by Cristina Brown
Two studies evaluated the efficacy of high-dose semaglutide taken orally: 15% of body weight lost. Evidenced side effects such as gastrointestinal problems and tingling
Could losing weight become as simple as popping a pill? Injectable (and often unobtainable for diabetics) semaglutide-based drugs, known for their ability to induce weight loss, could be taken orally. Two new research published in The Lancet and presented during the American Diabetes Association meeting showed that in obese or overweight people who want to lose weight, taking 50 milligrams of semaglutide orally every day works more or less like the weekly injections that contain 2, 4 milligrams of active ingredient. The pill is taken 30 minutes before eating or drinking in the morning.
Weight loss and dosages
In the first study 667 obese or overweight people with at least one related disease but no diabetes were monitored for 16 weeks. The volunteers who took the 50-milligram daily pill lost about 15 percent of their body weight, about six times that of the placebo group.
Il second job instead, it focused on oral semaglutide dosages in relation to people with type 2 diabetes. Just over 1,600 participants were divided into three groups and received daily doses of 14 milligrams, 25 milligrams, or 50 milligrams. Those who took the 25 and 50 milligram doses lost more weight and had greater blood sugar reductions than those who took the lower dose. Both studies were funded by Novo Nordisk, the company that makes two semaglutide-based drugs.
The gastrointestinal side effects
The magic pill that makes you lose weight could appear as a breakthrough for those who want to lose weight, diabetic or not, and are afraid of needles. However, side effects emerged during the two trials. The higher the dose of oral semaglutide you take, the more side effects you experience.
In the study evaluating overweight or obese people, 80 percent of those who took semaglutide by mouth reported gastrointestinal problems such as vomiting, nausea, constipation, or diarrhea. Nearly 13% said they experienced altered skin sensation that resembled a pins and needles. The majority of study participants were white and female, which means, according to the authors, that the findings may not apply to the broader population of people with obesity.
Similar side effects emerged in the study involving volunteers with diabetes: 80% of those who took the 50 milligram dose reported adverse effects, the most frequent being gastrointestinal problems, which occurred more often in people who they took the highest doses compared to those who took 14 milligrams of the active ingredient. 13% of people who took 50 milligrams stopped taking the drug due to side effects. It should be mentioned that injectable semaglutide causes similar side effects. In one previous study 74.2% of participants who received 2.4 milligrams of injectable semaglutide each week (the amount contained in one of the commercial drugs) experienced gastrointestinal complaints.
How semaglutide works
Semaglutide is a GLP-1 receptor agonist, which stimulates insulin production after a meal or only when carbohydrates are introduced; for this reason it does not cause sudden drops in blood sugar. It also slows down gastric emptying by increasing the sense of satiety and, by acting on the appetite centers in the central nervous system, reduces hunger.
Low-dose oral semaglutide is already on the market
Oral semaglutide is not really new: it already exists in tablet form on the market, even in Italy, and is approved only for adults with type 2 diabetes who take a 14 milligram tablet a day. The pills work similarly (but less effectively) to semaglutide injections.
The benefits of oral formula
Pharmaceutical company Novo Nordisk said it plans to file for approval for a diet pill in the US later this year and it is currently unclear when and if the higher-dose pill will hit the market or even how much it will cost. Certainly the oral formula will allow more people to take the drug, even for those who are just overweight and don’t have diabetes, even if the goal, beyond the desired weight loss, should be to stay healthy with the positive action on blood sugar and the protection of the cardiovascular system thanks to the reduction of parameters such as pressure, blood fat, abdominal circumference.
Semaglutide stocks
At the moment in Italy the use of semaglutide-based drugs in obese patients who are not suffering from diabetes is off-label or outside the permitted indications, because in order to protect people with diabetes, Aifa allows them to be prescribed only in the case of diabetes of uncontrolled type 2, as an adjunct to diet, exercise and possibly other medicines. The trend born on social networks of the weekly injection to lose weight quickly promoted by celebrities and influencers has in fact led to the shortage of the drug for patients who really need it: diabetics. Stocks are increasingly reduced and shortages in supplies will be possible at least throughout 2023.
June 27, 2023 (change June 27, 2023 | 1:09 pm)
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