Navigating Semaglutide Weight Loss Drugs for Women

Semaglutide, a medication found in drugs like Ozempic and Wegovy, has gained significant popularity in recent years for its effectiveness in aiding weight loss. Initially approved in 2017 as a treatment for type 2 diabetes, its remarkable weight-loss effects propelled it into the spotlight as a weight-loss drug.

While semaglutide can be effective in managing type 2 diabetes, reversing insulin resistance, and shedding excess weight, it’s important to acknowledge its potential side effects and risks. Additionally, like most medications, semaglutide offers a temporary solution rather than addressing the root cause of weight gain. Moreover, instructions for safely discontinuing the medication without experiencing rebound weight gain are not typically included with a prescription. This lack of guidance can lead to fear among women about stopping the medication once their weight loss goals are achieved, as the long-term consequences of extended use are not well understood.

At our clinic, when working with women on semaglutide, we emphasize temporary use and successful discontinuation. We educate our patients on how to manage associated side effects and risks, while also addressing the underlying causes of their weight gain, which can be complex and multifaceted. When they are ready, we empower women to transition off the medication successfully with the help of supplements that offer similar benefits.

It’s important to note that we do not advocate the use of these medications for all women. However, for those struggling with metabolic syndrome, resistant weight, or dysregulated hunger hormones, semaglutide can be an effective tool for repairing metabolic health and initiating weight loss.

ozempic, wegovy, GLP-1 drugs

Benefits and Risks of Semaglutide for Women

Semaglutide is a medication in the GLP-1 agonist class, primarily used for diabetics and obese individuals. It works by increasing levels of GLP-1, a peptide produced by the endothelial cells lining the intestine. GLP-1 acts as a hormone by signaling satiety, slowing gastric emptying, and increasing insulin levels, ultimately conveying a sense of fullness to the brain. This increase in GLP-1 leads to improved glucose metabolism, reduced hemoglobin A1c levels, and significant weight loss.

However, there are downsides to artificially elevating GLP-1 with pharmaceuticals. No medication is free from potential side effects and risks, including GLP-1 agonists. These medications are known for causing gastrointestinal (GI) side effects such as reflux, nausea, vomiting, and constipation. Additionally, women may be alarmed to learn that GLP-1 medications can accelerate skin aging, leading to sagging skin in the face, neck, or buttocks. More serious but rare side effects include kidney injury, pancreatitis, and thyroid cancer, among others.

Of particular concern for longevity health is the fact that women experience significant muscle mass loss while on semaglutide. Discontinuing the prescription without addressing the root cause of weight gain and restoring metabolic health may result in regaining the weight lost as fat without the recovery of lost muscle tissue.

While semaglutide can be an effective strategy for weight loss and metabolic syndrome, it’s crucial to be aware of the potential side effects and work closely with a healthcare provider to manage them effectively. Semaglutide is best utilized as part of a comprehensive strategy to restore metabolic health for the long term. Our focus is on helping women increase their natural GLP-1 production while on semaglutide, so its use can be temporary and the transition off it can be seamless.

Managing GI Issues

GLP-1 agonists can cause temporary side effects such as nausea and constipation. It’s critical to start with a low dose and gradually increase it to help the body adjust to the medication. Additionally, taking an anti-nausea supplement with ginger can be beneficial, and magnesium can help prevent constipation. Improving gut health, especially the gut microbiome, is also crucial when patients are on semaglutide, as the right gut bacteria influence natural GLP-1 production.

Addressing Skin Aging

GLP-1 agonists can accelerate skin aging, resulting in sagging skin and wrinkles. This is sometimes referred to as “Ozempic Face.” Skincare products and fillers can help, as well as supplements that support skin health from the inside. Products that support mitochondrial health and collagen production and reduce oxidative stress and inflammation can benefit overall skin health.

Preserving Muscle Mass

The famous STEP 1 trial showed that over 12-18 months, people on semaglutide lost an exciting average of 22-33 pounds of fat and a detrimental 11-15 pounds of muscle. This significant loss of muscle mass can have serious consequences, especially for women. As we age, our muscle mass naturally decreases—after age 30, we lose 2-6 pounds per decade. After age 40, hormonal changes make it more difficult to build muscle. After age 60, muscle loss accelerates. Women need to exercise great caution when taking semaglutide, as we cannot afford to accelerate muscle loss for an extended time.

Emphasizing adequate protein intake and strength training is crucial to preserve and build muscle mass. However, many women tend to undereat protein and emphasize cardio over strength training. The combination of semaglutide, inadequate protein, and lack of strength training can have serious consequences for women. It’s critical for women on GLP-1 agonists to emphasize muscle mass, which is what we do with our patients.

Do Women Have to Stay on Semaglutide for Life?

While GLP-1 agonists offer a valid path for weight loss and restoring metabolic health, concerns about rapid weight regain after discontinuation may lead women to believe they need to stay on the medication for life. However, our patients are able to stop the medication successfully–when they follow a step-by-step personalized plan to improve their health and metabolism.

Our goal is for women to limit semaglutide use to 12 to 18 months and then successfully transition off it. This period allows for the maximum benefits of the medication, normalizing metabolic markers and appetite hormones and achieving up to 20% body weight loss.

However, we acknowledge that diabetes and obesity are complex conditions, and some individuals may benefit from long-term semaglutide use to reduce associated health risks.

How to Get Off Semaglutide Safely and Not Gain Weight Back

Discontinuing semaglutide after a maximum of 18 months provides ample time to take charge of metabolic health and manage weight effectively. Here are the steps we recommend:

1. Learn your sweet calorie spot – cutting too much can backfire!


Understanding the risks associated with calorie-restricted diets is crucial. Prolonged caloric restriction can result in a significant slowdown of metabolism, leading to rebound weight gain. We adopt a personalized approach to managing calorie intake to prevent this pitfall, guiding women on safe calorie reductions that won’t compromise their metabolism.

2. Optimize protein

Protein is essential for preserving and building muscle mass and supporting fat loss. Higher-protein diets have been shown to lead to greater weight and fat mass loss and better appetite control. This paper, published in the American Journal of Clinical Nutrition, concludes that higher-protein diets containing between 1.2 and 1.6 g protein per kg of body weight and meal-specific protein quantities of at least 25–30 g protein/meal improve appetite control and body weight. Most women enter our practice undereating protein, and we break down what adequate protein per meal and snack looks like.

3. Know your metabolic health markers

Metabolic markers start normalizing while on GLP1 agonist medications, which can feel rewarding and provide motivation. We run bloodwork every three months and target these optimal ranges:

  • Fasting glucose <90
  • Hemoglobin A1C 5.0
  • Fasting insulin 5.0
  • Triglycerides <80

We also teach women to track their blood sugar with a continuous glucose meter and/or traditional skin-prick test strips. The goal is to stabilize blood sugar levels through food intake. Tracking blood sugar levels can provide profound education about how food affects you individually.

4. Optimize your gut biome

A growing body of research shows the relationship between the gut biome and metabolic health. Research has identified specific probiotic strains that increase GLP-1 and support weight control. We stay up-to-date with this research and use these products with our patients. We use functional stool tests like the GI-MAP to assess an individual’s gut microbiome and digestive health. This provides the data needed for a personalized approach.

6. Address the root cause

The root causes of type 3 diabetes, insulin resistance, and weight gain are often complex and multifaceted. We thoroughly explore and identify the underlying reasons that lead to metabolic unwellness or weight gain in women. Once identified, we offer personalized support to address and heal these underlying issues, leading to profound and sustainable changes.

7. Add supplements

Upon discontinuing semaglutide, we introduce supplements with similar benefits to but without the side effects and risks. These include specific probiotics that raise GLP-1 naturally and bitter agents that suppress hunger hormones. We also use nutrients that help reverse metabolic syndrome and regulate blood sugar.

Empowering Female Patients: Transitioning Off Semaglutide Successfully

Our comprehensive approach has enabled our female patients to transition off semaglutide seamlessly without experiencing rebound weight gain or metabolic disruptions. Taking control of your metabolic health requires education, a well-crafted plan, and the right support. Semaglutide can serve as a tool to kickstart progress, but please don’t feel that it’s a life sentence. For those who prefer alternatives to medication, we can do all of the above and use supplements as an effective solution.

If you need help losing weight and restoring your metabolic health, please contact us!

Dr. Laura Paris is a Doctor of Acupuncture & Chinese Medicine and Institute for Functional Medicine-certified practitioner who specializes in hormone balance, immune regulation, and metabolic health

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