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SEMAGLUTIDE FOR WEIGHT LOSS

Updated: Mar 28

Over 70% of the adult population in the Unit-ed States is overweight or obese—OVER 70%. Obesity-related conditions include heart disease, stroke, type 2 diabetes, and certain types of cancer. These are among the leading causes of preventable, premature death. The estimated annual medical cost of obesity in the United Stated was nearly $173 billion in 2019, and medical costs for obese adults were $1,861 higher annually than medical costs for people of healthy weight.


Our mission at Norland Avenue Pharmacy is to glorify God by educating and providing our community with solutions that improve quality of life. It is impossible to live out this mission without addressing weight and weight loss.


In 2021 the FDA approved a new medication to treat chronic weight management: Semaglutide. Originally used to treat type 2 diabetes, Semaglutide is in a class of medications known as glucagon-like peptide-1 receptor antagonists or GLP-1 RAs. You may know this medication by the name Ozempic (used for type 2 diabetes) or Wegovy (used for weight loss). While both of these versions are weekly injections, there is also an oral tablet called Rybelsus; however, per the labeling, only up to 1% is absorbed through your gut when taking Rybelsus orally.


While Semaglutide is not a miracle drug and is not a one-size-fits-all solution for everyone, it is good to see the medical world start to view obesity as a disease. It requires life-long treatment and support—not leaving it up to the patient’s willpower alone to correct.


Semaglutide works by decreasing your appetite and reducing inflammation. It mimics the GLP-1 hormone released in your gut when you eat. In larger amounts, these hormones interact with the part of your brain that suppresses appetite and signals the feeling of fullness. In other words, you will feel full sooner during your meal and you will feel full longer after. Semaglutide also helps your pancreas produce insulin and prevents your liver from producing too much glucose resulting in blood sugar stabilization.


When combined with diet and exercise, Semaglutide has been known to help with significant weight loss and a reduced risk of cancer, type 2 diabetes, heart disease, stroke, and kidney disease in obese patients. In one study of 2,000 obese adults, after 68 weeks half of the patients that combined Semaglutide with diet and exercise changes lost 15% of their body weight. Another third lost 20% of their body weight. Compared to those who only made diet and exercise changes and lost just 2.4% of their body weight, these are exciting numbers.


There are some concerns. Aside from having to inject the medication each week, patients have also reported side effects including dizziness, fatigue, diarrhea, constipation, gassiness, headaches, nausea, vomiting, stomach pain, distension/bloat, and burping. Some of these side effects can be addressed by starting at a lower dose and titrating to a higher dose over time. Patients with a history of medullary thyroid cancer, gallbladder disease, pancreatitis, or multiple endocrine neoplasia syndrome type 2 (MEN 2) should avoid Semaglutide altogether.


In order to get a prescription for the name brand medications, you must have a BMI of 30 or higher OR a BMI of 27 or higher plus at least one weight-related health condition (i.e. high blood pressure, type 2 diabetes, high cholesterol, etc.).


The amazing results have led to the popularity of these medications skyrocketing. As a result, they have been on the FDA’s drug shortage list since April of 2022. These medications can also be quite expensive and insurance companies are making people jump through hoops before they will help cover the cost—another hurdle in being able to get them in the hands of patients who need them.


We are excited to announce that we are now offering a compounded sublingual Semaglutide suspension. In other words, through our membership in the Professional Compounding Centers of America (PCCA) and the Compound Licensing Group, we are able to custom make Semaglutide into a liquid that you hold under your tongue once a day. We combine Rybelsus and a patented base called Submagna HMW that was specifically designed to help high molecular weight active ingredients, like Semaglutide, get absorbed through oral tissue.


There are a few important things to note. First, the compounded version still requires a prescription from a physician. Second, we do not bill insurance for this compounded solution. The positive side of that is that your physician can decide to prescribe compounded Semaglutide without being constrained by your insurance’s requirements for BMI or health conditions. And, finally, there is no patent violation issues with the compounded sublingual version as there have been with compounded injectable versions that other pharmacies have attempted to make.


To learn more, visit www.subsema.com or give us a call anytime and ask for our compounding pharmacist, Tony.




*These statements are culmination of the knowledge and experience of the team at Norland Pharmacy. The information provided here is for informational purposes only. Please consult your healthcare provider with questions concerning any medical condition or treatment. Compounded medications are not reviewed by the FDA for safety or efficacy. 

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