Semaglutide nasal spray: Can it deliver the same weight loss results?

If you've almost run out of the room when your doctor mentions an injection, we're not judging.

Apparently wanting to avoid needles at all costs is more common than you think — around 25% of the world's population struggles with needle phobia [1].

With injection-based weight loss medications becoming more popular, it's no wonder people have been looking for alternatives. Enter: semaglutide nasal spray, the newest kid on the block. There's definitely been a buzz around this new way of taking weight loss medications, but is it effective? Or safe?

What is semaglutide?

Let's back it up a little for anyone who's new here. Semaglutide is a medication that helps with weight loss and is used for weight management and/or treating obesity.

You've probably heard of Ozempic  (used to treat diabetes) and Wegovy (used for weight management) — semaglutide is the main ingredient in these medications [2].

Semaglutide helps with weight loss by being a bit of a copycat. It's what's called a glucagon-like peptide (GLP-1), which means it mimics the hormones in our body that look after insulin levels, blood sugar, and feelings of fullness [2].

Up until now, semaglutide has been available exclusively as an injection that's taken once a week. So how did the nasal spray come about?

How does semaglutide nasal spray work?

It's pretty much what it sounds like — when taken as a nasal spray, semaglutide is inhaled through the nose instead of injected under the skin.

Like other nasal sprays (such as allergy or antihistamine sprays), a fine mist is sprayed into your nostrils and inhaled [3].

A quick Google search will make it seem as though nasal semaglutide works the same way as the injection, but it's important to know that the research is still very limited.

In general, the main way semaglutide helps with weight loss is to suppress hunger [2].

It also helps by slowing down the emptying of your stomach, meaning you feel fuller for longer — and want to consume fewer calories. And that pesky food noise that keeps you stuck in a loop all day? Semaglutide is known to help reduce that too [2].

Researchers have suggested there may be a few advantages of nasal semaglutide, including:

• It can be a more comfortable option for people who can't tolerate needles, have needle phobia, or are unable to inject themselves
• It might encourage people to stick to taking their medication regularly, being easier to administer than an injection
• Limited studies have stated that nasal medication might work faster than the injection — being absorbed more quickly into the body [4]

The crucial thing to note is that nasal semaglutide isn't MHRA or FDA-approved, as there hasn't been enough testing done on its safety. So how has it started showing up on the market?

Can you access semaglutide nasal spray in the UK?

The short answer is yes, you can — but it might not be safe to use. Semaglutide nasal spray isn't regulated in the UK, which means it hasn't been officially authorised for medical use [5].

Medications like Wegovy have become really popular since they were approved for weight loss treatment. This means they've been harder to get hold of, due to supply shortages [6].

Because of this, some pharmacists have started compounding their own versions of these drugs to meet the demand.

Compounding is a process where specialty pharmacies custom make medicines onsite, instead of dispensing the ones from larger manufacturers [6].

Compounding pharmacies have an important role to play in helping treat those who need specific doses of medications, or making up certain authorised medications when someone's medicine is unavailable [6].

The trouble with the shortage of these weight loss medications is that there have been reports of semaglutide being made with different active ingredients than the regulated version.

Some pharmacies have reportedly used things like research chemicals or unregistered ingredients to make compounded semaglutide formulations — like nasal sprays, oral drops, tablets, or compounded injections [7].

These new formulas haven't been through the same safety checking measures as the original injection, meaning they carry potential health risks.

For this reason, healthcare experts strongly recommend to avoid taking compounded semaglutide if you can [6].

Are there any side effects?

There have been reports of people overdosing or going to hospital because of dosing errors with compounded semaglutide.

This has happened when people have taken the wrong dose, been prescribed an amount that's different to the authorised guidelines, or they've been given the wrong dose by the pharmacist who made the medicine [5].

People have described experiencing nausea, vomiting, diarrhoea, abdominal pain, constipation, and other more serious side effects.

Aside from this, you might experience more common side effects like headaches, dizziness, fatigue, and minor stomach issues [8].

The importance of making sure your semaglutide is from a reliable source

We're not saying you should never consider a compounded medication (especially if a medicine you need is in shortage!) but it's really important to do your research first.

If you can, you should try to use an FDA-approved medication wherever possible [7].

Here are some other things to keep an eye out for when you're deciding where to source your semaglutide from:

Remember you always need a prescription for semaglutide

Avoid places offering the medication without it needing to be prescribed (in case it ends up being counterfeit medicine) [7].

Try to look for an accredited compounding pharmacy

These pharmacies have stricter regulations and have to be compliant with national safety standards, meaning the medicines they produce should be safer than non-accredited pharmacies [7].

Don't take anything advertised as generic

There are no authorised generic versions of semaglutide/Wegovy, so avoid taking any medicines claiming to be the generics of these brands [7].

Always check in with your GP or healthcare professional

You should always chat with a healthcare professional before taking any new medications — they can help you check you've got the right dose and make sure you know how to administer it properly  [7].

Don't have time for all that legwork? Let us do it instead. Juniper's team of health experts are here to help you find the right medication for you.

Juniper's Weight Loss Programme has all medication strengths available — prescribed by accredited clinicians. Depending on your needs and goals, they can help recommend the best treatment for you.

Our coaches and forums are also there to help you make the lifestyle changes that will support your weight loss journey.

Semaglutide nasal spray vs injection: Which one is more effective?

Honestly? It's too early to tell. There's new research that's testing the effectiveness of nasal semaglutide, but there are no conclusive results just yet.

Some of this research has been exploring nasal semaglutide and how fast it gets to your central nervous system.

Because your nasal cavity is close to your brain, scientists are suggesting that the nasal spray might be a more direct way to take the medication — helping it be absorbed into your system faster than the injection [4].

But opinions are still mixed. Other researchers point out that semaglutide has a large molecular size (when you look at it under a microscope, picture bigger blobs!).

This means it might not even be able to be absorbed properly, making it less effective than the injection [6].  

For people who really can't take the injectable form of semaglutide, nasal sprays might eventually be the way to go (once more research has been done). For now, though, it's clear that the injection provides the best results for weight loss [4].

Other strategies to help with weight loss

If there's one thing we know for sure, it's that medication alone (no matter which way you take it) doesn't lead to sustainable weight loss.

It's important to make some realistic goals and decide on changes that will work for you. This could be things like:

• Eating regularly, and choosing healthy meal options where you can
• Swapping out snacks for healthy alternatives (e.g. replace sweets with fruit)
• Limiting foods high in saturated fats, added sugar, or salt
• Finding a type of exercise you enjoy, and trying to do it regularly
• Limiting soft drinks, alcohol, and lollies
• Moving more throughout the day where you can — take the stairs, or go for a lunch break walk
• Drinking more water, and avoiding sugary drinks
• Choosing less processed foods and trying to 'eat the rainbow' or eat from the 5 food groups
• Considering your portions
• Identifying any triggers for overeating (e.g. stress, feeling upset, boredom) [9]

The most important thing is going at your own pace, and making sure you have the right support. The more realistic your goals are, the more likely you are to achieve them!

If we have to leave you with only one piece of advice, it's to always check in with your healthcare team about this stuff.

If you're considering any type of medication, make sure you ask questions until you understand how it works, what the ingredients are, and how you should be taking it — no question is too silly when it comes to your health.

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