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> Semaglutide, sold under the brand name Ozempic among others, is an anti-diabetic medication used for the treatment of type 2 diabetes and chronic weight manag

> Semaglutide, sold under the brand name Ozempic among others, is an anti-diabetic medication used for the treatment of type 2 diabetes and chronic weight management. [1] > Semaglutide acts like human glucagon-like peptide-1 (GLP-1) such that it increases insulin secretion, thereby increasing sugar metabolism. It is distributed as a metered subcutaneous injection in a prefilled pen or as an oral form. One of its advantages over other antidiabetic drugs is that it has a long duration of action, thus, only once-a-week injection is sufficient. [1] > Side effects including nausea, vomiting, diarrhea, abdominal pain, and constipation may occur. In people with heart problems, it can cause damage to the back of the eye (retinopathy). Side effects include kidney problems, diabetic retinopathy, allergic reactions, low blood sugar, and pancreatitis. [1] > Warning: Risk of Thyroid C-Cell Tumors - In rodents semaglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures. It is unknown whether semaglutide causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined. [2] [1] https://en.wikipedia.org/wiki/Semaglutide https://en.wikipedia.org/wiki/Semaglutide [2] https://www.drugs.com/sfx/semaglutide-side-effects.html https://www.drugs.com/sfx/semaglutide-side-effects.html

rich-cartwright 5y ago
Yep Semaglutide is the key medication. Important to emphasize it appears to be a safe medication.
- gnicholas 5y ago
  What is the evidence on safety? The side effects sound potentially pretty serious, and as if the likelihood goes up the longer you take it. If this has only been around for a couple years, I'm not sure I'd jump on this just yet. More details would be useful!
  - lharries 5y ago
    (Richie's co-founder here) Semaglutide was FDA approved for diabetes in 2018 (3 years ago) and in June this year for weight management. It's part of a class of medication called GLP-1 RAs which operate in a similar way (they all stimulate the same GLP-1 receptor). Liraglutide is another common one that was approved by the FDA in 2010 (11 years ago) for diabetes (by the EU in 2009) and for weight management in 2014. So there is a 3 year of history with this particular medication and an 11 year history for this class of medication. Here's more about the history of GLP-1s and other weight loss if you'd like: https://blogs.sciencemag.org/pipeline/archives/2021/02/15/glp-1-and-obesity https://blogs.sciencemag.org/pipeline/archives/2021/02/15/gl... The main side effects that people seem to get are nausea and vomiting when adjusting to the dose, this is likely due to the slowing down of food leaving your stomach. This is documented in the study of nearly two thousand people which lasted for 68 weeks here [1] (where you can also see the other side effects). It's worth noting that, as with any medication, there is a cost-benefit trade-off. In this case it will depend on someone's current weight, what they've tried in the past, and the risks of other conditions e.g. heart disease, diabetes, and their past medical history. Each person that joins Fella has an in-depth discussion about this with an independent obesity physician and is welcome to speak it through with their own PCP too. https://www.nejm.org/doi/full/10.1056/NEJMoa2032183 https://www.nejm.org/doi/full/10.1056/NEJMoa2032183
    - gnicholas 5y ago
      Thanks for your candor. It would be interesting to see what positive effects can be achieved for what types of patients at various different dosing levels. I'm not at a weight where I'd want to add additional cancer risk in order to lose weight, and unfortunately the data on this sort of incremental risk probably takes decades to be fully realized. Perhaps I'd feel comfortable taking a smaller dose if there were a shorter-than-ideal track record of people taking larger doses without much additional risk.
      - rich-cartwright 5y ago
        Agree it's early days in terms of longitudinal follow-up studies. We're looking forward to playing a part in those studies ourselves.

rich-cartwright 5y ago

Yep Semaglutide is the key medication. Important to emphasize it appears to be a safe medication.

gnicholas 5y ago
What is the evidence on safety? The side effects sound potentially pretty serious, and as if the likelihood goes up the longer you take it. If this has only been around for a couple years, I'm not sure I'd jump on this just yet. More details would be useful!
- lharries 5y ago
  (Richie's co-founder here) Semaglutide was FDA approved for diabetes in 2018 (3 years ago) and in June this year for weight management. It's part of a class of medication called GLP-1 RAs which operate in a similar way (they all stimulate the same GLP-1 receptor). Liraglutide is another common one that was approved by the FDA in 2010 (11 years ago) for diabetes (by the EU in 2009) and for weight management in 2014. So there is a 3 year of history with this particular medication and an 11 year history for this class of medication. Here's more about the history of GLP-1s and other weight loss if you'd like: https://blogs.sciencemag.org/pipeline/archives/2021/02/15/glp-1-and-obesity https://blogs.sciencemag.org/pipeline/archives/2021/02/15/gl... The main side effects that people seem to get are nausea and vomiting when adjusting to the dose, this is likely due to the slowing down of food leaving your stomach. This is documented in the study of nearly two thousand people which lasted for 68 weeks here [1] (where you can also see the other side effects). It's worth noting that, as with any medication, there is a cost-benefit trade-off. In this case it will depend on someone's current weight, what they've tried in the past, and the risks of other conditions e.g. heart disease, diabetes, and their past medical history. Each person that joins Fella has an in-depth discussion about this with an independent obesity physician and is welcome to speak it through with their own PCP too. https://www.nejm.org/doi/full/10.1056/NEJMoa2032183 https://www.nejm.org/doi/full/10.1056/NEJMoa2032183
  - gnicholas 5y ago
    Thanks for your candor. It would be interesting to see what positive effects can be achieved for what types of patients at various different dosing levels. I'm not at a weight where I'd want to add additional cancer risk in order to lose weight, and unfortunately the data on this sort of incremental risk probably takes decades to be fully realized. Perhaps I'd feel comfortable taking a smaller dose if there were a shorter-than-ideal track record of people taking larger doses without much additional risk.
    - rich-cartwright 5y ago
      Agree it's early days in terms of longitudinal follow-up studies. We're looking forward to playing a part in those studies ourselves.