Weight loss with liraglutida

Liraglutide has become one of the main medications for weight loss. With this information, I aim to provide you with as comprehensive information as possible:

• What is liraglutide?
• What are its side effects?
• How is it administered?
• Safety
• Effectiveness of liraglutide
• Liraglutide and Pregnancy
• When and how to stop using liraglutide?
• Liraglutide rebound effect
• Expectations with liraglutide
• Price of liraglutide

Liraglutide is a GLP-1 agonist medication. When it binds to the GLP-1 receptor (GLP = Glucagon-Like Peptide), the following effects occur: it stimulates the release of insulin (making it useful in type 2 diabetes), stimulates the satiety center, reduces glucagon release, delays gastric emptying, which in turn generates a feeling of fullness, and slows down glucose absorption.

By generating a feeling of fullness, appetite disappears or significantly decreases, leading to reduced food intake, which facilitates weight loss.

In Spain there are other GLP-1 agonist drugs such as exenatide and semaglutide.

It is essential that, as prescription medications, these treatments are carried out under medical supervision and with the doctor’s recommendation. The purpose of this article is informative and can never replace medical monitoring.

Furthermore, we must not forget that this is only a help for those people who cannot achieve and maintain a healthy weight through traditional means (diet and physical exercise). It should never replace these methods but rather complement them. It will be crucial, as with any other method, to establish and reinforce healthy lifestyle habits (improve diet and acquire exercise habits) to maintain weight loss over time and reduce the associated risk factors of overweight and obesity.

The most common side effects are nausea, feeling of heaviness, diarrhea, constipation, vomiting, flatulence, and gastroesophageal reflux. These effects are usually temporary (they disappear within a few days or weeks), and to reduce the risk of experiencing them, a progressive titration of the dose is performed (the dose is increased weekly). It is important to stay hydrated. If nausea occurs, drinking in small quantities can help prevent vomiting.

Although initially marketed as a treatment for diabetes, the risk of hypoglycemia, that is, low blood glucose levels, is low, as the hypoglycemic effect of GLP-1 agonists depends on blood glucose levels. This means that if blood glucose levels start to drop, the drug no longer has a hypoglycemic effect, so the levels do not continue to decrease.

Other possible but less frequent effects include headaches, dizziness, and an increase in heart rate (2 beats per minute in studies, which is not clinically significant).

Some cases of pancreatitis and gallstones have also been described, but these complications seem to be more related to significant and relatively rapid weight loss rather than the drug itself. However, in case of severe abdominal pain, it is important to consult a doctor.

It is administered through a pre-filled pen that is injected subcutaneously daily. The needle is very thin, similar to the insulin needles used by diabetics.

Typical administration areas are the abdomen, the front of the thighs, or the upper arms.

It should be administered at approximately the same time every day, regardless of food intake and the time of day. Simply choose the most convenient time to incorporate it into your daily routine.

It is important to follow the doctor’s instructions for proper administration.

Unused pens should be stored in the refrigerator. However, once a pen has been started, it does not need refrigeration and can be kept at room temperature (up to 30°C) for one month.

The initial dose is 0.6 mg, → 1.2 → 1.8. From there, I will explain in a consultation how to proceed with dose adjustments.

Liraglutide was marketed in Spain in 2016, and a little earlier in the USA. It was approved in January 2015 by the CHMP (Committee for Medicinal Products for Human Use) as a safe and effective drug for weight loss in combination with dietary measures and physical exercise. It is indicated for individuals with a BMI equal to or greater than 30 kg/m2 (obese), or with a BMI of 27 kg/m2 (overweight) and a comorbidity related to overweight (prediabetes, type 2 diabetes, sleep apnea, hypertension, etc.).

Its off-label use is not recommended, and of course, it is a medication that SHOULD ONLY be used UNDER MEDICAL PRESCRIPTION AND SUPERVISION.

There are no studies on its use in pregnant women or people over 75 years of age, so its use is not recommended in these population groups due to unknown safety.

The same applies to those with severe kidney, liver, or heart failure.

There are no specific contraindications for the drug, except in cases of allergic reactions.

Since its launch, studies continue to be conducted to expand knowledge about the drug’s use, both in terms of safety and effectiveness in other areas (fatty liver, polycystic ovary syndrome, etc.), and in the near future, we may be able to expand this section of the article.

Liraglutide has recently been approved in Europe for use in obese children aged 12 and older, once its effectiveness and safety have been demonstrated in this age group.

In addition to liraglutide, new drugs from the same group like semaglutide have appeared. These drugs also have an appetite-suppressing effect (anorexigenic), and new molecules and indications are likely to appear as knowledge in this area continues to expand, with ongoing research.

We must not forget that obesity is considered a chronic and recurrent disease today, in which a state of low-grade inflammation (lipoinflammation) occurs. Therefore, in a correct approach to obesity, attention should also be paid to this process.

It is clear and demonstrated that the drugs described here help reduce food intake because they suppress appetite and slow down the digestive system in general. However, stopping at this point would be insufficient.

It is essential to help each patient establish healthy patterns (dietary, physical activity, and food relationship) tailored to the individual, so they can maintain them in the long term and avoid subsequent weight gain once the desired weight goal has been reached.

I will evaluate your case individually to offer you the best option for your needs.

It has been clinically effective in various clinical studies that included 5800 subjects with obesity and overweight, compared to placebo. In these studies, it showed a 7.5% reduction in the weight of its users, compared to a 2.3% loss in patients treated with a placebo. Furthermore, subjects continued to lose weight during the first 40 weeks of treatment. Weight loss was greater in women than in men.

If it is not effective after twelve weeks at the maximum dose (3 mg/day), discontinuation due to lack of efficacy would be recommended.

It is important to combine it with a healthier lifestyle regarding diet and physical exercise to ensure the maintenance of the obtained results.

It should not be used during pregnancy or breastfeeding. It is best to wait until after this period to start treatment.

On the other hand, I have had cases of women with obesity and difficulty getting pregnant who have been recommended to lose weight before starting fertility treatment to increase the chances of success and reduce the risks of pregnancy and childbirth.

The treatment should be used for as long as necessary to achieve the goal, as long as the treatment is useful. There is no specified maximum or minimum time.

It is also not a treatment to be used for a lifetime, by no means. The truth is that after prolonged use, the body can become accustomed to the drug, and its effectiveness may decrease. Therefore, this treatment should only be prescribed to individuals who are truly motivated to achieve their goals and are willing to make an effort with the “push” provided by the treatment, as this way they will achieve their goals before the drug potentially loses its effect.

This potential loss of effectiveness does not occur after weeks, but it could happen after months. It is also not the same for everyone: some people do not notice this loss of effectiveness, while others do.

Some notice results with low doses, while others need to increase to 3 mg/day to feel its effects. What I can say is that the success rate in weight loss, whether faster or slower, is significant. If it were not, it would not be so successful.

However, we must not forget that it is a drug, and therefore, there should be a medical prescription and supervision behind it.

As with any method, including surgery and gastric balloons, if one gradually returns to old habits, weight can be regained. There are no “miracle diets,” and if they are offered to you, you should steer clear of them.

It is a mathematical issue: if you consume more than you expend, the result is weight gain. If you start the treatment, you should see it as an opportunity to regain a healthy weight and habits.

You should take advantage of this treatment period to retrain your body and mind, get used to moving more (take the stairs instead of the elevator, walk more every day, do some sports, etc.), become more aware of your body and what you eat, understand why you eat (do you eat because you are hungry? Or because you are nervous, bored, etc.?).

Becoming aware of what you eat and why is very useful to avoid overeating or eating unhealthy foods. Liraglutide suppresses appetite, and with it, weight loss occurs, which in turn improves the mood and motivation of patients to follow this path, and it should be the beginning of a new stage, a stage with a different and healthier relationship with food and your body.

These medications require a medical prescription.

They are not funded or subsidized by the Social Security system, which means that their price is the same whether prescribed by a private doctor or through public healthcare.

Although their price in pharmacies may seem high, it should be considered that they can achieve the effects of bariatric surgery without surgery, and when compared to the prices of “miracle diets” offered in many places, they are cost-effective.