Oral semaglutide is the pill form of the drug semaglutide. You may already be familiar with semaglutide under the brand names Ozempic® (for diabetes) or Wegovy® (for weight loss), both of which are injectables. The oral version was previously available for diabetes management (under the brand name Rybelsus®), but this new FDA approval specifically authorizes a high-dose oral formulation for chronic weight management.

This medication belongs to a class of drugs known as GLP-1 receptor agonists. It works by mimicking a naturally occurring hormone in your body called glucagon-like peptide-1 (GLP-1). This hormone plays a crucial role in regulating appetite and blood sugar.

Mechanisms of Weight Loss:

1. Appetite Suppression: The medication targets the hunger centers in the brain, significantly reducing cravings and the desire to eat.

2. Slower Gastric Emptying: It slows down the speed at which food leaves your stomach. This helps you feel fuller faster and stay satisfied for longer periods after a meal.

3. Blood Sugar Regulation: By improving how your body handles insulin and sugar, it prevents the blood sugar spikes and crashes that often trigger hunger.

Unlike older weight loss pills that acted as stimulants, oral semaglutide works with your body’s metabolic signals to help you naturally reduce your caloric intake without the constant struggle of willpower.

While this new pill is a game-changer, it is a medical treatment intended for specific individuals. Dr. Abbasinejad evaluates every patient personally, but generally, the ideal candidate falls into one of the following categories:

• BMI Criteria: Adults with a Body Mass Index (BMI) of 30 or higher (obesity), or a BMI of 27 or higher (overweight) who also have at least one weight-related medical condition, such as hypertension, high cholesterol, or type 2 diabetes.

• Needle Aversion: Individuals who have avoided GLP-1 therapy solely because they are afraid of needles or uncomfortable with self-injections.

• Travelers and Busy Professionals: People who find managing refrigerated injectable pens difficult due to frequent travel or unpredictable schedules. A daily pill bottle is often easier to transport and store.

• Previous Struggles: Patients who have tried diet and exercise alone but have been unable to sustain significant weight loss.

This medication is not suitable for patients with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

Top Benefits of FDA-Approved Oral Semaglutide for Weight Loss Treatment

The approval of oral semaglutide brings several distinct advantages to the table for our patients in Fayetteville and the surrounding areas:

1. Needle-Free Convenience: The most obvious benefit is the elimination of injections. For many, taking a pill with water in the morning is a much more normalized and less stressful routine than preparing a needle.

2. Proven Efficacy: Clinical trials have shown that high-dose oral semaglutide produces weight loss results comparable to the injectable versions. Patients can expect to lose a significant percentage of their body weight when combined with lifestyle changes.

3. Cardiometabolic Health: Beyond the scale, semaglutide is known to improve markers of heart health, including blood pressure, cholesterol levels, and blood sugar control.

4. Privacy: Taking a pill is discreet. There is no need to store injection pens in the office fridge or carry sharps containers while on vacation.

Choosing between the oral pill and the traditional weekly injection is a decision Dr. Abbasinejad will help you make based on your lifestyle and medical history. Here is a quick comparison to help you understand the differences:

Oral Semaglutide

• Frequency: Taken once daily.

• Strict Routine: Must be taken on an empty stomach with no more than 4 ounces of water. You must wait at least 30 minutes before eating, drinking, or taking other meds. This is crucial for absorption.

• Ideal For: People who want to avoid needles and can stick to a strict morning routine.

Injectable Semaglutide (Wegovy®/Ozempic®)

• Frequency: Injected once weekly.

• Flexibility: Can be taken at any time of day, with or without food. Absorption is not affected by diet.

• Ideal For: People who have trouble remembering a daily pill or who cannot wait 30 minutes in the morning to eat or drink coffee.

The Verdict: Neither is strictly “better” effectively; the best option is the one you can adhere to consistently. If you cannot function without your morning coffee immediately upon waking, the injectable might actually be better for you. If you faint at the sight of a needle, the pill is the clear winner.

In the era of online telehealth and “quick-fix” prescriptions, it is vital to remember that obesity is a complex chronic disease requiring expert medical management.

Dr. Meisha K. Abbasinejad, MD, is not just a prescriber; she is Board Certified in Obesity Medicine. This distinction matters. It means she has undergone specialized training to understand the intricate biological, genetic, and environmental factors that contribute to weight gain.

At Cape Fear Physical Medicine and Rehab, we offer:

• A Holistic Approach: We don’t just hand you a prescription. We integrate medical management with nutritional counseling and behavioral support.

• Safety Monitoring: GLP-1 medications are powerful. We monitor your labs, muscle mass, and organ function to ensure you are losing fat, not muscle, and doing so safely.

• Personalized Care: Located conveniently in Fayetteville, NC, we treat you as a whole person. Whether you need help with joint pain that stops you from exercising or specific dietary adjustments, our team is here to support you.

Like all GLP-1 medications, oral semaglutide can cause side effects, primarily affecting the gastrointestinal system. The most common issues include nausea, vomiting, diarrhea, stomach pain, and constipation.

However, these side effects are often temporary and manageable. Dr. Abbasinejad employs specific strategies to minimize your discomfort:

• Slow Titration: We start you on a low dose and increase it very slowly. This allows your body to adjust to the medication, significantly reducing the risk of severe nausea.

• Symptom Management: Dr. Abbasinejad can prescribe supportive medications for nausea or heartburn if needed during the adjustment period.

• Dietary Guidance: We teach you how to eat while on this medication. Eating smaller meals, avoiding high-fat or fried foods, and staying hydrated can eliminate most side effects.

Oral semaglutide is a tool, not a magic wand. For it to work effectively and for you to keep the weight off long-term, it must be paired with lifestyle changes.

Dietary Changes:

• Protein First: You must prioritize protein intake to protect your muscle mass as you lose weight.

• Hydration: GLP-1s can reduce your thirst signal. You will need to consciously drink water throughout the day to prevent dehydration and constipation.

• Nutrient Density: Because you will be eating less food, every bite counts. We focus on nutrient-dense whole foods like vegetables, fruits, and lean meats.

Physical Activity:

Dr. Abbasinejad emphasizes “movement as medicine.” You don’t need to become a marathon runner, but incorporating regular physical activity is essential. This helps maintain your metabolism and improves cardiovascular health. Because we specialize in Physical Medicine and Rehab, we can even design an exercise program that accommodates any existing back or knee pain you might have.

Contact Cape Fear Physical Medicine and Rehab today to schedule your consultation with Dr. Meisha K. Abbasinejad. Let’s determine if the new FDA-approved oral semaglutide is the key to unlocking your healthiest self. We are conveniently located at 1540 Purdue Dr, Ste. 200, in Fayetteville, NC 28303.