A while back, my wife, Vanessa, asked me if I'd heard about this new weight loss drug called semaglutide. Neither one of us pay attention to celebrities, but she somehow came across some posts about it. I hadn't heard about it, and wondered if it was something special or another oily-stool-disaster-waiting-to-happen like orlistat. It turns out that semaglutide could be a great way to bolster the results of a good nutrition and exercise plan (like what I write about in The 3 Pillars of VIGOR).



Using semaglutide without eating a higher-protein diet and strength training regularly will undoubtedly lead to significant muscle loss and increase the likelihood you'll regain more body fat than before you started using it, if you ever stopped the medication. For those who remain on it long-term without eating a high-protein diet and strength training, they'll be more likely to develop osteoporosis and frailty, just like they would if they followed a long-term, calorie-restricted diet without proper nutrition and exercise.



With all that said, semaglutide appears to be a powerful tool to use with a high-protein diet and resistance training program. In my opinion, fitness centers that partner with weight loss or anti-aging clinics would be the perfect place to offer this therapy, as patients would be immersed in an environment that emphasizes the diet and exercise practices necessary to get the best results with the medication.



What is Semaglutide?



Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, has been making waves in the world of weight loss and diabetes management. It is sold under the brand names Wegovy, Ozempic, and Rybelsus. Recently, several studies have demonstrated its potential in not only helping individuals with type 2 diabetes but also those who want to lose weight effectively.Jiahui Xu, Yanbin Chen, Qianqian Chen, Lingling Xu, Zhiqiang Wang, and Rongping Chen, "Long-term efficacy and safety of semaglutide for obesity: A systematic review and meta-analysis," Obesity Reviews, February 2023.



To fully appreciate semaglutide's potential for weight loss, it's essential to understand what GLP-1 is and how semaglutide interacts with it. GLP-1, or glucagon-like peptide-1, is a hormone produced in your gut that plays a vital role in regulating blood sugar levels and appetite.Drucker, D. J. (2018). Mechanisms of Action and Therapeutic Application of Glucagon-like Peptide-1. Cell metabolism, 27(4), 740–756. By mimicking the effects of GLP-1, semaglutide can help you better manage your weight and improve your overall health.



How GLP-1 Works



GLP-1 is released in response to food consumption and works in several ways to help maintain healthy blood sugar levels and control your appetite.Holst, J. J. (2007). The physiology of glucagon-like peptide 1. Physiological reviews, 87(4), 1409–1439. These functions include:




Stimulating insulin production: GLP-1 promotes the release of insulin, a hormone that helps lower blood sugar levels by allowing glucose to enter your cells.Nauck, M. A. (2016). Incretin therapies: highlighting common features and differences in the modes of action of glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors. Diabetes, obesity & metabolism, 18(3), 203–216.



Suppressing glucagon secretion: Glucagon is a hormone that raises blood sugar levels by stimulating the release of stored glucose. GLP-1 helps to suppress glucagon secretion when it's not needed, preventing excessive glucose release.Ahrén, B. (2009). Glucagon-like peptide-1 receptor agonists for type 2 diabetes: a rational drug development. Journal of diabetes investigation, 1(1-2), 9–19.



Slowing gastric emptying: GLP-1 slows down the rate at which food moves through your stomach, allowing for better nutrient absorption and a prolonged feeling of fullness.Horowitz, M., Flint, A., Jones, K. L., Hindsberger, C., Rasmussen, M. F., Kapitza, C., Doran, S., Jax, T., & Zdravkovic, M. (2012).