Semaglutide, Ozempic, WeGovy & Rybelsus in Singapore

1. Ozempic (Semaglutide)

What is Ozempic (Semaglutide) and How Does It Work?

Semaglutide is part of a family of medicines known as GLP-1 RAs (Glucagon Like Peptide Receptor Agonist). GLP-1 is a protein that is naturally produced by the gut in response to food. Its main effects are to make us feel full (satiated), slow down food from leaving the stomach and bring our blood sugar back down to normal by stimulating the pancreas to produce insulin.

For people who suffer from Obesity, their bodies produce very little GLP-1 and instead produce more Ghrelin. Ghrelin is the hormone that makes us feel hungry. This is what we call energy dysregulation. In other words, the body loses control over how it takes in and uses energy.

Semaglutide works by enhancing the amount of GLP-1 in the body, consequently giving the body back control over its energy intake and output.

What are the Benefits of Taking Ozempic?

Ozempic was first developed as a treatment for Diabetes. However, subsequent research found that the active ingredient found in Ozempic (Semaglutide) can lead to significant weight loss even in people who do not have Diabetes. Furthermore, the same research showed Semaglutide can be given safely in much higher doses to treat Obesity compared to treating Diabetes.

Aside from weight loss, Semaglutide has been shown to have many other health benefits including:

1. Reversal of pre-diabetes
2. Lowering blood pressure
3. Improvement of fatty liver
4. Reducing waist circumference which is linked to a reduction in the risk of heart attacks

Who is Recommended to Take Ozempic?

Medical weight loss therapy is recommended for people who:

1. Have a BMI of > 30 OR
2. Have a BMI of > 27 with a medical condition related to obesity, for example painful knees, sleep apnea, high cholesterol, high blood pressure or pre-diabetes; or have tried lifestyle management but are still unable to lose weight.

These are just guidelines. During the medical consultation we will understand your medical concerns and health goals. We will then discuss with you the pros and cons of medical weight loss therapy and make a joint decision if it is right for you.

Of course, medical weight loss therapy is not just about taking medicines and must always be accompanied with a nutritious diet and exercise program.

How is Ozempic Different from Various Weight Loss Options?

Obesity is a complex disease with various causes. There are also different ways people put on weight. It is therefore important to see a doctor to find out which medical weight loss therapy best suits you.

That said, Ozempic has several advantages over older weight loss medicines. These include:

1. Very limited side effects. Older weight loss medicines can cause palpitations, insomnia and even raise the blood pressure. The commonest side effect with Ozempic is nausea that usually subsides with continuous use. Some older weight loss medications also cause oil to leak from the anus. Potentially causing extremely embarrassing social situations. Ozempic does not have this side effect.
2. No weight rebound. Older weight loss medicines have been known to cause significant weight regain once they are stopped. Ozempic causes less of a weight rebound.
3. Does not lose effect. Older weight loss is known to become less effective as quickly as after 3 months of continuous use. Ozempic retains its effects

What are Possible Side Effects of Ozempic?

The commonest side effect with Ozempic is nausea. To minimize this side effect, we will usually start you on a small dose then increase the dose slowly. We will also advise you to not eat if they do not feel hungry and stop eating once you feel full. And to stay away from rich creamy and oily foods. All these will help to alleviate the nausea.

The other possible side effect is constipation. This is usually easily fixed with adequate hydration. Drink lots of water!

Some patients however get the opposite reaction which is diarrhea. This usually stops all on its own after a few days and do not require medicines

Where Can I Get Ozempic/Semaglutide in Singapore?

Ozempic is only available from Doctors. Even so, there is a significant worldwide stock shortage of Ozempic and not all clinics have ready stock.

At Dr Tan Medical Center, we manage our Ozempic stocks and ensure all our patients have access to it.

2. Difference between Ozempic and Saxenda

How do Ozempic and Saxenda Work?

Both Ozempic and Saxenda are GLP-1 RAs. They work in the same way by reducing appetite, increasing satiety and increasing insulin production in response to a meal. The key difference is the body breaks down Ozempic much more slowly compared to Saxenda. This is why Ozempic requires a much smaller dose and much fewer injections to achieve greater weight loss effects compared to Saxenda.

How is Saxenda and Ozempic Used?

Both Saxenda and Ozempic are given as a small injection under the skin (subcutaneous injection). Most people inject it into the tummy. However, other approved injection sites are the thigh and upper arm.

The key difference is Ozempic only needs to be injected only once a week. Saxenda needs to be injected every day.

What is the Effectiveness/Weight Loss Results of Ozempic and Saxenda?

Results vary greatly between patients. In studies, patients on Saxenda can lose up to 10% of their body weight. While patients on Ozempic can lose even up to 20% of their body weight.

Are There Differences in Side Effects Between Ozempic and Saxenda?

Both Saxenda and Ozempic have similar side effects which are nausea, diarrhea or constipation. These usually subside with continued use.

The severity of side effects varies greatly between patients. In fact, some patients do not get side effects at all. Mild side effects can usually be managed with lifestyle change (see above). To manage the side effects, we would usually start you off on a low dose then slowly increase the dose over time. If side effects are uncomfortable, we may keep you at a lower dose until the side effects subside before increasing the dose.

3. Introduction of WeGovy

What is WeGovy?

WeGovy is a medicine indicated for the treatment of obesity. It contains the same active ingredient as Ozempic (Semaglutide). The only difference is the WeGovy pen is capable of delivering a much higher dose (up to 2.4mg) as opposed to Ozempic which can only deliver a maximum of 1mg at a time.

WeGovy has been approved the Health Science Authority of Singapore as a weight loss medicine

What are the Benefits of WeGovy?

WeGovy has all the benefits of Ozempic. This is not surprising as they contain the exact same active ingredient (Semaglutide). It causes weight loss by reducing appetite and increasing satiety. It also slows down food from leaving the stomach, consequently making you feel full for longer after a meal.

WeGovy also has been shown to have other health benefits including:

1. Reversal of pre-diabetes
2. Lowering blood pressure
3. Improvement of fatty liver
4. Reducing waist circumference which is linked to a reduction in the risk of heart attacks

How is WeGovy Different from Competitors (Dosage Options?)

There are many different medicines for weight loss currently available. We will determine which medicine is best suited for you after a medical consultation.

That said, WeGovy has certain advantages over other weight loss medicines including:

1. Ease of use. WeGovy is given as a once-weekly small injection under the skin.
2. Increased dose. WeGovy is capable of delivering a maximum dose of up to 2.4mg at a time as opposed to Ozempic that can only deliver a maximum of 1mg at a time.

Who is Eligible for WeGovy?

Medical weight loss therapy is recommended for people who:

1. Have a BMI of > 30 OR
2. Have a BMI of > 27 with a medical condition related to obesity for example painful knees, sleep apnea, high cholesterol, high blood pressure or pre-diabetes. Or have tried lifestyle management but are still unable to lose weight.

These are just guidelines. During the medical consultation we will understand your medical concerns and health goals. We will then discuss with you the pros and cons of medical weight loss therapy and make a joint decision if it is right for you.

Of course, medical weight loss therapy is not just about taking medicines and must always be accompanied with a sound diet and exercise program.

Are there any Side Effects of WeGovy?

The commonest side effect with WeGovy is nausea. To minimize this side effect, we will usually start you on a small dose then increase the dose slowly. We will also advise one to not eat if they do not feel hungry and stop eating once they feel full. And to stay away from rich creamy and oily foods. All these will help to alleviate the nausea.

The other possible side effect is constipation. This is usually easily fixed with adequate hydration.

Some patients however get the opposite reaction which is diarrhea. This usually stops all on its own after a few days and do not require medicines.

Where to Get WeGovy in Singapore?

WeGovy is approved for weight loss therapy by the Health Science Authority in Singapore. However, there is currently a worldwide stock shortage. We expect it to be available in Singapore in 2024.

Can I Switch from Ozempic to WeGovy?

Yes, you absolutely can. They contain exactly the same active ingredient. You can switch from Ozempic to WeGovy anytime at the same dose. We will then guide you on increasing the dose if necessary.

4. Rybelsus

What is Rybelsus?

Rybelsus is the oral form of Ozempic and WeGovy. It contains exactly the same active ingredient (Semaglutide).

Rybelsus is taken as a daily tablet instead of a weekly self-injection which is how Ozempic and WeGovy are taken.

Rybelsus has to be taken on an empty stomach with just a mouthful (maximum 120ml) of water. Please do not take too much water as water can interfere with the absorption of Rybelsus. You then are not allowed to eat or drink anything (even water) for at least 30 minutes after taking Rybelsus. In fact, it is better to wait for 1 hour.

Does Rybelsus Contain Different Side Effects?

Rybelsus has the same possible side effects as Ozempic which are nausea, constipation or diarrhea. We would alo start you off at a low dose then increase the dose slowly over time. This helps to minimize the side effects.

Rybelsus contains the same active ingredient as Ozempic and WeGovy (Semaglutide). Semaglutide is a GLP-1 agonist. This is a hormone that is naturally produced by your gut after you have eaten. It reduces your appetite and also slows down food from leaving your stomach. You will not feel hungry. You will feel full after eating a much smaller portion than your usual. You will also feel full for longer after your meals.

Similar to Ozempic, Rybelsus was first developed as a medicine to treat diabetes. However, research has shown that at a higher dose, Rybelsus also leads to weight loss.

Where to Get Rybelsus in Singapore?

Rybelsus is available at Dr Tan Medical Center.

5. Contrave

What is Contrave?

Contrave is the newest weight loss medicine available in Singapore.

It contains 2 active ingredients- Naltrexone and Bupropion.

It works by modifying 2 areas of the brain that control hunger and cravings.

It works especially well for people with a “hungry brain”. In other words, people who do not actually feel hungry but eat because their brains tell them to. Common symptoms of hungry brain include:

1. Addiction eating - Eating to feel good (medically speaking to get the endorphin hit)
2. Subconscious eating - Eating while distracted or tired
3. Emotional eating - Eating for comfort when stressed or in a low mood. Using food as an emotional crutch or comfort. A common example is overeating to feel better after a hard day at work.

What are the Side Effects of Contrave?

Possible side effects of Contrave include nausea, dizziness, dry mouth, constipation and headache. Contrave does NOT cause palpitations or insomnia. To manage these side effects, we will start you on a low dose and increase the dose slowly over time.

How is Contrave Used?

Contrave is taken as a daily oral tablet. It is best absorbed when taken with food.

Studies on Contrave show that patients can lose up to 13.6% of their body weight when coupled with lifestyle changes.

Contrave can be given with Ozempic, Saxenda, WeGovy or Rybelsus. Patients who reach a weight loss plateau with Ozempic, Saxenda, WeGovy or Rybelsus may experience further weight loss when Contrave is added to their treatment.

Where to Get Contrave in Singapore?

Contrave is available at Dr Tan Medical Center.