The short version
- Semaglutide is a prescription medicine; it requires a medical evaluation and is prescribed and monitored by Dr. Hector Molina, MD.
- Wegovy is FDA-approved for chronic weight management in adults with obesity, or overweight plus a weight-related health problem; Ozempic is approved for type 2 diabetes.
- In the main trial, adults lost about 15 percent of body weight on average over 68 weeks, but results vary and weight tends to return when it is stopped.
- Common side effects are nausea, diarrhea, vomiting and constipation; it carries a boxed warning about thyroid C-cell tumors.
- The FDA does not review compounded semaglutide for safety, effectiveness or quality, so it is not the same as an FDA-approved product.
What is medical weight loss at our clinic?
Medical weight loss is a weight management plan supervised by a physician. At our Dallas clinic, it is run by our clinic physician, Dr. Hector Molina, MD, not by the chiropractor. Dr. Molina has more than 25 years of experience in general medicine, earned his medical degree at UT Southwestern Medical School, and has a special interest in preventive care.
For people who qualify, the plan may include semaglutide, a prescription medicine given as a weekly injection. Medicine is only one part. Eating habits, physical activity, sleep and follow-up visits all matter.
Why would a spine clinic offer weight loss care?
Extra body weight puts more load on the knees, hips and low back, and it is linked to type 2 diabetes and heart disease. Dr. Currington's approach includes combining adjustments with rehab, strengthening and sometimes weight loss. Having a physician on the team lets medical weight management be part of the same plan. Learn more about our team on the about page.
What is semaglutide and how does it work?
Semaglutide belongs to a class of medicines called GLP-1 receptor agonists. GLP-1 is a hormone your gut releases after you eat. Semaglutide acts like a long-lasting version of it. It slows how fast your stomach empties and acts on appetite centers in the brain, so you tend to feel full sooner and eat less.
For a deeper look at what kind of weight people lose on it, see our guide, does semaglutide burn fat?
Which semaglutide products are FDA-approved?
| Brand | FDA-approved uses |
|---|---|
| Wegovy | Chronic weight management in adults with obesity, or overweight plus a weight-related condition, and in children 12 and older with obesity; lowering heart attack and stroke risk in adults with heart disease and excess weight; a type of fatty liver disease called MASH with liver scarring |
| Ozempic | Blood sugar control in adults with type 2 diabetes; lowering certain heart and kidney risks in some of those adults |
Wegovy is used together with a reduced-calorie diet and more physical activity. Ozempic is not approved as a weight loss medicine, though weight loss is a known effect.
What results can you expect?
In the main trial of adults without diabetes, people taking semaglutide 2.4 mg weekly lost about 15 percent of their body weight on average over 68 weeks, compared with about 2 percent on placebo. Some lost much more and some much less. Results vary.
Weight tends to return when the medicine stops. In a follow-up, people regained about two thirds of their lost weight within a year of stopping. Obesity is a long-term condition, and treatment is often long term too.
What are the side effects and risks?
The most common side effects involve the digestive system. Dr. Molina increases the dose slowly to help your body adjust.
- Common: nausea, diarrhea, vomiting, constipation, stomach pain, heartburn, headache and tiredness.
- Serious but less common: inflammation of the pancreas, gallbladder problems, kidney injury from dehydration, severe stomach problems, allergic reactions, a faster heart rate and changes in eye health for people with type 2 diabetes.
- Before surgery or sedation: tell your care team you take semaglutide, since food may stay in your stomach longer.
Who should not take semaglutide?
It is not right for people with a personal or family history of medullary thyroid cancer or MEN 2, a past serious allergy to semaglutide, or a current or planned pregnancy. A history of pancreatitis, gallbladder disease, kidney disease, diabetic eye disease or an eating disorder needs careful discussion first.
Why does the evaluation matter, and what about compounded versions?
Semaglutide needs a prescription and a medical evaluation. Dr. Molina reviews your health history, medicines, weight history and goals, and orders lab work when needed. Follow-up visits track side effects, progress and dosing.
You may see compounded semaglutide advertised online. Compounded drugs are not FDA-approved, and the FDA does not review them for safety, effectiveness or quality. The agency has reported hospitalizations from dosing errors with these products. They are not equivalent to FDA-approved Wegovy or Ozempic.
How does exercise fit in?
Keeping muscle matters during weight loss. Strength work through physical rehab and enough protein help you hold onto lean tissue. Less weight may also reduce strain on painful joints, as discussed on our knee pain page. If joint pain limits exercise, medical pain management may be an option to discuss.
Conditions this is used for
Frequently asked questions
Wegovy is FDA-approved for adults with obesity, or with overweight plus at least one weight-related condition such as high blood pressure, type 2 diabetes or high cholesterol. The clinical trials used a body mass index of 30 or higher, or 27 or higher with a related condition. The final decision depends on a medical evaluation of your history, medicines and goals.
Both contain semaglutide and are made by the same company, but they are approved for different uses and come in different doses. Ozempic is approved to improve blood sugar control in adults with type 2 diabetes and to lower certain heart and kidney risks. Wegovy is approved for chronic weight management and to lower heart risks in some adults with heart disease and excess weight.
No. Compounded drugs are not FDA-approved, and the FDA does not review them for safety, effectiveness or quality before they are sold. The FDA has received reports of hospitalizations linked to dosing errors with compounded semaglutide. It advises using compounded drugs only when an approved product cannot meet a patient's medical needs.
Weight often comes back. In an extension of the main trial, people who stopped semaglutide regained about two thirds of the weight they had lost within a year, and improvements in blood pressure and blood sugar faded as well. That is why it is usually considered a long-term treatment, and why building eating and exercise habits matters.
Wegovy should not be used during pregnancy. The label advises stopping it at least two months before a planned pregnancy because the medicine stays in the body for a long time. If you become pregnant while taking it, stop and contact your physician. Discuss birth control and pregnancy plans during your evaluation.
Sources
- FDA label: Wegovy (semaglutide) prescribing information (DailyMed) (opens in a new tab)
- MedlinePlus: Semaglutide injection (opens in a new tab)
- FDA: Concerns with unapproved GLP-1 drugs used for weight loss (opens in a new tab)
- Wilding et al. 2021: Once-weekly semaglutide in adults with overweight or obesity, STEP 1 (PubMed) (opens in a new tab)
- Wilding et al. 2022: Weight regain after withdrawal of semaglutide, STEP 1 extension (PubMed) (opens in a new tab)
- NIDDK: Prescription medications to treat overweight and obesity (opens in a new tab)
This page is general education, not medical advice. It cannot replace an exam. Results from any treatment vary from person to person.
