Many of us are looking to shed some extra weight, as typical fixes such as diet and exercise sometimes do not cut it. Thankfully, there are several medications on the market that while not FDA-approved for weight loss, demonstrate significant results when it comes to losing weight. Rybelsus is one of these available medications which will be discussed in this article.

What is obesity?

Obesity is a multifaceted disorder characterized by too much fat accumulation in the body. Defined as a body mass index (BMI) over 30, obesity can affect individuals physically, mentally, and socially. Worldwide in the year 2000, over 300 million individuals suffered from obesity. This is an increase of 100 million since 1995. Consequently, more than 115 million individuals experience health issues related to their obesity. Likewise, many consider the prevalence of obesity to be an epidemic.

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Whether you suffer from obesity or are overweight, keeping on the excess pounds can be damaging both physically and psychologically. Obesity significantly increases your risk of diseases such as diabetes, high blood pressure, stroke, cardiovascular disease, and certain types of cancer. In addition, being overweight or obese can contribute to poor mental health, correlating to things such as depression, eating disorders, low self-esteem, stress, poor body image, and a lower quality of life.

Because of the profound impact weight can have on quality of life, both researchers and the general public have sought answers to this epidemic. While diet, exercise, and lifestyle contribute to weight, sometimes these are not enough. Certain medications have emerged as potential weight loss solutions in recent years, providing a potential treatment option for patients. One such drug is Rybelsus, which will be discussed further in this article.

What is Rybelsus?

Rybelsus contains an active ingredient known as semaglutide, which is classified as a glucagon-like-peptide 1 (GLP-1) agonist. Being that it is an agonist, it works similarly to GLP-1, a compound that your body naturally produces. GLP-1 works to activate insulin release, thus helping to control and manage your blood sugar levels. It also can prolong stomach emptying, thus affecting your appetite and satiety.

Currently, the Food and Drug Administration (FDA) has approved Rybelsus for type 2 diabetes mellitus. Type 2 diabetes occurs when your body does not utilize insulin appropriately, causing blood sugar dysregulation. Rybelsus works in diabetes by activating insulin production in response to increased blood sugar levels. It also lowers blood sugar release in the liver and delays gastric emptying in the stomach.

Although Rybelsus is indicated for type 2 diabetes, studies show that its beneficial effects may extend beyond just blood sugar control. Certain research indicates that Rybelsus can induce weight loss in addition to managing glucose levels. Though the FDA has not approved Rybelsus for weight loss, some healthcare providers may prescribe Rybelsus for weight loss off-label.

How does Rybelsus contribute to weight loss?

As previously mentioned, Rybelsus slows gastric emptying. Gastric emptying refers to the process in which your stomach contents move through the digestive tract. By slowing this process, you can increase feelings of satiety, thus lowering your appetite. In turn, you may eat less and thus lose weight.

What do studies show with Rybelsus?

Several clinical trials have evaluated how Rybelsus affects weight. The STEP program is a series of studies that aim to answer this question. The details and results of these four studies are as follows:

  • STEP 1. This trial enrolled 1,961 patients. Results were published in 2021, in which participants lost an average of 14.9 percent of their body weight while treated with semaglutide 2.4 mg for 68 weeks. This is a significantly different amount than the placebo group, which lost an average of 2.4 percent of their body weight. It is also important to note that both treatment arms also implemented lifestyle interventions. In summary, 86.4 percent of individuals treated with semaglutide lost a minimum of five percent of their body weight.
  • STEP 2. This trial included 1,210 individuals with diabetes who were either overweight or obese. This trial also evaluated a 1 mg dose in addition to the 2.4 mg dose. Individuals lost 9.64, 6.99, and 3.42 percent of their body weight with the 2.4 mg dose, 1 mg dose, and placebo, respectively. Likewise, the higher dose proved to be a bit more effective than the approved 1 mg dose.
  • STEP 3. In this trial, 611 patients received either semaglutide 2.4 mg or placebo in addition to intensive behavioral therapy. Semaglutide-treated individuals lost an average of 16 percent of their weight, while placebo-treated individuals lost an average of 5.7 percent of their weight. Additionally, 86.6 percent of semaglutide-treated participants lost a minimum of 5 percent of their body weight versus 47.6 percent in the placebo group.
  • STEP 4. This trial treated all patients with 2.4 mg of semaglutide for the first 20 weeks and then randomly assigned individuals to semaglutide or placebo for the last 48 weeks. Continuation with semaglutide was associated with an added 7.9 percent reduction in weight whereas the placebo cohort regained roughly 6.9 percent of their weight.
  • STEP 5. This trial evaluated how semaglutide treatment sustained weight loss over two years. Semaglutide continued to lower weight up until week 60, after which this weight was sustained up until week 104.
  • STEP 6. This trial focused on the efficacy of semaglutide on weight loss in Asian populations. Results demonstrated reductions of 13.2, 9.6, and 2.1 percent in semaglutide 2.4 mg, semaglutide 1.7 mg/week, and placebo, respectively.

Aside from these published studies, several other studies evaluating Rybelsus for weight loss are pending publication or are currently active. Results from these trials will help to further characterize the weight loss effects of Rybelsus, thus informing clinical decision-making and weight loss strategies.

What are the side effects of Rybelsus?

Just like any medication, Rybelsus has a risk of certain side effects. These effects range from minor to more severe. Minor side effects of Rybelsus include nausea, vomiting, diarrhea, constipation, stomach pain, or loss of appetite. Other more serious side effects include issues relating to low blood sugar, kidney issues, allergies, vision problems, thyroid cancer, and pancreas inflammation (5).

If you experience any side effects associated with Rybelsus treatment, you should contact your doctor. More minimal side effects may require a simple decrease in dosage, while more serious effects may warrant discontinuation of the medication.

Are there other medications I can take to lose weight?

Rybelsus is not the only medicine available for weight loss. There are a few other marketed drugs available that have been shown to shed pounds. Metformin, for example, is another medication indicated for those with diabetes. However, studies have demonstrated that it can also have a significant effect on weight. Other medications, like phentermine and orlistat act as appetite suppressants and thus can curb cravings helping you to lose weight.

It is important to note that you should consult with your healthcare provider before starting any medication. Certain medications have contraindications or drug-drug interactions that can affect how they work or make them unsafe to use. It is also important to implement other weight loss strategies in addition to medication to maximize the potential benefit.

Other alternatives to Rybelsus include:

How else can I lose weight?

It is important to note that the trials studying Rybelsus evaluated its effects in addition to lifestyle changes. Diet and exercise, amongst other lifestyle factors, are important to your weight loss journey whether or not you take Rybelsus. To effectively start losing weight, consider implementing:

  • A healthy diet. A nutritious diet, full of natural whole foods, is a key component to a healthy lifestyle and weight loss. Integrate a minimum of four servings of veggies and three servings of fruit a day. Switch out refined grains for whole grains, and implement healthy fats like olive oil, nuts, and avocado. Avoid processed and refined food and lower your intake of added and refined sugar.
  • An effective workout routine. Adding regular physical activity in addition to a low-calorie diet can help you shed the pounds. Experts recommend a minimum of 40 minutes of aerobic exercise most days of the week.
  • Get a good night’s sleep. Research shows that individuals who do not get enough sleep have a greater chance of obesity compared to those who get a full seven to eight hours a night. One study found that over 16 years, women who slept five hours or less had a 15 percent increased risk of obesity versus those who got a full night of sleep.
  • Find a support system. Starting and sticking to your weight loss journey and following through on your goals is no easy feat. Having individuals in your social network that support or join you in this journey can be helpful. You can also turn to your healthcare providers, who can assist you in developing weight loss strategies, be it with diet, exercise, and/or medication.