
Semaglutide, known under the brand names Ozempic, Wegovy, and Rybelsus, is a drug first marketed for the treatment of type 2 diabetes. This molecule is a GLP-1 (glucagon-like peptide-1) receptor agonist and should be used as a complement to lifestyle changes, such as a balanced diet and increased physical activity. By acting on GLP-1 receptors in the central nervous system, semaglutide activates anorectic signaling and exerts an appetite-regulating effect.
In a meta-analysis, subcutaneous semaglutide demonstrated superior efficacy in reducing glycated hemoglobin when compared to other antidiabetic drugs, without increasing the rate of hypoglycemia. Greater weight loss is also observed with semaglutide when compared to a placebo. This weight loss appears to be greater in women than in men. However, a randomised study demonstrated that one year after stopping weekly semaglutide and lifestyle modification interventions, participants had regained two-thirds of the lost weight.
Beneficial effects have also been studied in overweight or obese non-diabetic individuals. For example, according to a meta-analysis of randomised controlled trials, therapies with GLP-1 receptor agonists significantly reduced cardiovascular events and improved cardiometabolic parameters. A slight decrease in LDL and total cholesterol was reported, with no significant effect on triglycerides, VLDL, or HDL cholesterol. A positive effect was also observed on systolic blood pressure.
Research has also explored other promising effects of semaglutide. Like other antidiabetic drugs such as metformin and insulin, this molecule has shown benefits in terms of fracture risk for people living with type 2 diabetes.
Although studies on the subject are limited, GLP-1 receptor agonists may improve depressive or neurocognitive disorders by being positively associated with neurogenesis. A mixed-method study analysed online discussions and showed potential for reducing cravings for substances such as alcohol, cigarettes, and sweets.
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