Medical Weight Loss


The Ultimate Guide to Medical Weight Loss

In 2021, the U.S. Food and Drug Administration approved Semaglutide injections as a weight loss treatment for adults with obesity. In recent years, clinical trials at various medical centers and institutions have shown that when Semaglutide is combined with exercise, a calorie deficit, and a balanced diet, overweight adults can achieve significant, long-term, and sustained weight loss. 

The FDA indications for subcutaneous Semaglutide injections at this time are for adults with a body mass index (BMI) of 30 or greater, meaning that they must be clinically obese or have a BMI of 27 with at least one comorbidity related to obesity. Such comorbidities can include high blood pressure, diabetes, and high cholesterol.

At Aesthetica, we have Semaglutide injections available for those with less severe BMI and without comorbidities.

These weight loss injections are typically subcutaneously administered in/near the stomach area, the thigh, or the upper arms every week.

If you are struggling with excess weight, Semaglutide may be an incredible weight loss option for you! If you’d like to learn more about how Semaglutide injections work to help you lose weight, the side effects, and how quickly you’ll see results, keep on reading! In this guide, we will cover everything you need to know about Semaglutide weight loss injections and how they can simplify your weight loss journey.

What is Semaglutide?

Semaglutide is an injectable peptide medication for weight management and for patients with type 2 diabetes. After studies and testing, semaglutide was FDA-approved as a weight loss injection for the general public in 2021. Now, both diabetics and non-diabetics can benefit from these weight loss injections.

Specifically, semaglutide is a glucacon-like peptide-1 (GLP-1) receptor agonist that increases glycemic control in diabetic patients. Since diabetes patients often struggle with weight management, GLP-1 medications such as semaglutide are most commonly used for long-term and sustainable weight loss. Adults who are non-diabetic but who struggle with excess weight may also benefit from semaglutide when used with a balanced diet and exercise.

How does Semaglutide work?


It mediates glycemic control.

To promote medical weight loss, semaglutide acts on blood sugar levels–also known as glycemic control. It encourages the pancreas to release controlled levels of insulin when blood sugar levels are high. In parallel, semaglutide also stops the body from producing glucagon. Glucagon is a hormone that promotes glycogenolysis (glucose or ‘sugar’ breakdown) and gluconeogenesis (production of glucose by the liver). This means that by slowing down glucagon production, semaglutide helps your body break down carbohydrates.

Why is managing blood glucose levels important for weight loss?

When people think about weight loss, they tend to focus on how many calories they burn. However, weight loss is a much more complicated process. To understand weight loss, it is important to learn how your body responds to food, exercise, and hormones.

Insulin is one of the most important hormones that play a role in regulating weight loss because it modulates glucose or blood sugar levels. Your blood sugar levels go up when the carbohydrates you eat are broken down into glucose and enter your bloodstream. Then, the pancreas receives a signal to make more insulin. This production of insulin is important because insulin is responsible for mediating the transfer of glucose from your blood and into your cells. Once in your cells, glucose can be used for energy.

Blood glucose levels in diabetic patients:

For diabetic patients, managing blood glucose levels is important because the lack of insulin leads to hyperglycemia (blood glucose levels above 125 mg/dL). Without enough proper insulin, the body cannot decrease the amount of glucose in the blood. These high glucose levels prevent the body’s cells from using glucose for energy and often lead to weight retention, build-up of ketones, fatigue, blurred vision, and increased thirst in patients.

Blood glucose levels in non-diabetics:

In non-diabetics, managing blood glucose levels is important because of insulin resistance, which is thought to result from excess weight. When there is consistently too much sugar (or glucose) in the blood, the pancreas produces more and more insulin to try to break it down. Unfortunately, this eventually causes the body’s cells to become unresponsive to insulin. This is known as insulin resistance.

Normally, when the body’s cells detect insulin, cells uptake glucose and use it for energy. If this glucose isn’t used immediately, it is stored in your liver and muscles as glycogen. When there is too much excess glucose that can no longer be stored as glycogen, the body stores it in fat cells as triglycerides. Consequently, your body holds onto more fat, which causes weight gain and obesity.


It activates parts of the brain that control satiety (‘fullness’) and food intake.

Studies have shown that Semaglutide also works by activating parts of the brain that control satiety and food intake. A study published by the Johns Hopkins University School of Medicine in 2015 reported that GLP-1 receptor agonists mediate appetite and weight loss by activating the hypothalamus and hindbrain. In particular, these medications influence the connections between the hindbrain and parts of the hypothalamus that mediate motivation to eat and the feeling of reward in general. This causes an increase in feeling satiated (fuller) faster, which also leads to less food consumption.

A more recent 2020 study published in JCI Insight, a journal by the American Society for Clinical Investigation, showed that Semaglutide also mediates weight loss by affecting secondary brain areas involved in energy metabolism.

Semaglutide works by:

  • Glycemic control (lowering blood sugar levels)
  • Stimulating insulin production in the pancreas
  • Signaling the hypothalamus and hindbrain to decrease hunger
  • Increase the feeling of fullness when eating by various mechanisms
semaglutide for men

Is Semaglutide good for weight loss?

Yes! Research shows that GLP-1 medications such as Semaglutide help your body adjust to maintain a lower body weight. As such, these injections will not only helps you lose weight–it also helps you keep it off for sustained long-term weight loss.

Semaglutide reduces your appetite, increases satiety, and helps regulate your blood sugar levels. In other words, weight loss is induced by reducing hunger and by helping you feel fuller faster when you eat. By regulating your blood sugar levels, it also helps your body burn glycogen and triglyceride reserves.

Essentially, Semaglutide increases the amount of fat your body burns for energy. However, the effectiveness of these weight loss injections increases when you combine it with a healthy change in diet, exercise, sleep, and regulated stress.

What are other benefits (other than weight loss) of Semaglutide?

Combined with a healthy diet and exercise, Semaglutide can drastically improve long-term weight loss management and the quality of life. However, Semaglutide is also great for other health concerns besides weight loss. Other benefits of these injections include the following:

  • Lowering high blood pressure
  • Lowering cholesterol levels
  • Reducing the risk of heart or blood vessel disease
  • Reduced risk of heart attack
  • Reduced risk of kidney disease

How much weight will you lose on Semaglutide?

Clinical trials show that people who use Semaglutide and make healthy lifestyle changes will lose 5-17% of their body weight. In these studies, people who made lifestyle changes without receiving these injections only lost an average of 5.7 lbs.

Therefore, you may expect similar weight loss results when you combine Semaglutide with lifestyle changes that support your weight loss goals.

Does Semaglutide get rid of belly fat?

Yes, these injections can decrease belly fat in both diabetic patients and nondiabetics when combined with exercise and a healthy diet.

In diabetic patients, clinical trials show that treatment once a week can help lower overall body fat composition. In fact, insulin resistance in diabetic patients is what causes the retention of intra-abdominal fat, leading to an obesity comorbidity. For that reason, these injections are particularly helpful for diabetics who struggle with obesity, which is clinically defined as the accumulation of excess fat in the abdominal area that poses a health risk.

In nondiabetic and overweight adults, a study published in The New England Journal of Medicine showed that weekly injections lead to sustained and clinically-relevant weight loss. This includes a reduction in overall body composition, including belly fat.

How quickly does Semaglutide start working?

Semaglutide injections will begin to work slowly after the first week of treatment.

Please keep in mind that Semaglutide injections can only be given to you once a week, and your medical care provider will mostly advise you to begin at a lower dose for the first few weeks. Starting at a lower dose helps your body adjust to the treatment and lowers the chance that you will experience any strong side effects.

As a long-acting medication, Semaglutide takes a minimum of 8 weeks for its full therapeutic effects to take place. Treatments should be maintained on a weekly schedule to keep seeing therapeutic effects to accomplish weight loss goals.

What are long-acting medications, and what does that mean for Semaglutide?

Semaglutide is a long-acting medication, meaning that its accumulation in your bloodstream will lead to a therapeutic dose over time, but not immediately. A fraction of Semaglutide is released into your bloodstream right away, and the remaining amounts are released slowly over the course of the day. When taking Semaglutide, this means that your blood sugar levels will be regulated almost all day, allowing you to satiate hunger longer.

On the other hand, short-acting drugs are released almost immediately into your bloodstream. This means that they also wear off rather quickly, usually in a window of 3 to 6 hours after taking them. If Semaglutide were a short-acting drug, your blood sugar levels would only be regulated for part of the day, and therapeutic effects would diminish quickly. Essentially, you would only feel fuller for part of the day, and hungrier during later parts of the day.

Since Semaglutide is a long-acting medication, it’s important to adhere to the treatment agreed upon with your medical care provider so that the effects don’t taper off. That way, you can achieve sustained weight loss in the long run!

What happens if I miss a dose?

Missing one dose or injection of Semaglutide will not cause weight gain or severe side effects. However, it is recommended that you take your missed dose as soon as possible. Ideally, you should take your missed dose within 5 days of the missed treatment date. However, if it has been more than 5 days since your last dose, your clinician will decide on the next dose or dose level to administer.

If you miss more than one dose, it is possible that the therapeutic effects of Semagultide will subside. If you miss a treatment for more than two weeks in a row, your clinician at Aesthetica will decide on the most appropriate dose to resume dosing.

How fast is weight loss on Semaglutide?

Most who use Semaglutide injections may experience weight loss within the first 3 months. At least 10% body weight loss may be accomplished by using these injections for at least 6 months.

Semaglutide weight loss is best accomplished with healthy lifestyle changes that support your weight loss goals. For this, we recommend committing to a lower-calorie diet and regular exercise. GLP-1 medications like Semaglutide will help you lose weight by satiating hunger and burning fat, but it must be complemented by being thoughtful about your diet. You may be able to see faster weight loss when combining these  injections with regular exercise as well.

Semaglutide FAQ

How long do I need to stay on Semaglutide?

The longer, the better. Maintaining regular Semaglutide weight loss injections is beneficial for people with obesity to keep the weight off.

A clinical study published in the Journal of American Medical Association (JAMA) in 2021 reports that people who receive these injections for 20 weeks lost an average of 10.6% of their body weight. That’s only about 5 weeks! In this study, participants were split into two groups: one group continued to receive Semaglutide injections, and the other received an injection without Semaglutide, otherwise known as a placebo. At week 68 of treatment, the group of people who continued to receive Semaglutide continued to lose weight. In total, participants who stayed on Semaglutide shed the most pounds–almost 18% of their body weight! However, the group who received a placebo had gained back weight.

Therefore, continuing treatments once weekly is the most effective way to keep the weight off. We recommend that you maintain your regime as long as possible, however, once your weight loss goal is achieved, your clinician at Aesthetica will work with you to design a regimen to wean off the medication, or a low dose maintenance program.

What happens if I stop taking Semaglutide?
Discontinuing Semaglutide weight loss injections may result in gradual weight gain.

Another clinical study published in the Journal of Obesity, Metabolic Syndrome, and Prediabetes found that within one year of taking Semaglutide injections for weight loss, participants lost an average of 17.3% of their weight. These same participants discontinued their Semaglutide injections after one year of weekly treatments. At their one-year follow-up without Semaglutide, this same group of people has regained an average of 11.6% of the weight they had lost when taking Semaglutide.

What happens after discontinuing Semaglutide treatment depends on your ability to maintain your healthy lifestyle changes.

If you need to stop Semaglutide weight loss injections, you can avoid gaining back pounds by adhering to a balanced diet and regular exercise. Since Semaglutide treatment helps you feel full faster and longer, stopping treatment will cause these effects to wear off. As such, the best thing you can do is stick to a calorie deficit, eat healthily, and exercise to reduce the amount of weight you may gain back.

Can non-diabetics take Semaglutide for weight loss?
Yes! Semaglutide is recommended for people with problems regulating weight loss and obesity. Although it was primarily developed for diabetics, the FDA recently approved Semaglutide as an effective and safe medication for non-diabetics.
Who should not take Semaglutide?

Although you should always consult with your doctor first, GLP-1 medications are generally not recommended for people with family or personal histories of the following:

  • Thyroid cancer
  • Multiple endocrine neoplasia (disorders that affect the body’s hormone-producing glands)
  • Pancreatitis (swelling or inflammation of the pancreas)
  • Kidney disease
  • Gallbladder disease
  • Diabetic retinopathy (damage to eye blood vessels due to diabetes)
  • Type 1 diabetes
  • Digestion problems
  • Depression
Does Semaglutide interact with other drugs or medications?
Yes. According to the Mayo Clinic’s report on Semaglutide, it may not be recommended to begin taking Semaglutide weight loss injections if you take Chloroquine, Hydroxychloroquine, or Venlafaxine. We recommend that you always honestly disclose all of your current medications with your medical care provider, who will determine the best course of treatment for you.
Can I buy Semaglutide over the counter?

No. Semaglutide requires a prescription or administration from an authorized medical provider.

What are the side effects of using Semaglutide?
A study published in the New England Journal of Medicine in 2021 reported that the most frequent side effects of weekly use were gastrointestinal disorders, including:

  • Diarrhea
  • Nausea
  • Vomiting
  • Constipation

Other less common side effects may include:

  • Feeling bloated and/or stomach discomfort
  • Abdominal pain
  • Passing gas
  • Heartburn/acid reflux
  • Pancreatitis
  • Fatigue
  • Recurrent fever
  • Low blood sugar
  • Gallbladder disease
  • Kidney damage
  • Belching
  • Allergic reactions (itching, rash, redness, and more severe reactions)
  • Thyroid tumors
What are the immediate side effects?

It is common to experience some side effects when you first begin taking Semaglutide weight loss injections. Some patients who start taking Semaglutide injections may experience nausea, vomiting, and diarrhea during the first few weeks of treatment.

Your medical care provider will likely administer your treatment at lower doses for the first few weeks, and increase does as you tolerate the medication. This helps you adjust to treatment and alleviate any strong or undesirable side effects of starting a new medication. At Aesthetica we will work with you to manage your side effects and initiate other medications to help you control possible side effects and stay on the medication until you achieve your health goal.

Aesthetica Medical Spa is located in San Diego. We serve nearby areas as well, including Oceanside, Carlsbad, Hillcrest, La Jolla, Del Mar, Coronado, Encinitas, Rancho Santa Fe, San Marcos, and the rest of San Diego County. Call to schedule a complimentary consultation!