- Semaglutide is a medication that can help people lose weight when other strategies haven’t worked.
- Obesity doctors recommend starting with lifestyle changes like diet and exercise, or combining them.
- Other factors in weight should also be assessed first, including other health conditions and medications.
The weight loss drug semaglutide has been called a “game changer” for significant, sustainable weight loss in instances where more traditional lifestyle changes have failed to produce lasting changes, according to research.
Designed to treat diabetes, the medication was approved in June 2021 to treat obesity, quickly selling out.
It works by mitigating hormonal and metabolic changes that typically make long-term weight loss difficult, according to Dr. Rami Bailony, an obesity medicine specialist and CEO and co-founder of the obesity management platform Enara Health.
“It’s not a shortcut. What is does is make it so your biology rewards you instead of tries to fight you,” Bailony told Insider.
Most patients considering semaglutide have repeatedly tried to lose weight by other means, which can result in feelings of guilt, shame, or feelings of failure, endocrinologist and obesity medicine specialist Dr. Scott Isaacs told Insider.
“If someone is working really hard at losing weight and not getting anywhere, that’s the time when you’d want to see a specialist,” he said.
You can get the best weight loss results by working with a qualified obesity medicine doctor to assess all your potential treatment options, including lifestyle changes and other medications or conditions, before trying semaglutide, according to Bailony and Isaacs.
A sustainable diet is often the first step for healthy weight loss
The vast majority of patients requesting semaglutide or other weight loss medications have repeatedly tried different weight loss diets without success, the doctors said.
While many restrictive weight loss diets can work for a few weeks or months, people rarely stick to them over time and regain the weight (and sometimes more), research suggests.
“Anything you do temporarily, you’re going to get temporary results,” Isaacs said.
Isaacs recommends a reduced-calorie Mediterranean diet for health benefits like lower risk of disease — it’s flexible, allows enjoyable foods, and is rich in nutritious leafy greens, whole grains, and healthy fats.
But it can be tricky to lose weight and keep it off no matter how healthy your diet, because your body will often adjust hormones and metabolism in an effort to keep your weight stable, known as your weight set point.
“We often think of weight loss as an equation, but weight loss is more like a tug-of-war. You’re pulling, and eventually your weight set point will realize and start pulling back,” Bailony said.
Exercise is helpful for weight maintenance
While working out is commonly suggested for weight loss, research now indicates that exercise isn’t very effective for significant, long-term weight loss, since the body can adapt by burning fewer calories over time.
However, exercise is great for overall health and can also build and maintain muscle mass to keep your metabolism strong, especially if you do resistance training.
“Exercise doesn’t help much with initial weight loss but it’s very important to keep it off,” Isaacs said.
Check your medications — some can cause weight gain
As many as 20% of Americans may be on medications linked to obesity, research suggests.
The most common ones include:
Prioritizing sleep can help you reduce appetite and cut calories
Getting at least 7-9 hours of sleep per night is an underrated way to help manage weight, Isaacs said.
Sleeping well may significantly reduce your calorie intake, according to one study.
Get tested for underlying conditions that may interfere with weight loss
Other medical issues can contribute to or complicate obesity, including Cushing syndrome, hypothyroidism, and metabolic disorders.
Treating underlying conditions may not entirely resolve weight gain, but it’s important for overall health and wellbeing, Isaacs said.