What You Need to Know About Semaglutide

By Jamie Bussin 

Semaglutide is a drug originally conceived and marketed as a treatment for those with Type 2 Diabetes. Most recently it has shown to be effective in reducing the risk of heart disease. There is ongoing research indicating that it can help people manage addictive behaviour including gambling, alcohol and illicit drug use.

But it is probably best known as a drug that will help with weight loss. Many people who’ve struggled with obesity and weight management are getting great results. What people may not realize is that the drug is effective as long as it is taken continuously. Once you stop taking semaglutide the weight loss will likely reverse.

While the drug may seem like a magic bullet to those who are losing weight, because of the way the drug works there are lifestyle choices that should be made in order to remain healthy. I discussed this issue with the Tonic round table of experts on the Talk Show/Podcast: registered dietician Shauna Lindzon, chiropractor and rehab expert Sender Deutsch and natural health researcher David Nelson. This is a digest of our conversation.

Muscle Loss: While you can expect to lose weight while taking semaglutide, your weight loss will not consist only of fat. You can expect to lose muscle mass as well. 

So, it’s important that you counter that muscle loss. Sender recommends regular strength training at least three times a week in order to build back and maintain muscle. Strength training could include the use of free weights or machines or could be accomplished with body weight exercises. 

Unfortunately taking semaglutide also results in a loss of bone density, which is another reason to strength train. Those exercises not only increase muscle mass, which serves to protect the bones, but they also help build stronger bones.

Nutrition:  Those taking semaglutide report that they are eating less, because they are less hungry. Anecdotal evidence suggests that food intake is reduced by as much as 40%, which, on the face of it, seems great. But upon further investigation, it may be problematic.

Shauna sees patients whose appetites are suppressed to the point that they may be skipping meals.  This may or may not be a bad thing. But there is no doubt that if someone is eating 40% less food, it becomes more important that they are eating healthy nutritious foods in order to get all the necessary vitamins and nutrients.

Her focus is on making sure her patients are eating enough protein. Which of course, ties into building proper muscle mass. She recommends eating three meals a day, each of which includes 20-30 grams of protein. To counter the loss of bone density, Shauna recommends a diet rich in calcium and vitamin D (or supplementation). And to counter cramping due to muscle loss, she recommends supplementing with magnesium. 

As an emotional eater, who has struggled with weight issues my entire life, I wonder if people who are taking semaglutide for weight loss are inclined to gravitate towards comfort foods which are higher in fat and salt content, but perhaps lower in nutritional value. Which would compound the problem of getting proper nutrition. 

Mindfulness: Shauna thinks that whatever the reason for not eating a healthy diet, be it ignorance, lack of effort, or belief that the drug works well enough on its own, they should be eating mindfully. David agrees and adds that support should come from friends and family, who can help you navigate your weight loss and wellness journey. 

According to David, emerging research shows that polyphenols and probiotics in our gut are releasing components into our bodies similar to the GLP-agonists that are released by semaglutide. He thinks that encouraging the body to generate appetite suppressants naturally might one day be the way in which people can be weaned off of semaglutide.

Staying on the drug: Many people are taking semaglutide as it was prescribed, perpetually. However there are a cohort of people who are taking it temporarily, on purpose. Perhaps to lose that “last 10-20” pounds. 

Sender sees that patients tend to stay on the drug as long as they aren’t suffering from side effects, which can include nausea, diarrhoea, vomiting, cramping or constipation. Or they are prepared to suffer the side effects for the greater good.

David sees a different picture.  Approximately ⅓  have no problem with side effects and are achieving the desired results with the drug. While the remaining ⅔ aren’t seeing the results they wish or aren’t willing to live with the side effects.

Whatever your reason for taking semaglutide, be sure to follow the advice of your doctor or attending health practitioner and consider leading a healthy lifestyle.