For safety reasons involving the use of general anesthesia, we require patients at Mia Aesthetics to have a BMI of 34 or less (32 or less for tummy tucks and combination procedures). This sometimes leaves our patients feeling stuck between a rock and a hard place. Let’s say, for example, that you decide you want to start working out so you can get in better shape. But you have oversized breasts that make exercising difficult or painful. You want to get a breast reduction so you can lower your weight, but you can’t find a surgeon to perform the surgery until you lose weight.
In the past, we’ve had to turn patients away with a diet and exercise plan and the hope that we could help them in the future. But thanks to a fairly new drug called semaglutide, we can help patients with a BMI over 30 now rather than waiting. Here is what you need to know about this new option.
What is Semaglutide?
Semaglutide is the generic name of a drug sold under the brand names Wegovy, Rybelsus, and Ozempic. Wegovy and Ozempic are injectable drugs while Rybelsus offers semaglutide in pill form. Developed to help control blood sugar levels in people with type 2 diabetes, this medication has also been found to promote significant weight loss. Ozempic and Rybelsus target those with diabetes and enjoy weight loss as a side effect. Wegovy, on the other hand, is FDA-approved specifically for use as an obesity treatment in those with medical problems related to their weight. This can include but is not limited to diabetes.
How Does Semaglutide Work?
Semaglutide is a medication categorized as a glucagon-like peptide-1 (GLP-1) receptor antagonist. This is quite a mouthful, but here is what it means: Your body releases a GLP-1 hormone into your digestive and intestinal tracts when you eat. This hormone helps to tell your brain know that your body is full. It also tells your pancreas to make more insulin. Semaglutide mimics this hormone.
Your body uses insulin to move sugar from your blood into cells that need them for energy. If your body doesn’t make enough insulin, the sugar stays in your blood rather than moving into the cells, and this is what causes the high blood sugar associated with diabetes.
While the signal that semaglutide sends to produce more insulin is helpful to diabetics, the signal that you’re full helps everyone by telling your brain that you’ve eaten enough and decreasing your appetite.
Benefits of Semaglutide
Semaglutide benefits diabetics by reducing their blood sugar along with their risk of heart attack and stroke. It also helps obese patients lose weight so they can get to a healthier BMI and reduce their risk of weight-related health conditions and complications. At Mia Aesthetics, we use semaglutide to help patients reach a healthy BMI that will allow them to have their desired cosmetic surgeries.
Can Semaglutide Be Used for Weight Loss in Non-Diabetics?
We’ve been talking a lot about diabetes because that is the condition semaglutide was originally intended to treat. People without diabetes can safely use this drug for weight loss, however. In fact, obese patients who are able to lower their weight reduce their risk of developing weight-related illnesses, including diabetes. They also reduce their risk for sleep apnea, high blood pressure, cardiovascular disease, osteoarthritis, and other health problems. According to the Mayo Clinic, people without diabetes who take semaglutide need not worry about developing low blood sugar.
Who is the Right Candidate for Semaglutide?
The ideal candidate for semaglutide is someone with a BMI over 30 who is willing to combine the medication with lifestyle changes to lose weight. If you also have type 2 diabetes, you’re likely a good candidate for semaglutide, but you’ll need to talk to your doctor or endocrinologist about working this drug into your current regimen.
At Mia Aesthetics, we use semaglutide to help our patients reach the proper weight to make plastic surgery safe. We’re not a weight loss or bariatric clinic, however, and as such don’t prescribe semaglutide on a wholesale basis. In order to get a prescription for this medication from us, you must schedule a free virtual consultation and put down a deposit for your desired surgery.
You should not take semaglutide if you or your family members have a history of thyroid tumors, including medullary thyroid cancers (MTC). A history of pancreatitis or gallbladder disease are also contraindications for semaglutide, as is a history of multiple endocrine neoplasia type 2 (MEN2).
Be aware that in studies, those who stopped taking semaglutide gained some of their lost weight back and did so fairly quickly. Taking this medication may require a long-term commitment. Procedures like liposuction and BBLs can have altered results if you gain a substantial amount of weight after having the procedure, so consider this commitment carefully. Some insurance companies don’t cover semaglutide for weight loss, and paying out-of-pocket can easily run $1,300 to $1,400 a month. As of now, there are no approved generic versions of this medication.
How Fast Does Semaglutide Work?
Doctors report seeing some weight loss in patients as early as 4 weeks into treatment with semaglutide. When you start taking semaglutide, however, you begin with a low dose, gradually increasing your dose over a 16-week period. As such, you may not see results until you step up a dose or two.
In a widely referenced study published in the New England Journal of Medicine, patients receiving semaglutide were monitored and tracked for 68 weeks. At the end of the study, those on semaglutide lost an average of 14.9 percent of their body weight. Those taking a placebo, by contrast, lost only 2.4 percent of their body weight. It is important to note that although these results are impressive, study participants received healthy lifestyle counseling and guidance as well as medication.
Is Semaglutide Safe? Is it FDA Approved for Weight Loss?
Semaglutide is FDA-approved for weight loss under the brand name Wegovy as of June 4, 2021. The Ozempic and Rybelsus brands are FDA-approved as well, but only for those with type 2 diabetes. Using these two drugs for weight loss is an off-label use.
Semaglutide is considered safe, but it’s important to follow your doctor’s dosing instructions. You must also ask your doctor about this drug and how it may impact others you are taking. This will help you avoid any unwanted drug interactions.
