{"id":4397,"date":"2025-08-11T20:57:08","date_gmt":"2025-08-11T20:57:08","guid":{"rendered":"https:\/\/qelizaesthetics.com\/semaglutide-the-magic-pill-against-obesity-truth-or-fallacy\/"},"modified":"2025-08-11T20:57:08","modified_gmt":"2025-08-11T20:57:08","slug":"semaglutide-the-magic-pill-against-obesity-truth-or-fallacy","status":"publish","type":"post","link":"https:\/\/qelizaesthetics.com\/sq\/semaglutidi-pilula-magjike-kunder-obezitetit-e-vertete-apo-e-gabuar\/","title":{"rendered":"Semaglutidi, pilula magjike kund\u00ebr obezitetit: E v\u00ebrtet\u00eb apo gabim?"},"content":{"rendered":"

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Obeziteti \u00ebsht\u00eb nj\u00eb s\u00ebmundje shum\u00eb e p\u00ebrhapur, multifaktoriale, kronike dhe recidivuese q\u00eb prek 650 milion\u00eb t\u00eb rritur n\u00eb nivel global, q\u00eb p\u00ebrkthehet n\u00eb af\u00ebrsisht 30% burra dhe 35% gra. Obeziteti k\u00ebrkon menaxhim afatgjat\u00eb dhe shoq\u00ebrohet me disa nd\u00ebrlikime t\u00eb sh\u00ebndetit fizik dhe mendor. N\u00eb m\u00ebnyr\u00eb specifike, mund t\u00eb \u00e7oj\u00eb n\u00eb rezistenc\u00eb ndaj insulin\u00ebs dhe diabet t\u00eb tipit 2, hipertension, dislipidemi dhe s\u00ebmundje kardiovaskulare, apne obstruktive t\u00eb gjumit dhe s\u00ebmundje t\u00eb m\u00ebl\u00e7is\u00eb yndyrore joalkoolike (NAFLD). Gjithashtu shoq\u00ebrohet me jet\u00ebgjat\u00ebsi t\u00eb reduktuar, kryesisht p\u00ebr shkak t\u00eb morbiditetit dhe vdekshm\u00ebris\u00eb kardiovaskulare. <\/span><\/p>\n

Edhe pse nd\u00ebrhyrja n\u00eb stilin e jet\u00ebs (dieta dhe ushtrimet) p\u00ebrfaq\u00ebson gurthemelin e menaxhimit t\u00eb obezitetit, ruajtja e humbjes s\u00eb pesh\u00ebs n\u00eb planin afatgjat\u00eb \u00ebsht\u00eb sfiduese. Shumica e njer\u00ebzve mbipesh\u00eb ose obez\u00eb zakonisht arrijn\u00eb vet\u00ebm humbje modeste n\u00eb pesh\u00eb, t\u00eb cil\u00ebn shpesh e rifitojn\u00eb, duke kaluar k\u00ebshtu n\u00ebp\u00ebr d\u00ebshtime t\u00eb panum\u00ebrta n\u00eb humbjen e pesh\u00ebs. Ve\u00e7an\u00ebrisht, \u00ebsht\u00eb demonstruar se humbja e pesh\u00ebs p\u00ebrmes modifikimit t\u00eb stilit t\u00eb jet\u00ebs zakonisht arrin plato n\u00eb nj\u00eb nivel prej 5%-10% dhe shoq\u00ebrohet me nj\u00eb rrezik t\u00eb lart\u00eb t\u00eb rikthimit, i cili mund t\u00eb lidhet me p\u00ebrshtatjen metabolike. Edhe pse humbja e pesh\u00ebs prej 5%-10% \u00ebsht\u00eb e lidhur me p\u00ebrmir\u00ebsime n\u00eb faktor\u00ebt e rrezikut kardiovaskular, diabetin e tipit 2 dhe cil\u00ebsin\u00eb e jet\u00ebs, humbjet e pesh\u00ebs p\u00ebrtej 10% prodhojn\u00eb p\u00ebrfitime edhe m\u00eb t\u00eb m\u00ebdha sh\u00ebndet\u00ebsore, duke p\u00ebrfshir\u00eb faljen e diabetit t\u00eb tipit 2 dhe uljen e ngjarjeve kardiovaskulare (SKV). Si e till\u00eb, humbja e pesh\u00ebs prej \u2265 10%-15% rekomandohet tek njer\u00ebzit me nd\u00ebrlikime t\u00eb mbipesh\u00ebs dhe obezitetit, t\u00eb tilla si s\u00ebmundjet kardiovaskulare, osteoartriti, apnea obstruktive e gjumit, NAFLD dhe diabeti i tipit 2. <\/span><\/p>\n

Prandaj, trajtimet farmakologjike p\u00ebr njer\u00ebzit q\u00eb nuk jan\u00eb n\u00eb gjendje t\u00eb arrijn\u00eb q\u00ebllime t\u00eb tilla p\u00ebr humbje peshe vet\u00ebm me nj\u00eb program gjith\u00ebp\u00ebrfshir\u00ebs p\u00ebr humbje peshe ofrojn\u00eb nj\u00eb shtes\u00eb t\u00eb vlefshme p\u00ebr nd\u00ebrhyrjet n\u00eb stilin e jet\u00ebs. Udh\u00ebzimet klinike sugjerojn\u00eb farmakoterapi shtes\u00eb (medikamente kund\u00ebr obezitetit) me nj\u00eb diet\u00eb me kalori t\u00eb reduktuara dhe aktivitet fizik t\u00eb shtuar p\u00ebr t\u00eb rriturit me nj\u00eb indeks t\u00eb mas\u00ebs trupore (BMI) \u2265 30 kg\/m2.<\/span>2<\/span> ose \u2265 27 kg\/m<\/span>2 <\/span>tek ata me nj\u00eb s\u00ebmundje komorbiditet t\u00eb lidhur me obezitetin, si\u00e7 \u00ebsht\u00eb diabeti i tipit 2, hipertensioni ose dislipidemia. <\/span><\/p>\n

Medikamentet aktuale t\u00eb miratuara p\u00ebr menaxhimin kronik t\u00eb pesh\u00ebs n\u00eb SHBA ose Evrop\u00eb jan\u00eb orlistati, fentermina-topiramati, naltrekson-bupropioni, liraglutidi 3.0 mg dhe semaglutidi 2.4 mg. Nd\u00ebrsa kat\u00ebr t\u00eb parat n\u00eb p\u00ebrgjith\u00ebsi prodhojn\u00eb nj\u00eb humbje mesatare prej 4%-8% m\u00eb t\u00eb madhe n\u00eb pesh\u00eb sesa nd\u00ebrhyrjet n\u00eb stilin e jet\u00ebs vet\u00ebm (2.6 kg deri n\u00eb 8.8 kg n\u00eb nj\u00eb vit), semaglutidi duket se e rrit k\u00ebt\u00eb vler\u00eb n\u00eb 15%, duke p\u00ebrkthyer n\u00eb nj\u00eb humbje mesatare peshe prej 12.5 kg nga pesha baz\u00eb pas 68 jav\u00ebsh. Semaglutidi i dh\u00ebn\u00eb p\u00ebr dy vjet rezultoi n\u00eb ndryshime t\u00eb konsiderueshme dhe t\u00eb q\u00ebndrueshme n\u00eb pesh\u00ebn e trupit krahasuar me nd\u00ebrhyrjet n\u00eb stilin e jet\u00ebs vet\u00ebm (-15.2% kundrejt -2.6%), duke demonstruar gjithashtu inkurajimin e mir\u00ebmbajtjes afatgjat\u00eb t\u00eb humbjes s\u00eb pesh\u00ebs. T\u00eb marra s\u00eb bashku, rezultatet tregojn\u00eb se semaglutidi \u00ebsht\u00eb m\u00eb efektivi i miratuar aktualisht p\u00ebr humbjen e pesh\u00ebs tek t\u00eb rriturit me mbipesh\u00eb ose obezitet. <\/span><\/p>\n

Si liraglutidi ashtu edhe semaglutidi jan\u00eb agonist\u00eb t\u00eb peptidit-1 t\u00eb ngjash\u00ebm me glukagonin (GLP-1). GLP-1 \u00ebsht\u00eb nj\u00eb hormon i zorr\u00ebve q\u00eb \u00e7lirohet n\u00eb p\u00ebrgjigje t\u00eb marrjes s\u00eb ushqimit, duke vepruar si nj\u00eb sinjal ngopjeje n\u00eb tru, duke rregulluar k\u00ebshtu homeostaz\u00ebn e energjis\u00eb. P\u00ebr m\u00eb tep\u00ebr, ai kontrollon metabolizmin e glukoz\u00ebs duke stimuluar \u00e7lirimin e insulin\u00ebs dhe duke penguar sekretimin e glukagonit. P\u00ebr menaxhimin kronik t\u00eb pesh\u00ebs, liraglutidi administrohet n\u00ebnl\u00ebkur\u00ebsisht n\u00eb nj\u00eb doz\u00eb prej 3.0 mg n\u00eb dit\u00eb, nd\u00ebrsa semaglutidi ka nj\u00eb efekt m\u00eb t\u00eb gjat\u00eb veprimi dhe administrohet n\u00ebnl\u00ebkur\u00ebsisht n\u00eb nj\u00eb doz\u00eb prej 2.4 mg n\u00eb jav\u00eb. Edhe pse t\u00eb dyja kan\u00eb treguar se zvog\u00eblojn\u00eb marrjen e energjis\u00eb, ulin urin\u00eb dhe d\u00ebshirat p\u00ebr ushqim, si dhe rrisin ndjenjat e ngopjes, semaglutidi ka efektin m\u00eb t\u00eb fuqish\u00ebm.<\/span><\/p>\n

Liraglutidi ishte agonisti i par\u00eb i GLP-1 i miratuar nga Administrata e Ushqimit dhe Barnave (FDA) p\u00ebr menaxhimin kronik t\u00eb pesh\u00ebs, pasi tregoi humbje peshe prej 4%-6% mbi at\u00eb t\u00eb arritur vet\u00ebm me nd\u00ebrhyrje n\u00eb stilin e jet\u00ebs pas 20-56 jav\u00ebsh. Semaglutidi, nga ana tjet\u00ebr, u miratua fillimisht nga FDA n\u00eb vitin 2017 n\u00ebn emrin e mark\u00ebs Ozempic p\u00ebr trajtimin e diabetit t\u00eb tipit 2 dhe p\u00ebr uljen e faktor\u00ebve klasik\u00eb t\u00eb rrezikut kardiovaskular (p.sh., presioni i gjakut, nivelet e lipideve), pra rrezikun e ngjarjeve kardiovaskulare tek personat me diabet t\u00eb tipit 2 dhe s\u00ebmundje kardiovaskulare. P\u00ebr m\u00eb tep\u00ebr, nj\u00eb version oral nj\u00eb her\u00eb n\u00eb dit\u00eb i ila\u00e7it, me nj\u00eb doz\u00eb maksimale prej 14 mg, u miratua p\u00ebr trajtimin e diabetit t\u00eb tipit 2 n\u00eb SHBA n\u00eb vitin 2019 dhe n\u00eb Evrop\u00eb n\u00eb vitin 2020. Semaglutidi ul glukoz\u00ebn n\u00eb gjak dhe p\u00ebrmir\u00ebson HbA1c duke stimuluar insulin\u00ebn dhe duke shtypur sekretimin e glukagonit n\u00eb nj\u00eb m\u00ebnyr\u00eb t\u00eb varur nga glukoza, duke \u00e7uar n\u00eb nivele m\u00eb t\u00eb ul\u00ebta t\u00eb glukoz\u00ebs n\u00eb gjak me nj\u00eb rrezik t\u00eb ul\u00ebt p\u00ebr hipoglicemi.<\/span><\/p>\n

N\u00eb qershor 2021, FDA miratoi semaglutidin si nj\u00eb shtes\u00eb p\u00ebr uljen e konsumit t\u00eb kalorive dhe rritjen e aktivitetit fizik p\u00ebr menaxhimin kronik t\u00eb pesh\u00ebs, pasi provat shkencore treguan nj\u00eb humbje peshe shtes\u00eb prej 12.4% krahasuar me ila\u00e7et e tjera kund\u00ebr obezitetit. Humbja e pesh\u00ebs me semaglutid\u00eb u shoq\u00ebrua gjithashtu me p\u00ebrmir\u00ebsime m\u00eb t\u00eb m\u00ebdha n\u00eb lidhje me faktor\u00ebt e rrezikut kardiometabolik, duke p\u00ebrfshir\u00eb uljen e perimetrit t\u00eb belit, presionin e gjakut, nivelet e hemoglobin\u00ebs s\u00eb glikuar (HbA1c) dhe nivelet e lipideve, si dhe nj\u00eb r\u00ebnie m\u00eb t\u00eb madhe t\u00eb protein\u00ebs C-reaktive (CRP), nj\u00eb sh\u00ebnues i inflamacionit. Prandaj, po b\u00ebhet e qart\u00eb se semaglutidi mund t\u00eb jet\u00eb shum\u00eb i dobish\u00ebm p\u00ebr njer\u00ebzit me komplikacione t\u00eb mbipesh\u00ebs dhe obezitetit (p.sh., prediabet, hipertension dhe apnea obstruktive e gjumit) t\u00eb cil\u00ebt k\u00ebrkojn\u00eb humbje peshe prej 10% deri n\u00eb 15% ose m\u00eb shum\u00eb p\u00ebr t\u00eb leht\u00ebsuar k\u00ebto komplikacione.<\/span><\/p>\n

 Aktualisht, semaglutidi 2.4 mg n\u00ebnl\u00ebkuror nj\u00eb her\u00eb n\u00eb jav\u00eb \u00ebsht\u00eb miratuar p\u00ebr p\u00ebrdorim n\u00eb Kanada, Evrop\u00eb, Mbret\u00ebrin\u00eb e Bashkuar dhe SHBA n\u00ebn emrin e mark\u00ebs Wigovy si nj\u00eb shtes\u00eb ndaj nj\u00eb diete me kalori t\u00eb reduktuara dhe aktivitetit fizik t\u00eb shtuar p\u00ebr menaxhimin kronik t\u00eb pesh\u00ebs tek t\u00eb rriturit me obezitet (BMI \u226530 kg\/m2).<\/span>2<\/span>) ose mbipesh\u00eb (BMI fillestare \u226527 kg\/m<\/span>2<\/span>) me t\u00eb pakt\u00ebn nj\u00eb komorbiditet t\u00eb lidhur me pesh\u00ebn. <\/span><\/p>\n

T\u00eb dh\u00ebnat gjithnj\u00eb e n\u00eb rritje kan\u00eb demonstruar efikasitetin dhe toleranc\u00ebn e semaglutid\u00ebs n\u00ebnl\u00ebkurore prej 2.4 mg nj\u00eb her\u00eb n\u00eb jav\u00eb tek individ\u00ebt q\u00eb jan\u00eb mbipesh\u00eb ose obez\u00eb. Efekti an\u00ebsor kryesor \u00ebsht\u00eb mund\u00ebsia e simptomave gastrointestinale, t\u00eb cilat zakonisht jan\u00eb kalimtare dhe me ashp\u00ebrsi t\u00eb leht\u00eb deri n\u00eb t\u00eb moderuar. \u00c7\u00ebshtjet kryesore t\u00eb siguris\u00eb me barnat e k\u00ebsaj klase jan\u00eb shfaqja e rrall\u00eb e pankreatitit dhe ndalimi i p\u00ebrdorimit tek pacient\u00ebt me nj\u00eb histori personale ose familjare t\u00eb neoplazis\u00eb s\u00eb shum\u00ebfisht\u00eb endokrine t\u00eb tipit 2 ose karcinom\u00ebs medulare t\u00eb tiroides.<\/span><\/p>\n

 Nj\u00eb tjet\u00ebr \u00e7\u00ebshtje sigurie q\u00eb ka dal\u00eb n\u00eb pah dhe meriton diskutim \u00ebsht\u00eb cil\u00ebsia e humbjes s\u00eb pesh\u00ebs me semaglutide. P\u00ebrqindja e zakonshme e humbjes s\u00eb mas\u00ebs s\u00eb lig\u00ebt n\u00eb humbjen totale t\u00eb pesh\u00ebs \u00ebsht\u00eb 25%. Tek pjes\u00ebmarr\u00ebsit e trajtuar me semaglutide, u vu re nj\u00eb humbje mesatare prej 8.36 kg t\u00eb mas\u00ebs totale t\u00eb yndyr\u00ebs trupore dhe 5.26 kg t\u00eb mas\u00ebs totale t\u00eb lig\u00ebt trupore, q\u00eb do t\u00eb thot\u00eb se masa e lig\u00ebt p\u00ebrb\u00ebnte af\u00ebrsisht 39% t\u00eb pesh\u00ebs totale, duksh\u00ebm m\u00eb e lart\u00eb se ideale. \u00c7udit\u00ebrisht, kjo p\u00ebrqindje mesatare ishte e zbatueshme edhe p\u00ebr humbjen edhe m\u00eb t\u00eb vog\u00ebl t\u00eb pesh\u00ebs totale, q\u00eb do t\u00eb thot\u00eb se n\u00eb rastet e humbjes s\u00eb pesh\u00ebs <15%, humbja e mas\u00ebs muskulore mund t\u00eb jet\u00eb madje e barabart\u00eb me humbjen e mas\u00ebs s\u00eb yndyr\u00ebs. Kjo \u00ebsht\u00eb shqet\u00ebsuese pasi nj\u00eb r\u00ebnie n\u00eb mas\u00ebn muskulore shoq\u00ebrohet me nj\u00eb rrezik n\u00eb rritje t\u00eb sarkopenis\u00eb dhe brisht\u00ebsis\u00eb, ve\u00e7an\u00ebrisht tek pacient\u00ebt e moshuar, me nj\u00eb gjas\u00eb m\u00eb t\u00eb lart\u00eb t\u00eb rifitimit t\u00eb pesh\u00ebs pas humbjes s\u00eb pesh\u00ebs, si dhe me nj\u00eb rrezik n\u00eb rritje p\u00ebr nivele t\u00eb larta t\u00eb glukoz\u00ebs n\u00eb gjak, pra diabetin e tipit 2. Prandaj, \u00ebsht\u00eb e preferueshme t\u00eb zvog\u00eblohet kryesisht dhjami i trupit pa humbje t\u00eb konsiderueshme t\u00eb mas\u00ebs muskulore kur humbet pesh\u00eb. Fakti q\u00eb semaglutidi rezulton n\u00eb humbje t\u00eb shtuara t\u00eb mas\u00ebs muskulore nuk i eliminon r\u00ebniet e ndjeshme t\u00eb mas\u00ebs totale t\u00eb yndyr\u00ebs (-19.3% nga niveli baz\u00eb) dhe mas\u00ebs s\u00eb yndyr\u00ebs viscerale (-27.4% nga niveli baz\u00eb). Ai thjesht thekson r\u00ebnd\u00ebsin\u00eb e diet\u00ebs dhe aktivitetit fizik, t\u00eb cilat duhet t\u00eb jen\u00eb gjithmon\u00eb linja e par\u00eb e trajtimit p\u00ebr obezitetin, dhe madje edhe n\u00eb rastet kur p\u00ebrmbushen kriteret e nd\u00ebrhyrjeve farmakologjike, p\u00ebr t\u00eb plot\u00ebsuar nga af\u00ebr recet\u00ebn mjek\u00ebsore.<\/span><\/p>\n

N\u00eb p\u00ebrgjith\u00ebsi, semaglutidi dhe ila\u00e7et e tjera kund\u00ebr obezitetit nuk jan\u00eb nj\u00eb ila\u00e7 p\u00ebr t\u00eb gjitha problemet dhe duhet t\u00eb p\u00ebrdoren vet\u00ebm nga t\u00eb rriturit obez\u00eb me nj\u00eb indeks t\u00eb mas\u00ebs trupore (BMI) \u2265 30 kg\/m2.<\/span>2<\/span> ose t\u00eb rritur mbipesh\u00eb me nj\u00eb BMI \u2265 27 kg\/m<\/span>2 <\/span>me t\u00eb pakt\u00ebn nj\u00eb s\u00ebmundje komorbide t\u00eb lidhur me obezitetin. P\u00ebr m\u00eb tep\u00ebr, r\u00ebnd\u00ebsia e kombinimit t\u00eb modifikimeve t\u00eb stilit t\u00eb jetes\u00ebs, si\u00e7 jan\u00eb dieta dhe aktiviteti fizik, nuk duhet t\u00eb injorohet n\u00eb trajtimin e obezitetit. Modifikimi i diet\u00ebs dhe aktiviteti fizik prej t\u00eb pakt\u00ebn 150-250 minutash\/jav\u00eb jan\u00eb thelb\u00ebsore p\u00ebr menaxhimin afatgjat\u00eb t\u00eb obezitetit dhe duhet t\u00eb ken\u00eb gjithmon\u00eb p\u00ebrpar\u00ebsi ose t\u00eb pakt\u00ebn t\u00eb p\u00ebrdoren si shtes\u00eb ndaj farmakoterapis\u00eb.<\/span><\/p>\n

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     Referencat<\/strong><\/em><\/p>\n

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