Categoría: Overweight and obesity
Etiquetas: #adults, #liraglutida, #obesity, #treatment, #weight loss
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It is important to follow a doctor’s guidelines for the proper administration of these medications.
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?
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.
What are its side effects?
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.
How is it administered?
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.
Safety
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.
Effectiveness
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.
Liraglutide and Pregnancy
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.
When and how to stop using it
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.
What happens when you stop, the rebound effect
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.
Liraglutide and Expectations
Many people ask me how many kilos they can lose with liraglutide or how long it takes to lose weight. The truth is that it is a very useful treatment to help with weight loss, mainly because it suppresses appetite and slows down digestion.
It is not a “fat-burning” substance or anything like that, so the rate of weight loss depends on other factors. The person’s age, sex, lean mass (muscle), and other factors also play a role, but it mainly depends on whether exercise is added to the treatment or not, the intensity and frequency of exercise, and the type of diet followed.
For example, a person who exercises four times a week and follows a low-calorie diet of about 1200 calories per day will lose weight faster than someone who leads a sedentary lifestyle (sitting-office-bed) and does not keep a record of their meals (that is, they do not write down what they eat to truly understand the calories they consume and become aware of their eating habits).
The second person in the example will probably also lose weight; liraglutide suppresses their appetite, causing them to eat less than usual. However, it is also more likely that this person will regain the weight once the treatment is over because they have not learned new, healthier lifestyle habits.
In the end, weight loss is determined by the fact that the amount of food you consume is less than the energy you expend in a day. That’s how it works. Liraglutide is only an aid (a significant one, I would say) to do things right.
Price of liraglutide
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.
Hi! I was in the USA (where I’m from) and decided to visit my dr. She had treated me in the past.
She decided to try Tirzepatide. We did it for 2 weeks. It help with my appetite and helped lower my anxiety. Unfortunately she cannot prescribe in Spain. I live in Marbella and need a prescription of the lowest dose.
Interested what is the cost and process please
I have a BMI of 33.could you please inform me of costs and could we do a video consultation.
I sent you an email
I’m interested in Saxenda. I live in Cadiz. How much is it? Thanks
Send me an email to doctorapaulamoreno@gmail.com and I will explain everything. Too much text to put it all here! Thank you
I’ll send you an email
Hi Dr moreno I sent you email
Few weeks ago regarding the pen and weight loss ! You replied and I deleted the email so sorry can you email me
A contact number to make app please
Sharon
Absolutely, my email is doctorapaulamoreno@gmail.com
Hi can I get details please, price etc
Please can you advise me how I get this, and costs.
Thank you
Laura stokes
Hello
I’m interested in having a consultation regarding weight loss. Can you give me availability and cost?
Thanks
Tracy Walker
We live in Foryuna( Murcia) bmi is 31, with slow tyorid, can i buy it and do the consulations online?
I mean Fortuna
Can I get priZe á d Joe it ís best tí svo this
Hi, could i have some more details and estimated monthly cost please.
Can you advise me the price please
Do you prescribe Qsymia?
FDA has made a warning to Qsymia for false advertising and I don’t use it.
Hi. I am interested in buying Saxenda. Could you please tell me how much it is . Thank you.
I sent you an email explaining all about it
Interested
Hello after consultation do you ship medication to the UK? How much are your saxprices please x
No, that’s not even legal. I’m sorry. I’m a Spanish doctor, hence my license is only valid here. Also, this medication needs to be refrigerated. What I do after the consultation is to prescribe it, then you could go to any SPANISH pharmacy and buy it there with my prescription. Thank you.
Hi I am interested. Please send me further details by email
I’d like to book a consultation for some more information. Via video.
Kind Regards
Hazel
Sure Hazel, let me send you an email
I would like a consultation online please. I am overweight and want to buy the saxenda pen.
Thank you
Carolyn
Hi I would like to buy Saxenda on line
Hi I would like to buy semaglutide I have a bmi of 31
Hi Helen, Saxenda is not semaglutide, it’s liraglutide, which is slightly different. Liraglutide is indicated for obesity. If you’d like to book an appointment in order to assess your case and prescribe it, let us know!
I am interested in purchasing a skinny pen
Hello Christine! Saxenda is a prescription drug, and therefore I need to assess your case first, as a doctor, and then make the prescription if indicated. In order to do that, you need to get a consultation with me. It can be at the clinic in Estepona, or online (video call).
Ola,
I would like to buy saxenda liraglutide pen .
Please let me know the procedure.
Kindly contact me .
Thankyou
Hello and thank you for contacting us. In order to prescribe this medication I would need to assess your case personally. You can get a consultation either at the office in Estepona, or online (through video call). If you’re still interested, let me know!
Hello Paula, i am interested and would like to get in touch with you for the procedure.
Kind regards,
Servane
I sent you an email
Hello, I’m very interested in this weight loss medication. I live in Alicante region ,Spain. 03158
Can you advise of the proceedure and costs of assessment for suitability a d cost of the injection pens here in Spain.
Thank you in advance
Fiona
Sure, I just sent you an email
Interested in this form of weight loss.
Staying in Murcia at present
YOu can contact me through email for more information: doctorapaulamoreno@gmail.com