Semaglutide tablets: What are they and how do they compare to injections?

Unless you've been off-grid or wandering in the wilderness, you've probably heard of semaglutide — a medication used to assist weight loss or help with conditions like diabetes.

As one of the active ingredients in the drugs known as Ozempic and Wegovy, semaglutide is being talked about more than ever before. But what actually is it, and how should it be used?

In this article, we'll filter through the hype and clickbait, and explore semaglutide in detail. We're all about empowering you with the facts, so you can make informed decisions for your health.

What is semaglutide?

Semaglutide is a type of drug/medication that mimics the body's hormonal response to eating. Our gut hormones control the release of insulin, which our body needs to convert the glucose/sugar in our foods into energy [1].

Originally, semaglutide was developed to help people with type 2 diabetes manage their illness. After medical experts realised it helped with weight loss in diabetic patients, semaglutide was also approved to be used as a weight loss medication in specific circumstances [2].

This includes people who sit within a certain body mass index (BMI) category and those who might be at risk of weight-related conditions such as hypertension, sleep apnoea, high blood pressure, and cardiovascular disease.

Semaglutide can be taken in 2 ways — as an oral tablet, or a subcutaneous injection (a needle beneath the skin) [2].

Nowadays, semaglutide has been having a full-blown hype moment, but it's important to remember that this is a medication, not a new diet trend. So let's put the headlines aside for a minute, and see what the science has to say.

How do semaglutide tablets work?

Semaglutide tablets can help with weight loss in a couple of ways. The first is blood sugar control —semaglutide encourages the body to make more insulin, which helps lower blood sugar [1].

Why is this important? Studies suggest that people who have high blood sugar (or unbalanced blood sugar) may be more prone to weight gain, or find weight loss challenging [3].

Semaglutide also works by regulating your appetite. Remember we said it could mimic hormones? Well, the hormone GLP-1 is the one that your body uses to figure out what to do when you're eating. One of its jobs is to let you know when you feel full [1].

By working on the same GLP-1 pathways, semaglutide can help your brain regulate appetite and send signals that you feel full. It also slows gastric emptying, which means you feel fuller for longer [1].

When combined with other factors like healthy eating and exercising, this can help people achieve their weight loss goals [1].

Pros and cons of taking semaglutide tablets

Now we know how they work, but why do people take them? Here's a handy little pros and cons list we prepared earlier.

Pros

• Enhanced weight loss (when combined with diet and exercise)
• Reduced risk/prevention of health conditions like cardiovascular disease, cancer, diabetes, and other illnesses that are linked to being overweight [1]
• Improved ability to engage in healthier habits, more confidence in the early stages of weight loss, and fewer barriers to getting started [4]
• Decreased mental health issues associated with being overweight [5]
• Reduced need for further medical procedures e.g. bariatric surgery [6]
• Improved quality of life and overall health for people who are overweight [2]
• No need for injections, more accessible and easy to fit into your schedule

Cons

• Not a fast fix or cure-all — weight gain can happen after stopping the medication, especially if lifestyle changes aren't introduced
• Can have potential side effects (see below)
• Can't be taken with certain medications or health conditions — such as gallbladder disease, thyroid cancer, pancreatitis, and others [1]
• Can't be taken during pregnancy or when planning to become pregnant [7]
• The cost of medication might be a barrier for some people [8].

So in a nutshell, semaglutide tablets might not be for everyone, but they can help people who need them. Before you decide if it's the right treatment for you, it's important to chat with your GP or trusted healthcare professional.

Comparing semaglutide tablets vs injections

While a lot of the current media buzz is about semaglutide injections, oral semaglutide is the quiet achiever. For people who might be afraid of using needles, or not able to inject themselves, oral medications can be a great option [9].

While studies suggest there isn't a huge difference in effectiveness between oral or injectable semaglutide, there are some major differences in how they need to be taken.

Depending on your lifestyle, preferences, and medical history, you can decide on which formulation suits you [9]. Let's break down what each treatment type looks like.

Dosage

Injectable semaglutide usually has a starting dose of one 0.25mg injection, once per week.

As your body gets used to the medicine, your doctor will start increasing the dose slowly (called dose escalation). Usually, this means moving through doses of 0.5mg, 1mg, and 1.7mg, until you get to the final 'maintenance dose' of 2.4mg [10].

For oral administration, the semaglutide starting dose is usually a 3mg dose once daily — then slowly increasing the dose to 7mg once daily. For some people, they may increase again to 14mg a day, depending on your needs [8].

How and when to take it

For the injectables, the process is pretty simple — you administer your injection once a week, and don't have to worry too much about the time of day or whether you've already eaten [10].

The tablets can take a little more to get the hang of, as there are specific instructions to follow.

You need to take the tablet whole on an empty stomach. This means taking it at least 30 minutes before the first food of the day and before drinks or other oral medicines. The tablet should also only be taken with a small amount of plain water (about 118ml or 4oz), and nothing else [8].

If you miss a dose of your semaglutide injection, it's important to try to take it as soon as possible after your last dose, and within 5 days of your previous dose. If it's been more than 5 days, you should skip that dose and take the next one according to your usual dosing schedule [11].

If you miss a dose of semaglutide tablets, don't take an extra dose. Just skip the missed dose, and take your next tablet as usual the following day [12].

Side effects

As with all medicines, there's a potential risk of side effects when you take semaglutide. These side effects can happen whether you're taking the tablets or the injections. Common side effects can include:

• Nausea and/or vomiting
• Abdominal pain
• Dizziness
• Blurred vision
• Dry mouth
• Fatigue
• Other gastrointestinal issues like diarrhoea, constipation, or increased gas/bloating
• Headaches

If you're experiencing any of these side effects, it's important to see your doctor for medical advice on how to manage them or explore whether your dose needs to be adjusted.

Rarer, but more serious side effects can include:

• Trouble breathing
• Thyroid tumours and increased risk of thyroid cancer
• Low blood sugar
• Kidney problems and kidney disease
• Inflammation of the pancreas
• Gallbladder problems
• Severe stomach pain
• Allergic reactions — e.g. swelling of the face, trouble swallowing, rashes or itching, or rapid heartbeat [13]

If you're experiencing any of the above symptoms, or think you might be having an allergic reaction, make sure you seek urgent medical attention.

It's also a great idea to get medical advice about side effects before starting and read over your medication leaflet to make sure you know what to look out for.

Effectiveness

There's been limited clinical trials directly comparing semaglutide injections to tablets in terms of their effectiveness. However, from the research available, patients treated with either type of medication appeared to achieve weight loss at similar rates [9].

Future studies may provide us with more insight, but for now, it means that choosing the right medication for you may depend more on personal preference and your doctor's recommendations.

Choosing the right medication for you

So now that you've got the scoop on how each medication stacks up, which one is the one to go with?

This can depend on lots of things: whether you're okay with needles, whether or not you're likely to remember a daily tablet, which dosing rules are more accessible for you, or what's more available in your area/what your doctor recommends.

Still not sure where to start?

We've already done all the groundwork! Juniper's Weight Reset Programme can take care of everything from prescription and dosing guidance to having our team of medical experts check in on how you're travelling and help you reach your goals.

Whether you're just gathering information for now or ready to take the next step, we hope you feel more confident to make some informed decisions about your weight loss journey. We're always here to help.

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