Semaglutide vs Phentermine Which one is better for weight loss?
Introduction
Phentermine and semaglutide are two highly well-liked weight-loss drugs. Over the past few years, injectable drugs like semaglutide have gained popularity. Celebrities and common people alike laud Semaglutide’s ability to help them lose weight. The medication is so well-liked that many pharmacies have had trouble maintaining supplies. A well-known appetite suppressor with over 60 years of effective use is phentermine. Even though it was only used short, it was well-liked in the 1990s. The medication was given the go-ahead for extended usage in 2012. The first few weeks of using this medication are usually when people lose the greatest weight. Semaglutide and Phentermine have similar goals but have different working ways.
Individuals who are obese are more likely to experience heart disease, high blood pressure, and type 2 diabetes, among other health issues. This is the reason why using drugs to treat obesity and aid in weight loss has grown so popular when combined with lifestyle modifications.
What kind of medication is: phentermine vs semaglutide
Semaglutide
- Semaglutide belongs to the GLP-1 pharmacological class. It functions similarly to the body’s glucagon-like peptide-1 (GLP-1).
- The tablet form is generally marketed as Rybelsus, while the injectable form is available under the names Wegovy and Ozempic.
- Semaglutide has been used to treat type 2 diabetes and heart disease since Ozempic’s 2017 approval for lowering the risk of cardiac arrest, stroke, or death in persons having type 2 diabetes, even though the FDA approved the drug for weight loss in 2021.
- It emulates the GLP-1 hormone, which raises insulin production, lowers blood sugar, and sends a fullness signal to the brain. Although semaglutide is meant to be used for a long time, users may gain weight if they stop taking it.
- It may impact how your body reacts to insulin and insulin-releasing drugs, so your doctor may need to change your dosages to lower your risk of hypoglycemia (low blood sugar).
- Other oral medications, such as over-the-counter aspirin and allergy treatments, may not be absorbed as well when taken in the injectable form of semaglutide.
Phentermine
- Phentermine is a member of the anorectics’ drug class. A sympathomimetic amine that activates your central nervous system is phentermine.
- It was originally authorized by the FDA in 1959 as an appetite suppressant. It is offered for sale under the brands Suprenza, Lomaira, and Adipex-P.
- Additionally, it is marketed as part of the pharmaceutical Qsymia along with a prescription known as topiramate.
- Although the precise mechanism by which phentermine suppresses appetite is unknown, it may raise neurotransmitter levels in the brain.
- The effectiveness of this medication may wane with time, and its 12-week approval period may limit its use.
- It’s considered a controlled substance that can lead to addiction, withdrawal symptoms, and negative effects like an irregular or fast heartbeat.
- It is not advised for anyone with hyperthyroidism, glaucoma, or a history of cardiovascular disease to use this medicine.
How does semaglutide cause weight loss?
Semaglutide has been used for weight loss for a long time and people trust it as this medication is FDA-approved and safe for many reasons.
Action mechanism
Semaglutide is a glucagon-like peptide-1 receptor agonist and has the glucagon-like peptide-1 receptor in the brain that controls appetite. It helps to lose weight in various ways.
- It targets the brain centers that regulate the appetite, spatially after eating which may help you eat less.
- It slows down the emptying of the stomach, which gives you the feeling of fullness for a long time.
- Semaglutide activates GLP-1 receptors, which increases the effectiveness of incretin activity.
- It lowers postprandial and fasting glucose by several mechanisms, including elevation of insulin secretion (glucose-dependent), suppression of glucagon release, and decreased hepatic gluconeogenesis.
- Semaglutide has demonstrated a favorable proinsulin-to-insulin ratio, showing increased insulin biosynthesis and enhanced β-cell efficiency.
- Additionally, it showed high insulin sensitivity, which is probably due to a decrease in body weight. Semaglutide also results in weight reduction, which is explained by a decrease in intake of calories and a slowdown of stomach motility.
- This treatment is recommended for long-term use. It aids in losing weight and keeps it normal for over a year.
How does Phentermine cause weight loss?
Phentermine is utilized to enhance weight loss in obese people. It is used along with a balanced diet and physical activity to treat obese patients.
Action mechanism
Phentermine is like amphetamine that stimulates the central nervous system resulting in increased heart rate and blood pressure and decreased appetite.
- Presynaptic vesicles in the lateral hypothalamus release noradrenaline, which is how phentermine, an indirect sympathomimetic, works.
- The activation of beta2-adrenergic receptors is the outcome of this rise in noradrenaline concentration in the synaptic cleft.
- Because phentermine increases norepinephrine and dopamine levels and has an indirect effect on serotonin, it is categorized as an indirect sympathomimetic. According to certain research, phentermine suppresses the main signaling route responsible for inducing hunger, neuropeptide Y.
- The body experiences a constant flight-or-fight response because of these combined effects. It slows the hunger signal since the body’s focus is on the urgent need for energy.
- Finally, phentermine may be an inhibitor of monoamine oxidase, but this mechanism is not usually associated with a clinically meaningful response, according to some publications.
- This drug is approved to be used for 12 weeks only. But the management of weight loss takes time so some practitioners may suggest it for a long time.
Side Effects: phentermine vs semaglutide
It is observed that the person receiving the semaglutide and phentermine treatment may experience different side effects. If the side effects are for a longer period and do not go away in a couple of days the patient must consult their doctor for proper treatment. Telling a healthcare professional about the effects a patient is experiencing will help to treat them on time. Both medications have a few side effects.
Side effects of Phentermine
Using phentermine can have various side effects on the person’s body. Some of those side effects are headache, dry mouth, changes in mood, hypertension, irregular heartbeat, hallucinations, etc.
- Dry mouth
Phentermine usage reduces saliva production; if it persists, it can lead to a drier mouth which causes tooth decay and difficulty swallowing food.
- Tremors or shaking
Phentermine can cause shaking or tremors, but it is just an indication that the patient is receiving a high dose and needs to reduce it.
- Insomnia
Phentermine is a stimulant that makes you energetic and alert, making it difficult to fall asleep.
- Erectile dysfunction
Phentermine may have negative effects related to sexual function. These may include erectile problems.
- Diarrhea or constipation
Some people may get diarrhea or constipation while using phentermine.
- Changes in behavior
Phentermine can cause euphoria and dependence due to its release of chemicals in the brain, making it unsuitable for those with a history of substance misuse.
- Headache
People may feel headaches as phentermine causes the contraction and relaxation of blood vessels due to changes in the amount of blood flow to the brain.
Side effects of semaglutide
Some of the common side effects of semaglutide are:
- Gallstones and tumors
Gallbladder disease like gallstones may result from the usage of semaglutide. It also increases the risk of thyroid C cell tumors.
- Nausea
About 20% of the people who used semaglutide during the clinical trials have experienced nausea and vomiting.
- Diarrhea and stomach pain
About 30% of the people who used it for weight loss and almost 9% of the people who used it for diabetes experienced diarrhea. People may also feel mid-stomach pain.
- Hair loss
Weight loss with semaglutide may result in the loss of hair quickly. About 3% of the people have experienced this during clinical trials.
Who should take: phentermine vs semaglutide
Phentermine
Phentermine is recommended for those patients who have a body mass index of 30 kg/m2 or greater or a BMI of 27 to 29.9 kg/m2 with weight-associated different conditions, who despite modifications in their lifestyle are unable to achieve weight loss goals prescribed by the doctor.
Semaglutide
To qualify for a medical program of weight loss a person must be 18 years of age, have a BMI of 30 or higher, and be obese or overweight with one weight-associated health problem. A person must be committed to attending all the sessions and completing the course to get effective results.
Who shouldn’t take: phentermine vs semaglutide
People who should not take Phentermine
There are several conditions, if the person is suffering from these conditions, they must avoid phentermine usage.
- If you have glaucoma, an overactive thyroid, serious cardiac issues, uncontrolled hypertension, coronary artery illness, severe agitation, or drug misuse, you should not use phentermine.
- It may be risky to take phentermine when you are expecting or nursing a child. You must avoid it because it can cause some side effects which can be severe during such conditions.
- If you have taken an MAO inhibitor within the last 14 days, such as phenelzine, isocarboxazid, rasagiline, linezolid, selegiline, or tranylcypromine, do not use this medication. There may be a risky medication interaction.
People who should not take semaglutide
While semaglutide is safe for certain people with obesity problems it causes some problems for a few people having different conditions. People with several conditions are recommended to avoid semaglutide.
- People suffering from type 2 diabetes, hypertension, heart disease, and kidney issues are not recommended to have this medicine.
- Breastfeeding and pregnant women are recommended not to use semaglutide as it is not safe to use it during these conditions.
- People with a family history of medullary thyroid carcinoma, pancreatitis, and gastroparesis should not use semaglutide.
- Individuals who take medications that interact with semaglutide or people who are allergic to semaglutide should not use it
How is phentermine administered?
Oral route
There are four different ways to get this medication:
- As tablets
- Dissolving tablets
- Capsules
- Extended-release capsules
Pay close attention to guidelines specific to the type you are taking. Swallow completely the extended-release capsule. Never eat, shatter, or crush it. You can take the dissolving pill with or without meals. Before handling the tablet, make sure to dry your hands. Take the tablet out of the bottle and place it on your tongue. It should dissolve fast. Swallow the tablet whole or take a drink of water once it has melted. Never eat, shatter, or crush the tablet. Take your last dose of the day four to six hours before going to bed to avoid having difficulty falling asleep.
How is semaglutide administered?
Oral route
Semaglutide is orally administered with SNAC (Sodium-N-[8-(2-hydroxybenzoyl) amino] caprylate), a fatty acid derivative. Raising the surrounding environment’s pH and following a passive transcellular pathway to pass via cell membranes enhance semaglutide’s solubility. The stomach’s acidic pH shields semaglutide from proteolytic breakdown. It is necessary to take the tablet empty-handed, ideally half an hour before eating.
Subcutaneous route
Weekly-once, semaglutide (Ozempic; 0.5, 1.0 mg) requires dose titration, in contrast to other weekly GLP-1 agonists. Starting at 0.25 mg, the dosage is increased to 0.5 mg and 1.0 mg over 4 weeks. Ozempic Pen having a strength of 1.34 mg/ml is available. The blue pen is intended for 1.0 mg which is the maximum maintenance dose, while the red pen provides an initiating dose of 0.25 mg and a dose of maintenance of about 0.5 mg of semaglutide.
The transition between Ozempic and Rybelsus
Patients may be moved from Ozempic to Rybelsus or vice versa, based on their needs and convenience.
How much weight can I lose: phentermine vs semaglutide
Weight loss caused by phentermine
About 5 % of the total body weight is lost by using phentermine for about 12 weeks of usage, a person may lose 10% of their total body weight. This medication is designed to be taken with a healthy diet, exercise, and positive lifestyle modifications. Phentermine has demonstrated an average weight loss of 3.6 kg in clinical trials when taken as a combination therapy and monotherapy in subjects in 2 to 24 weeks. Additionally, after stopping their phentermine therapy, patients maintained their weight better.
Weight loss caused by semaglutide
After semaglutide treatment, weight loss may be noticed after almost 4 weeks of treatment but the full effect on your body may take several months.
- Weight loss in adults
Over 68 weeks, semaglutide-treated adults lost an average of 35 lbs. in weight, while 31% of those using a placebo lost only 2.5%.
- Weight loss in children
Semaglutide significantly reduced BMI in children 12 years and older by 16.1% after 68 weeks, with 77% of children experiencing a 5% reduction compared to 20% receiving a placebo.
Which one is better for weight loss?
Semaglutide and Phentermine are effective options to help you shed excess weight and look and feel great. However, Semaglutide is the only long-term option that helps you lose weight, keep it off, and continue living a healthy life and maintaining a healthy weight. With effective weight loss, it lowers the risk of cardiovascular issues, boosts glycemic control, and aids in appetite control by promoting feelings of fullness and reducing calorie intake.
Conclusion
Many people find it difficult to lose weight despite trying a healthy diet and exercise or due to some kind of disease like obesity. So, two types of treatments are suggested for such patients. One is weight loss by using semaglutide and the other is by using phentermine. Both are effective in healthy weight loss but semaglutide is preferred for weight loss treatment due to several reasons for its safety over phentermine. People who want to lose weight can consider one of these options depending on their health condition and their doctor’s advice.
What people are curious about?
Individuals with type 2 diabetes who are overweight or obese are typically treated with semaglutide. Those without diabetes who have a BMI of 30 or above may also be prescribed it.
A BMI of 30 or higher indicates that a person is obese or overweight and may be administered phentermine. Those with a BMI between 27 and 30 who also suffer from other weight-related medical disorders, such as diabetes or high blood pressure, may also be prescribed it.
There is no proof that semaglutide and phentermine shouldn’t be taken together. It’s crucial to talk to your healthcare practitioner about any possible drug interactions, though.
Should you abruptly discontinue taking this drug, withdrawal symptoms such as extreme fatigue and depression can occur. Your doctor may gradually reduce your dosage to help avoid withdrawal.
