GLP-1s work by mimicking the effects of natural GLP-1 hormones in the body, which help regulate blood glucose levels and cause weight loss. GLP-1, the pivotal hormone in this context, plays a crucial role in slowing down the rate of gastric emptying. Additionally, they not only stimulate the release of insulin from the pancreas but also inhibit a hormone responsible for prompting your liver to release sugar, known as glucagon. These combined actions have the effect of reducing your appetite, leading to a decreased food intake, and facilitating weight loss. GLP-1 also works on the pleasure pathways in the Hypothalamus to decrease cravings, specifically for sugar and carbohydrates, leading to more effective blood glucose control. Currently, brand name GLP-1 are approved by the Food and Drug Administration (“FDA”) for type 2 diabetes mellitus treatment, chronic weight management & heart disease.

Semaglutide was developed by Novo Nordisk and approved by the FDA for subcutaneous injection in December 2017. The tablet formulation was approved for oral administration in September 2019. The FDA does not approve or regulate compounded medications for safety, efficacy, or manufacturing practices. Novo Nordisk sells semaglutide as Ozempic® for only management of T-2 diabetes, and as WeGovy® for weight-loss management.

Semaglutide is a GLP-1 analogue with 94% sequence homology to human GLP-1. The principal mechanism in the long half-life is albumin binding, which results in decreased renal clearance and protection from metabolic degradation (DPP-4 enzyme). Maximum concentration is reached 1-3 days post dose and steady-state exposure is achieved following 4-5 weeks of once weekly administration.

What Are GLP-1 & GIP Medications