In addition to physical baseline requirements, Dr. Messer adds that patients should be screened for disordered eating, including binge eating and emotional eating. This type of added screening is important to ensure patients achieve weight loss in a healthy, sustainable way — both physically and mentally. She adds the only health conditions that would preclude the use of the shot are a history of gallstones, pancreatitis, or risk factors for medullary thyroid cancer. 

Are there side effects or risks to semaglutide?

Most users experience decreased hunger in the few days following the shot and typically find their hunger returning just in time for their next injection. Side effects can include nausea, constipation, diarrhea, belching, heartburn, and abdominal cramping. These effects are partially why physicians start semaglutide prescriptions with a low dosage, and gradually increase doses depending on tolerance. 

There are risks associated with semaglutide including worsening reflux, pancreatitis (likely caused by gallstones that develop in the setting of rapid weight loss), and increased chance of medullary thyroid cancer. Dr. Messer also warns patients currently prescribed other medications in the same class (GLP-1 receptor agonists) or diabetes medications (called DPP-IV inhibitors) against using semaglutide.

Both experts echoed the same sentiment: Semaglutide is meant to be used as a tool in addition to a calorie deficit and active lifestyle to achieve weight loss. Dr. Messer also shares a glimpse of her patients’ nutrition plan, which considers the side effects patients may incur: “[Since] Semaglutide has the potential to cause constipation, nausea, and reflux, I preemptively place my patients on high-fiber, low-fat, calorie-restricted diets to minimize the risk of these side effects. I also ask my patients to eat early dinners and minimize alcohol intake.”

Since rapid weight loss can negatively affect your metabolism and hormones, Dr. Frank explains it’s important to implement lifestyle changes along with the drug. “Like all medications, lifestyle changes are essential to ensuring safe and effective results,” he says. “While on these medications, one has to be cautious not to overeat as it can cause gastrointestinal upset. Semaglutide is merely a medical tool to be used in conjunction with good nutrition, diet, and exercise.”

As for the celebrities who’ve reportedly been using semaglutide but are not considered clinically obese, Dr. Frank advises against this type of use. “Using this drug to maintain a body weight that is low for one’s frame is not the intended purpose and is most likely a dangerous and unsustainable use of the medication,” he warns. In the end, using semaglutide solely for aesthetic purposes is considered off-label use, and hijacks a drug that is helpful for the actual health conditions the drug was created to improve. (There’s now even a shortage of semaglutide.) This drug — like all prescription drugs — should only be used when prescribed by a medical provider who thinks it’s truly necessary for a patient’s health.

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