In last week’s Health Tip I introduced you to the semaglutides, the weekly injectable medications originally approved by the FDA for Type 2 diabetes, but when it was discovered how many users were losing 20% of their weight, began getting quick approval for “obesity”.
Both the New York Times and the Washington Post reprinted older articles and wrote new ones, praising the effectiveness and safety of the semaglutides. Definitely worth a read is the NYT reader ‘Comments’, section 776 in 3 weeks alone, one article addressing how the med reduces craving for both sugar and alcohol.
The brand names to keep track of are: Wegovy, Trulicity, Mounjaro, Ozempic. Both articles (as well as my Health Tip) were very critical of the price, $1,300 a month, not generally covered by health insurance unless you have Type 2 diabetes that has failed other treatments.
One NYT reader remarked how her health insurance would pay all the costs of weight loss surgery (including readmissions for complications), which ranges from $25,000-35,000, but wouldn’t cover the semaglutides.
With last week’s Health Tip, I received a slew of questions about the semaglutides. This always means that for every one person writing, there are ten more who “mean to write but don’t have time”.
How do the semaglutides work? They mimic a hormone (glucagon) that makes us feel full. Interestingly, this especially applies to sugar, and those foods that convert to sugar (high glycemic foods and alcohol).
What are the side effects? The commonest side effects are nausea and diarrhea which usually go away when dose is lowered. There can sometimes be constipation, so we may caution use in a patient with SIBO. Extremely rare side effects are thyroid tumors and inflammation of the pancreas, so we’d also not recommend in a patient with a history of thyroid tumor or pancreatic issues.
How much weight will I lose? The combination of your semaglutide injections and nutritional counseling should bring you down 20% in 3 months. This means if you weigh 180, you can expect to reach 144. Some patients lose more, others less. As you have likely figured out already, there are no guarantees in health care.
Aside from the obvious benefit of weight loss, what are other benefits? The most dramatic have been reductions in cholesterol, diabetes markers (hemoglobin A 1 c), and high blood pressure. Taking a semaglutide for life will add about 2-3 additional disease free years to your lifespan (as long as you have no contraindications).
How long will I need to stay on a semaglutide? Research studies have been showing two important facts. First, you can remain on a semaglutide until you are happy with your weight but the longer the better. We recommend a minimum of six months, but also recommend a taper off regimen that your provider will discuss with you. Second, like all weight loss programs, there is always the risk of gaining your weight back. Here at WholeHealth Chicago, we’ll be carefully monitoring this possibility and restarting your semaglutide if needed. We strongly advise lifestyle and behavior modifications that WholeHealth will support you with (diet, exercise, sleep, stress, etc.).
How much does it cost? To start, you will receive a 3 month supply of compounded semaglutide for $795 (self-pay but much less when compared with three months brand name products for $3900). This includes an initial consultation and follow up consultation (plus baseline labs billed to your insurance). The price comes out to less than $2.00 per unit (a very competitive price when seeing some other offerings of closer to $5.00 per unit).
How can compounded semaglutide be so less expensive? The basic molecule is produced by the human body, like ‘thyroid’, ‘cortisone’, or ‘insulin’ and is in the public domain. It’s only when Big Pharma ‘tweaks’ it (“Synthroid”) can they patent it and the price skyrockets.
Who’ll be in charge of my care? WholeHealth Chicago is the oldest integrative and functional medicine center in the Midwest. Your case will be supervised by our team of: M.D.’s, Nurse Practitioners, Functional Medicine Physicians, Naturopathic Doctors, Nutritionists, and more.
Oh, by the way. Next week’s Heath Tip: using peptides for better sex. No kidding. Don’t miss it.
Be well,
David Edelberg, MD