After years of struggling to lose weight, can I finally take a shortcut?

Recently, semaglutide injection for long-term weight management was officially launched in China, which is undoubtedly a major benefit for people who need to lose weight. Many netizens are eager to try it: "After years of struggling to lose weight, there is finally a shortcut."

Is this really the case?

For this purpose, a reporter from Chao News Qianjiang Evening News interviewed Yu Weihua, deputy chief physician of the General Surgery Department of Weight Loss and Metabolic Surgery Center of Zhejiang University Run Run Shaw Hospital.

Weight loss drugs have a "threshold"

Prescription drugs require face-to-face evaluation

"The use of semaglutide began as early as two or three years ago," Yu Weihua introduced, but it was used to treat diabetic patients. It had a significant blood sugar lowering effect and their weight also improved to a certain extent.

The newly launched "weight loss version" has the same ingredients as the "sugar-lowering version" and is packaged in different dosage forms.

Compared with diabetic patients, obese people account for a larger proportion and will also obtain a larger market.

In recent years, the prevalence of overweight and obese people in my country has continued to rise. According to the "Obesity Diagnosis and Treatment Guidelines (2024 Edition)" recently released by the National Health Commission, obesity has become a major public health problem in my country. The obesity prevalence among adults is 16.4%. Among children and adolescents aged 6 to 17, the overweight rate and obesity prevalence are 11.1% and 7.9%, respectively. The overweight rate and obesity prevalence of children under 6 years old are 6.8% and 3.6%, respectively.

Faced with such a large population, the prospects of semaglutide are quite promising.

However, as a prescription drug, there is a "threshold" for prescribing semaglutide in regular hospitals.

Yu Weihua introduced that in addition to diabetic patients who meet the requirements, obese people with a body mass index (BMI = weight ÷ height squared) greater than 28 are also eligible. "If the body mass index does not meet the standard, but the patient suffers from two or more metabolic complications, and the weight has not improved by adjusting the lifestyle, we will also use semaglutide appropriately."

At the same time, semaglutide also has contraindications. For example, it is contraindicated in patients with pancreatitis and thyroid tumors. "Don't let the patient lose weight and the tumor metastasize."

The use of drugs requires strict face-to-face consultation and evaluation by professional doctors, so Yu Weihua emphasized that prescription drugs must be treated with caution and purchased and used through formal channels.

Celebrities have "endorsed" it many times

Most people rebound after using it

Last year, Musk posted on Twitter that he had successfully lost weight, losing 20 pounds (about 9 kilograms) in just one month. In addition to fasting, the secret to losing weight was the use of semaglutide.

The endorsement of many celebrities has quickly made semaglutide become a "goddess".

As early as March 2021, NEJM, one of the top medical journals, published a global blockbuster clinical trial. Researchers conducted a randomized, double-blind, placebo-controlled trial in 16 countries around the world, and eventually included 1,961 adults with BMI ≥ 30 (or BMI ≥ 27 but with ≥ 1 weight-related disease, such as hypertension, dyslipidemia, obstructive sleep apnea, or cardiovascular disease), but all participants did not have diabetes.

Over the entire 68-week trial period, the semaglutide group lost an average of 14.9% of their body weight.

It is undeniable that this data is exciting.

"The principle of the drug is actually quite simple. One is to enhance the feeling of fullness, and the other is to slow down the rate of gastric emptying, thus achieving the purpose of weight loss." Yu Weihua introduced that the weight loss version of semaglutide is a weekly dose, and the efficacy will be halved in about a week. Drug resistance will appear, usually after 3 months, "Using semaglutide, the weight loss rate will slow down after about 2 months."

Medicine focuses on large samples, not individual cases. So when many people test and show encouraging results, Yu Weihua said that we need to treat temporary data rationally.

"Too many people have experienced a big rebound after stopping the medication." Yu Weihua said that the weight-loss version of semaglutide has just been launched, but many people have purchased it through other channels. Some people will continue to "discipline themselves" with the help of medication to maintain a healthy weight, while more people will "intensify" their enjoyment of delicious food after stopping the medication, and their weight will become uncontrollable and even heavier than before.

In the follow-up of the original clinical trial one year later, adults who had previously successfully lost weight experienced varying degrees of rebound, with the rate dropping from 14.9% to 5%.

"It is also important to remind you that not everyone can achieve good results after using semaglutide. Some people are not sensitive to the drug and their weight does not change after using it." Yu Weihua said, "Facts have proved that 'blocking is not as good as unblocking'. Weight loss cannot be achieved by suppression alone, but requires a combination of diet and exercise."

Expensive and not covered by medical insurance

Experts warn of using drugs with caution

Some people have prepared a lot of money to rely on semaglutide to achieve the goal of weight loss.

Indeed, semaglutide is not cheap.

This year, the official WeChat public account of the National Medical Insurance Administration published an article to answer the question of whether the "magic weight loss drug" will be included in the medical insurance: as a hypoglycemic drug, semaglutide is indeed included in the medical insurance; but as a weight loss drug, no matter how "magic" it is, it cannot be included in the medical insurance. The "Interim Measures for the Management of Basic Medical Insurance Drugs" clearly stipulates that there are 8 types of drugs that cannot be reimbursed by medical insurance, and drugs that mainly enhance sexual function, treat hair loss, lose weight, beautify, quit smoking, quit drinking, etc. "Improve living conditions" are one of them. In this sense, semaglutide can be reimbursed as a hypoglycemic drug, but it cannot be reimbursed by medical insurance when used as a weight loss drug.

As a drug, semaglutide has a weight loss effect, but it is also accompanied by corresponding side effects: nausea, vomiting, diarrhea and other gastrointestinal discomfort. Yu Weihua once again reminded that drug assistance is only a means. If you only want to pursue beauty, people who are not fat should not blindly use drugs. The ultimate and effective way is a healthy lifestyle.