Semaglutide for weight loss: the (risky) fashion born on social networks, what we know about the antidiabetic used to lose weight

Fashion was born on social networks: one injection a week of a diabetes drug, semaglutide, and weight loss is quick and easy. Fast enough to leave a slightly sunken and haggard face, sagging skin with an aged appearance, but for influencers, stars and personalities like Elon Musk, who has admitted to using it, the possible negative consequences of its use are completely secondary to the desired weight loss. It is a pity that the rush to use it improperly, in those who do not have diabetes, is contributing to reduce stocks to the point of having led the Italian Medicines Agency to warn that supply shortages will be possible throughout 2023. Not a small problem because, as explained by Graziano Di Cianni, president of the Diabetologists’ Association, «out of about four million diabetics in Italy it is estimated that several thousand are treated with semaglutide and today they are forced to change therapy and use less effective or less tolerated products».

Increases the sense of satiety

Semaglutide is a GLP-1 receptor agonist, which stimulates the production of insulin after the meal or only when carbohydrates are introduced; because of this does not cause sudden drops in blood sugarFurthermore slows down gastric emptying by increasing the sense of satiety and, by acting on the appetite centers in the central nervous system, it reduces hunger. It is administered by subcutaneous injection once a week or orally, every day, and shares these effects with other drugs of the same class such as dulaglutide and liraglutidebut it is particularly effective in inducing a loss of kilos: in adults it is possible to lose even 20% of the weight and the result is maintained as long as the treatment is followed. «Slimming, which adds to the positive action on blood sugar and the protection of the cardiovascular system (thanks to the reduction of parameters such as blood pressure, blood fat and abdominal circumference, ed), is a beneficial “side effect” of semaglutide because people with type 2 diabetes in whom it is used are often obese» notes Di Cianni.

Upheaval of the metabolism

Also for this reason, the American FDA approved its use against obesity, but then there was a “lead forward” of those who have only a few extra pounds and started getting injections documenting everything on social networks such as Instagram and TikTok. A risky drift for many reasons, as specified by Angelo Avogaro, president of the Italian Society of Diabetology: «The improper use and the resulting lack puts people with diabetes at risk, who can lose their metabolic compensation and, by stopping the drug, have a dangerous weight “rebound”.; on the other hand, the use by those who are healthy can lead to excessive weight losswith loss of muscle mass and distortion of the metabolism which in the long run can lead to serious metabolic alterations ».

Contraindications and side effects

Even wanting to ignore that, like all drugs, semaglutide has contraindications (for example, it cannot be used during pregnancy or breastfeeding or if you have pancreas or kidney problems) and that it can have side effects such as diarrhea and vomiting, headache, drowsiness, confusion and so on, using it to lose a bounty is dangerous because there are no data on use in healthy people; even the use in obese patients at present is off labeli.e. outside the permitted indications, because to protect people with diabetes Aifa allows its prescription only in case of uncontrolled type 2 diabetesas an adjunct to diet, exercise and possibly other medicines. «In some regions, semaglutide has been prescribed off label paid by the obese patient, in the recent past, but now it is no longer possible and can only be provided by the National Health Service in the event of type 2 diabetes – observes Di Cianni -. This should suffice as deterrent to misuse, which in our country was probably quite limited; however it should be discouraged in every way, because this drug is an important first choice for the treatment of people with type 2 diabetes at high cardiovascular risk and it is essential to avoid shortages in supplies», concludes the diabetologist.

A therapy for obesity

A “close relative” of semaglutide, liraglutide in daily subcutaneous injection, it is already approved in Italy for the treatment of obesity; in the USA, the green light has also been given to semaglutide in a formulation with a higher dosage, currently not available in Italy. Probably, when the collective mania for the drug by those who don’t have weight problems or diabetes and who uses it in a completely improper way will have consumed it can be used in the real obese also in our country. As Renato Cozzi, president of the Endocrinologists Association, underlines, «deficiency must not become a tool to stigmatize obese patients and their need for health, because early intervention can prevent complications such as diabetes itself». Meanwhile, the research goes on and, as Enzo Nisoli of the University of Milan explained during the last congress of the Italian Society of Pharmacology, «there are promising prospects for other drugs».