As of September 1, semaglutide will be available in Germany for the treatment of overweight and obesity in tablet form for the first time. The therapy, previously known primarily as a “weight-loss injection,” can now also be taken orally. The market launch is likely to attract considerable interest – but anyone considering treatment should be aware of one thing first: the tablet is not a way to lose a few kilos, but a prescription medication for the treatment of a chronic disease.
“It is certainly not intended for making short-term adjustments to your weight simply because you feel like it,” says Prof. Christian Strassburg, Director of the Department of General Internal Medicine at UKB.
Who Is the Weight-Loss Pill Suitable For?
The tablet is approved for adults with obesity, defined as a BMI of at least 30. It may also be considered for people with a BMI of 27 or higher if they have at least one weight-related comorbidity – for example, type 2 diabetes, high blood pressure, or other metabolic disorders.
The decisive factor is therefore not simply the desire to lose weight. “This should be done under the supervision of a doctor,” emphasizes Strassburg. The treatment affects a central metabolic pathway in the body and must therefore be used where medically appropriate.
How Does the Tablet Work?
The active ingredient semaglutide mimics the effects of the body’s naturally occurring gut hormone GLP-1. Among other things, GLP-1 plays an important role in hunger, satiety, and food intake. Put simply, the feeling of hunger may decrease, while the feeling of fullness may become stronger and/or last longer.
“How much weight an individual person loses varies considerably,” says Strassburg. “Based on the study data available so far, we can expect approximately 14 to 15 percent with the tablet.”
A Tablet Does Not Automatically Mean It Is Easier
One important difference compared with the injection is the daily dosing schedule. While the injection is administered once a week, the tablet must be taken every morning on an empty stomach and according to specific instructions. After taking it, patients have to wait a certain amount of time before eating, drinking, or taking other medications. This is necessary to ensure that the active ingredient is adequately absorbed.
For patients, the tablet may nevertheless be an attractive alternative – particularly for people who do not want to inject themselves. However, it is not simply an “injection in pill form”: taking it requires discipline as part of everyday life.
What Happens After Stopping Treatment?
Anyone who stops taking the tablet should not assume that the weight they have lost will automatically remain off permanently. “In many cases, a rebound occurs, meaning that the weight increases again,” says the UKB expert.
The reason is that the effects on hunger and satiety disappear once treatment ends. That is why it is important not to view the therapy in isolation. “You have to use the opportunity to make other changes as well – changing your habits and also increasing physical activity.”
The medications therefore cannot replace changes in diet and exercise. The approved use of the treatment also considers it an addition to a reduced-calorie diet and increased physical activity.
What About Side Effects?
As with other medications, side effects can occur. Gastrointestinal complaints are particularly common, including a feeling of fullness, nausea, diarrhea, or constipation. More rarely, problems affecting the bile ducts or inflammation of the pancreas may occur.
Anyone who develops severe or unusual symptoms during treatment should therefore contact their treating doctor.
Can You Exercise or Drink Alcohol While Taking It?
In principle, physical activity is possible during treatment and is explicitly part of successful weight management. Alcohol, on the other hand, is not strictly prohibited but should be consumed with caution.
Another effect of the therapy is particularly interesting: because semaglutide affects hunger and appetite, personal preferences may also change. “It is possible, but you may simply no longer feel like having it,” Strassburg says, describing a possible effect on eating and drinking habits.
The Key Message: This Is Not a Lifestyle Pill
The fact that the medication is now available in tablet form could create the impression that losing weight has become easier and more straightforward. This is precisely where Strassburg sees an important role for medical advice.
“This is not simply some kind of fun factor for losing a little weight,” says the physician. Anyone considering the new weight-loss tablet should therefore not start by asking, “How many kilos can I lose with it?” but rather: “Is this treatment medically appropriate for me – and how can I combine it with sustainable changes to my lifestyle?”
That, according to the UKB, is the crucial perspective: The tablet can support people with an appropriate medical indication in losing weight. However, it cannot replace a healthy, sustainable lifestyle in the long term.
Contact:
Prof. Dr. Christian P. Strassburg
Medical Clinic I - General Internal Medicine
University of Bonn University
Venusberg-Campus 1
53127 Bonn
Email: christian.strassburg@ukbonn.de
Press Contact:
Daria Siverina
Deputy Press Officer at Bonn University Hospital (UKB)
Public Relations and Corporate Communications Office at Bonn University Hospital
Phone: (+49) 228 287-14416
Email: daria.siverina@ukbonn.de
