GLP1-RA medications were originally used for type 2 diabetes so have been used during Ramadan for many years. The same advice can be applied to those taking these medications for weight loss. Take it on the same day each week at roughly the same time. It can be taken with or without meals.

When considering fasting while on weight loss medication you have 3 options:
‍

• Pause the medication and be mindful. Recognise that Ramadan would only temporarily affect your weight loss efforts. Your journey to lose weight has to be part of your life for long term success so don’t worry about indulging yourself or taking a break from your medications during this important time to focus on what is important to you personally. As soon as Ramadan is over we’ll be around to support with a tailored restart now that you have already been on Semaglutide.

  • There have been studies that have shown a reduction in body fat stores following the period of fasting during Ramadan

• Continue medication and:

  • Don’t skip your pre-dawn meal and choose whole foods containing high amounts of fibre and protein (i.e.they have a low Glycaemic Index) as these will keep your sugar levels more stable and sustained during the fasting period

  • Watch out for any symptoms of low blood sugar and deal with them appropriately:

    • feeling hungry.
    • feeling dizzy.
    • feeling anxious or irritable.
    • feeling anxious or irritable.
    • feeling anxious or irritable.
    • tingling lips.
    • heart palpitations.
    • feeling tired or weak.

  • If this happens –  you may need to break your fast and you could consider decreasing the dose to a dose step lower

  • Be aware that fasting during the day might lead to a rebound hunger when breaking your fast. Your appetite control with Semaglutide should help avoid this and again when breaking your fast try and make healthy choices.

    • Having said that Iftar is a time of happiness to be shared with friends and family and you can treat yourself (a little!) .

  • As your routine is so different during Ramadan the impact on weight can be unpredictable but once you are back to your routine things will settle.

    • An example of this is the change in your sleep routine which could have an impact on your appetite so be mindful

  • As your routine is so different during Ramadan the impact on weight can be unpredictable but once you are back to your routine things will settle.

• It is recognised that illness is an exemption from fasting during Ramadan according to the Qur’an. Obesity is classified as a disease and if it has caused you to have other health related issues you could exempt yourself. This is a very personal decision though and it is suggested that you could discuss this if you felt comfortable with your Imam.

It’s important to know that Semaglutide isn’t a type of insulin, but instead it mimics a hormone that’s produced by your gut once you’ve eaten. Semaglutide helps many people to feel fuller and more satisfied for longer after eating smaller portions, ultimately resulting in eating less food and consuming fewer calories. In turn, this leads to weight loss when used alongside a healthy diet and lifestyle.

Wegovy and Ozempic share the common active ingredient, semaglutide, yet they are promoted for distinct purposes. Ozempic is approved and licensed for managing type 2 diabetes and has been available since 2017 - although, it is has been found in a number of studies that it can also support and be effective for weight loss. In contrast, Wegovy is a more recent introduction licensed specifically for weight loss.In essence, Wegovy and Ozempic operate identically, eliciting the same physiological response. However, disparities exist in factors such as the dosage of semaglutide and the medical conditions they are indicated for in their respective marketing.

Semaglutide is administered through injections once a week. When initiating the medication, you will commence with a lower dose, gradually increasing each month until reaching the maintenance dose. It is crucial to adhere to the prescribed dosage as directed by our healthcare professionals. You can find direction on how to use semaglutide injection pens here: https://www.youtube.com/watch?v=nKhku_1WZ-EWe do also have the offering of semaglutide in a tablet form, Rybelsus. Rybelsus is administered once per day, following the prescribed dosing and instruction as informed by one of our specialist nurses. Consume the medication with a small amount  of water. It is important to ingest Rybelsus 30 minutes before your meals, beverages, or any other daily medications. Consuming food or drinks within the 30-minute window after taking Rybelsus may diminish the drug's effectiveness.

If you receive a prescription for semaglutide, the key component in Rybelsus and Ozempic, to address weight loss, it falls under the category of 'off-label' prescribing. In such cases, the medication is recommended for a purpose diverging from its officially licensed use. This occurs when experts recognise the benefits of the medication for an alternative purpose, although the manufacturer has not yet updated the license. Semaglutide, the active ingredient, is already prescribed for weight loss under various brand names and formulations.Our healthcare professionals will only prescribe an off-label medication if they deem it safe and effective for your specific situation. *Due to high demand for Wegovy, this product may not always be available, in this instance you will be offered an appropriate alternative.

Common side effects of semaglutide include:
‍Nausea
Stomach pain
Diarrhoea
Vomiting
Constipation
Headache
Tiredness
Belching
Dizziness
Bloating
Gas
Upset stomach
Heartburn

These effects typically subside as your body acclimates to the medication and dosage. If you encounter challenges with the side effects, our healthcare professionals are available to offer support and guidance.

‍Rare or uncommon side effects of semaglutide include:
‍Pancreatitis (inflammation of the pancreas)
Gallstones
Hypoglycemia (low blood sugar) in patients with type 2 diabetes
Anaphylactic/ allergic reaction
Diabetic retinopathy (an eye condition) complications in patients with type 2 diabetes
Palpitations or feelings of a racing heartbeat while at rest

If you experience any of the serious side effects listed above, seek medical attention immediately.

Semaglutide, under the brand name Ozempic, was sanctioned for type 2 diabetes treatment in 2017. It is  administered through injection into the stomach, leg, or arm fatty tissue. Rybelsus later introduced an alternative delivery method of Semaglutide as an oral tablet. Rybelsus received approval for treating type 2 diabetes in 2019, but its active ingredient, semaglutide, obtained approval earlier, in the injectable form of Ozempic.

Extensive clinical trials preceded the licensing of semaglutide, with injections approved for weight loss under the name Wegovy. This followed promising research results.

Despite Rybelsus and Ozempic not being licensed for weight loss, they share the same active ingredient, semaglutide, that is contained in Wegovy. While all medications carry potential side effects, for most individuals, they are mild and manageable. And, at Dr Frank's, our dedicated and experienced team are able to be contacted to provide the support and guidance that is required when needed.

For Wegovy and Ozempic:Before initial use, store it in a refrigerator away from any freezing elements. Do not freeze the medication, and do not use it if it becomes frozen.

Following usage, you can either store the pen in the refrigerator or in a shielded, dark space below 30°C.

In the rare circumstance that the pen was not refrigerated before the first use, it remains suitable for use if the storage temperature is below 30°C. Dispose of the pen after 6 weeks, following the manufacturer's recommendation.

For Rybelsus:
Unlike other GLP-1 therapies, Rybelsus does not require refrigeration. It should be stored at room temperature between 20-25°C. Ensure it is stored in a dry place away from moisture.

Your medications undergo cold storage whilst in the assigned pharmacy or chemist, and have further cold-chain packaging for transportation ensuring the appropriate cold-chain regulations are met throughout the supply chain. The cold-chain packaging that the pharmacies dispense the medication in are designed to uphold a refrigerator temperature of 2 - 8°C for up to 72 hours.

In the rare circumstance that the pen has not been refrigerated before initial use, it remains suitable for use for up to 56 days after the dispatch date. If uncertain and would like a discussion with a member of our dedicated team, please do not hesitate to get in touch with us.

An unopened pen will stay viable and suitable for use when kept in the refrigerator until its expiry date (which you can find on the medication pen).After opening, refrigeration is advised, but the pen should not be used beyond 56 days from the date of first use.

Our cold chain packaging is designed to uphold a refrigerator temperature (2 - 8°C) for up to 72 hours. If your pen arrives at a temperature higher than that of a fridge, you can still use it for up to 56 days after the dispatch date.

As humans, we’re all different, so the amount of time that it takes to work can vary fromperson to person. However, most people do start seeing results in terms of weight losswithin the first few weeks of taking the injections – even before reaching the therapeuticdose of 1mg or above.

As a general guide, most people taking Semaglutide for weight loss are expected tolose at least 5% of their body weight within 12 weeks of starting treatment. Generally speaking, if Semaglutide doesn’t help you to lose 5% of your starting weight after 12weeks of using it, then our specialist nurses can arrange a referral to our specialistdietitians and nutritionists to look at alternative options/support routes.

At Dr Frank’s, we have an offering of a number of services:
-  Video Consultation with one of our specialist nurses leading to a tailored treatment plan
-  Online Assessment leading to the choice of a subscription model following standard protocol of dosing for semaglutide (0.25mg, 0.5mg, 1.0mg or higher) – if requiring to speak with a nurse it is £15 per appointment  -  Dietitian and Nutritionist Appointments

Experiencing video consultations with our specialist nurses allows you to discuss our services, create a unique treatment plan based on your current health position, goals, dietary requirements and lifestyle. If deemed eligible, a monthly video or phone call will be scheduled with one of our specialist nurses to check on your progress and if you are experiencing any side effects – from here, they can tweak and tailor your treatment plan accordingly.

A semaglutide pen has 4 doses , which, if following standard protocol, is one injection per week – this, in turn, means the pen will last you 4 weeks. Similarly, if you are prescribed the semaglutide tablets which are taken daily, this comes in a pack of 30 and will last 30 days.

As healthcare providers, we exclusively prescribe medications that have undergone rigorous clinical trials, establishing their safety and efficacy. Our clinicians collaborate with you to determine the optimal duration for maintaining the prescribed medication, tailored to your individual circumstances.Following comprehensive clinical trials affirming the safety and effectiveness of GLP-1 medications for diabetes, the FDA granted approval for the long-term treatment of obesity with semaglutide. These trials also revealed a reduced risk of adverse cardiovascular events, including heart attacks or strokes.