Semaglutide, a medication initially known for weight loss and diabetes management, is now FDA-approved for treating metabolic dysfunction-associated steatohepatitis (MASH) — a serious liver condition that can lead to cirrhosis. This treatment leverages weight loss as a key strategy to reduce liver inflammation and scarring.
How Semaglutide Works
Semaglutide is administered via weekly injection, typically under the skin in areas like the upper arm, thigh, or abdomen. Consistency is vital; missing doses can reduce effectiveness. While the exact timing isn’t critical, maintaining a regular schedule (e.g., every Wednesday) improves adherence.
The medication’s dosage is gradually increased over four months, starting at 0.25 mg and reaching a maintenance dose of 2.4 mg weekly. This slow titration minimizes common side effects like nausea, vomiting, and digestive upset. Weight loss benefits may become noticeable within the first few weeks, with more substantial results after one to two months.
Potential Side Effects and Management
Gastrointestinal issues are frequent: roughly 40% of patients experience nausea or vomiting. Constipation, diarrhea, stomach pain, and bloating are also common. These effects stem from semaglutide’s slowing of digestion.
Strategies to mitigate discomfort include:
- Eating smaller, more frequent meals
- Avoiding fatty, spicy, or rich foods
- Eating slowly
Dietary Adjustments Are Essential
Semaglutide alters appetite and digestion, often leading to faster fullness and reduced hunger. However, this can increase the risk of nutrient deficiencies, particularly protein. Consuming 20–30 grams of lean protein (from poultry, fish, beans, or low-fat dairy) at each meal is crucial to prevent muscle loss. Dividing intake into five or six smaller meals can aid nutrient absorption.
Cosmetic Effects and Long-Term Use
Rapid weight loss with semaglutide may result in cosmetic changes, such as hollow cheeks or sunken facial features (sometimes referred to as “Ozempic face”). These effects, caused by collagen and elastin reduction, are generally not harmful but can be undesirable. Maintaining a healthy diet, exercising regularly, and practicing good skincare can help mitigate these changes.
Stopping semaglutide often reverses its benefits, making long-term or indefinite treatment necessary for sustained liver improvements. The medication addresses a chronic condition, requiring ongoing management to maintain positive outcomes.
Semaglutide’s impact extends beyond liver health, potentially reducing cravings and even addictive behaviors by altering brain responses to food. Prioritizing protein and nutrient-dense foods is vital to prevent muscle loss and nutritional deficiencies. This treatment requires commitment to both medical protocols and lifestyle adjustments for optimal results.
