If only one could be slim, looking a bit slimmer makes one appear more spirited and attractive. More importantly, obesity not only damages one’s appearance but also affects health. It is well known that obese individuals are more prone to diseases such as hypertension, diabetes, coronary heart disease, stroke, cancer, and obstructive sleep apnea.
What’s worse is that the number of obese individuals in China is increasing. As early as March this year, the National Health Commission released the “Adult Obesity Nutritional Guidelines (2024 Edition),” stating that the overweight and obesity rates among Chinese residents aged 18 and above have reached 34.3% and 16.4%, respectively, showing an increasing trend.
Why are there more fat people? Some say it is mainly due to genetics, but in reality, genetic obesity is not that common. Most obese individuals have unhealthy lifestyle habits. If one can’t control their diet and exercise, how can they not be fat?
Many fat people find it very difficult to lose weight once they gain it. The reason is simple: for scientific weight loss, controlling diet and exercising are fundamental. For obese individuals, these two aspects are even harder, and the challenge lies in the long-term commitment. Many people simply cannot persist long term, leading their weight loss plans to end in failure.
As medical advancements continue, obese individuals are turning towards medical interventions to control weight. For severely obese individuals, procedures like gastric reduction surgery are an option to control appetite by reducing stomach size. Additionally, some opt for medication treatments like the popular semaglutide injection, known as sema, for weight control.
Semaglutide injection, approved in China for treating type 2 diabetes in April 2021, faces scarcity post-market due to use not only by diabetes patients but also by many obese individuals. The question arises: Can semaglutide injection truly aid in weight loss?
The situation in China differs from the US, where the FDA approved semaglutide for treating common obesity or overweight back in 2014. However, in China, it was initially approved only for type 2 diabetes treatment, not weight loss. Regardless, many obese individuals use it off-label just because they desire to lose weight.
First, can semaglutide truly aid in weight loss?
Semaglutide can indeed help in weight control. This is because semaglutide is a “glucagon-like peptide-1 receptor agonist (GLP-1RA),” which continuously activates GLP-1 receptors throughout the body. Activation of these receptors significantly suppresses appetite, increases satiety, delays food emptying from the stomach, and promotes the burning of visceral white fat for energy.
Therefore, after injecting semaglutide, many obese individuals experience notable appetite suppression, discomfort with overeating due to slowed food digestion, and weight control.
Clinical studies like the global large-scale semaglutide study series STEP, which included around 25,000 overweight and obese participants, showed an average weight reduction of 17% (16.8kg) with semaglutide usage, lasting up to 16 months.
Second, does semaglutide have side effects?
Semaglutide is not entirely safe. In a study published by Harvard University researchers in JAMA Ophthalmology on July 3, 2024, it was noted that individuals prescribed semaglutide for diabetes or weight loss have a higher risk of nonarteritic anterior ischemic optic neuropathy (NAION) compared to non-users.
Long-term semaglutide use can lead to gastrointestinal discomfort, impact vision, induce acute pancreatitis, cause hypoglycemia, malignancies, and a side effect known as “semaglutide face,” where rapid weight loss leads to facial fat reduction and resultant facial changes.
Third, weight rebound post-sema cessation is common.
From my perspective, using semaglutide for weight control is not a complete weight loss solution. Any weight loss effort should be based on diet control and exercise. Using semaglutide may appear to be an easy way to lose weight, but cessation can lead to weight rebound.
Some may wonder, can’t one continuously use semaglutide for weight control?
The issue is semaglutide has certain side effects. So, persistently using the injection just for weight management— does the benefit outweigh the risks it brings?
Fourth, the weight-loss version of semaglutide has been approved for sale in China.
On June 25th, the National Medical Products Administration (NMPA) approved the injection formulation of “Nohygenic” developed by Danish biopharmaceutical company Novonordisk for long-term weight management with semaglutide injection in China.
This signifies an expansion in the indications for semaglutide in China from solely treating type 2 diabetes to aiding in weight loss.
However, not all obese individuals are suitable for using semaglutide or even require it.
In general, individuals who should consider semaglutide injection should meet one of the following criteria: BMI≥30kg/m² for obese individuals, or BMI 27kg/m² to <30kg/m² with at least one comorbidity (diabetes, hypertension, dyslipidemia, obstructive sleep apnea, or cardiovascular disease). Remember, even if you decide to use semaglutide for weight control, always bear in mind diet control and exercise. These are essential lifestyle habits. Otherwise, weight rebound is highly probable, even if you manage to lose weight.
