How Semaglutide and similar drugs act on the brain and body to reduce appetite
GLP-1 analogues that were first approved to treat type 2 diabetes, like semaglutide (brand names Ozempic, Wegovy), have gained a lot of attention recently, largely because of their capacity to aid in weight loss. Thus far, research has indicated that GLP-1 analogues function by imitating the actions of glucagon-like peptide, a molecule with a similar shape that the intestines naturally release shortly after a meal. Because this peptide binds to a particular receptor on the surface of the pancreatic beta cells, it causes them to release insulin. For a very long time, researchers believed that GLP-1 analogues only had an effect on insulin release, which is why type 2 diabetes patients were prescribed them. Nonetheless, the impact these medications had on weight was soon recognized because reducing body fat can improve blood sugar regulation and even induce remission in type 2 diabetics. Recent research has shown that GLP-1 analogues contribute to weight loss in several ways, such as by delaying the emptying of the stomach and enhancing the feeling of fullness experienced after eating.
The other possible advantages of GLP-1 analogues have been the subject of extensive research in recent years, many of which may be related to their effects on obesity and body mass index (BMI). Individuals who use GLP-1 analogues may be at a lower risk of both cancer and cardiovascular disease, two conditions that are more common in obese people. Whether this is because of weight loss or other side effects of the medications is still unknown. More research is required to determine the primary causes of the weight gain, as there are still concerns about weight gain after stopping these medications. As these medications become more widely used and popular, we should expect to see more side effects as people meet their weight loss objectives.
Right now, research is being done to try and learn more about how these medications function. A recent review that was published in the International Journal of ObesityTrusted Source examined the body of research that has already been done on the subject, the methodology used in those studies, and the methods used to gather data on the use of GLP-1 analogs. The terms obesity, semaglutide, ligarglutide, and GLP-1 analog were searched for in PubMed by the authors to conduct the review. Liraglutide, also known as Saxenda, is a GLP-1 analog, just like semaglutide.
Researchers discovered that rather than focusing on the maintenance phase, which is when weight loss plateaus after this, most studies on the impact of GLP-1 analogs on weight loss focused on the initial weight loss phase of action, which typically lasts 12–18 months for semaglutide users. As of right now, scientists know that side effects like nausea and upset stomach usually start early in the course of treatment. However, a survey of the literature revealed that weight loss during the first few weeks of medication use did not appear to be associated with nausea. During the so-called maintenance phase that followed, users’ calorie intake was still found to be more restricted than baseline, even though the drug’s effect on reducing eating decreased after 12 to 18 months.
Researchers examined studies in which subjects taking the drug were questioned about their dietary preferences and cravings. They found that subjects wanted fewer foods overall, especially high-fat, non-sweet foods, and less dairy, starchy, salty, and spicy foods. The macronutrient profiles of the food consumed by the subjects did not change, though, either before or after the drug was started. Whether GLP-1 analogs increase the desire for sweeter foods—especially those that contain sucralose—is still unclear. The authors discovered that prior studies had demonstrated a reduction in the neuronal responses to food images in regions of the brain controlling reward and appetite in people taking exenatide (brand name Byetta), another GLP-1 analog. Using functional magnetic resonance imaging, this response was quantified (fMRI). Additionally, studies have demonstrated that semaglutide is not able to cross the blood-brain barrier, which shields the brain from outside influences. Rather, this medication blocks signals in areas of the central nervous system outside the blood-brain barrier that may influence appetite.
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