Medical Weight Loss
Ozempic/ Wegovy/ Rybelsus
Semaglutide is a GLP-1 agonist created for Type 2 Diabetes and FDA approved in 2019. It was approved for the indication of weight loss as Wegovy in June 2021.
ALSO KNOWN AS: Semaglutide
AVOID WHEN: History of Thyroid C-cell tumors; Pregnant; Breastfeeding; Trying to conceive; History of anorexia/bulimia
SIDE EFFECTS: Nausea (44%); Vomiting (25%); Diarrhea/GI distress (30%)
How it Works
GLP-1 works to increase insulin levels by activating cells in the pancreas. It also triggers hormone release to delay the emptying of the stomach, sometimes causing nausea.
Expected Results
When used alongside robust lifestyle management (200 min exercise/week, nutri-system diet, bimonthly nutritionist visits) patients observed 10-14% weight loss, maintained over 2 years (STEP3 Trial, Novo Nordisk).
Xenical/ Alli
Orlistat is a pancreatic lipase inhibitor that was created to block intestinal absorption of fat. It was created for the indication of weight loss, and FDA approved in 1999.
ALSO KNOWN AS: Orlistat
AVOID WHEN: Chronic malabsorption; Pregnancy; Cholestasis/History of Gallbladder disease
SIDE EFFECTS: Oily Spotting (26%); Flatus with Discharge (23.9%); Fecal Urgency (22.1%); Fatty/Oily Stool (20.0%); Oily Evacuation (11.9%); Increased risk of Vitamin D, E, A, K deficiency
How it Works
Orlistat works directly as a lipase inhibitor. By blocking the breakdown of fats in the intestines, fats cannot be absorbed and are excreted in stool.
Expected Results
Orlistat is associated with a modest reduction in weight: meta-analysis including 11 randomized control trials using 120mg of Orlistat 3 times per day showed 2.9% greater weight loss than placebo.
Saxenda/ Victoza
Liraglutide is a GLP-1 agonist medication, very similar to Semaglutide. It was initially developed as a medication for Type 2 Diabetes, but found to also help patients with weight loss! By activating GLP-1 receptors, this medication works to slow the rate at which your stomach empties, and to send signals to your brain to decrease appetite.
ALSO KNOWN AS: Liraglutide
AVOID WHEN: Pancreatitis Gallstones; Family history of Thyroid Cancer; Thyroid disorders
SIDE EFFECTS: Nausea (44%); Vomiting (25%); Diarrhea/GI distress (30%)
How it Works
GLP-1 works to increase insulin levels by activating cells in the pancreas. It also triggers hormone release to delay the emptying of the stomach, sometimes causing nausea.
Expected Results
The SCALE Trial showed patients can lose 6.2% over 52 weeks (CI 7.5 to 4.6%).