Low-dose semaglutide (1.0mg) once-weekly resulted in an average 11 pound weight loss in 12 weeks.

A recent 20-week, phase II trial investigated the effects of subcutaneous administration of semaglutide 2.4 mg on gastric emptying, appetite, and energy intake in patients. Patients receiving semaglutide 2.4 mg in this trial lost 9.9% of their bodyweight, compared with 0.4% in those receiving placebo.

High-dose (2.4mg) Semaglutide has been studied in non-diabetic patients suffering from obesity. The New England Journal of Medicine's publication of the STEP trial revealed more than 50 percent of trial participants lost 15 percent of their body weight, and between 33 to 40 percent are losing 20 percent of their body weight. This number is superior to the current best weight loss agent (phentermine plus topiramate; approximately 10% body weight loss in a year).

Semaglutide mimics the effect of "feeling full" resulting in a decreased caloric intake. Semaglutide will delay gastric emptying by reducing glucagon secretion in a glucose-dependent manner. The delay in gastric emptying can reduce appetite, improve control of eating, and reduce food cravings.

Currently, we are only offering semaglutide as a once-weekly subcutaneous injection. It may be available as an oral agent in the future, but we haven’t seen good studies on the oral form for weight loss. While some of you may be afraid of injections, these are actually quite straightforward injections with a VERY SMALL needle into the abdominal area (like insulin injections). There are big advantages to the once-weekly dosing - you don’t have to remember your medications and the semaglutide is working 24/7 suppressing your appetite without the stimulant effects of typical weight loss medication. The dosing schedule is the following: 0.25 mg/week for weeks 1-4; 0.5 mg/week for weeks 5-8; 1.0 mg/week for weeks 9-12; 1.7 mg/week for weeks 13-16; and 2.4 mg/week for subsequent weeks.

Most common side effects are: nausea, diarrhea, vomiting, constipation, stomach (abdomen) pain, headache, tiredness (fatigue), upset stomach, dizziness, feeling bloated, belching, gas, stomach flu, and heartburn. Note that most of these are manageable by proper dosing and some overlap with the intended effect of "feeling full".

There are only two qualifications for semaglutide:

A BMI over 30 and no weight-related complications

A BMI over 27 with weight-related complications

You can check your BMI online but a BMI of 27 corresponds to about 180 lbs in a 5'8" person and a BMI of 30 corresponds to 200 lbs in a 5'8" person. If your BMI does not quite meet those numbers, you may still qualify if your body composition determined in the office shows excess fat.

There are rare situations where semaglutide is contraindicated. Patients with a personal or family history of medullary thyroid carcinoma or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)

Semaglutide is not covered by most Medicare and insurance plans, but manufacturer and pharmacy coupons can help offset the cost. It currently is very expensive ($1300-1800 a month).

Dr. Brown has access to semaglutide from a compounding pharmacy for on-going use. The cost of the program is $400 for the first six weeks paid upfront ($400 - there is a six-week minimum) and $250 per 2.5 mg vial thereafter. Stated differently, the first 6 weeks cost only $400 (with cash discount). The next 5 weeks only cost $475 (with cash discount). Subsequent months cost anywhere from $250 to $1,000 based on how high of a dosage you desire for the goals you are wanting to reach. THESE PRICES INCLUDE THE MEDICATION AND OFFICE VISITS and are the best prices around (and much better than the cost of surgery or staying the same). The increase in price in later months is due to the increased dosing. While we do accept HSA plans, we do not take insurance or Medicare for payment for this service/product.