharton et al., 2023). Patients on Semaglutide showed improvement in overall health including CRP levels and alleviations of symptoms associated with heart failure and obesity (Mikhail N Kosiborod et. al., 2023).

Interpretation: Analysis of relevant research studies indicate a positive correlation between Semaglutide and weight loss, with additional benefits to metabolic health including but not limited to glycemic control and lipid profiles. Furthermore, studies demonstrated a positive relationship between dosing and amount of weight lost. Lastly, of note, weight regain was found to occur upon treatment cessation thus affecting the degree of long-term effectiveness of Semaglutide.