Wegovy (Semaglutide) 

Wegovy (semaglutide) is a prescription medication used to help with weight management in adults with obesity. Developed by the Danish pharmaceutical company Novo Nordisk, Wegovy was approved by the United States Food and Drug Administration (FDA) in June 2021. It is administered once a week by subcutaneous injection.

As with all medications intended to help with weight loss, Wegovy should be part of a comprehensive weight loss program that includes a nutritious diet, calorie reduction, exercise, and other lifestyle modifications.

Wegovy has generated significant interest among healthcare professionals and patients due to its effectiveness in helping with weight loss and its excellent safety profile. However, the major deterrent to including Wegovy in a weight loss care plan is its cost. Currently, the cost for Wegovy is typically over $800 per month, and many insurance plans do not provide coverage for Wegovy.

How does Wegovy work for weight loss?

Wegovy is an extended-release formulation of semaglutide that belongs to a class of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists. An agonist is a drug or substance that binds to a cell receptor and causes the same action as the substance that normally binds to the receptor. Semaglutide is an agonist that mimics GLP-1.

GLP-1 is a hormone produced by the small intestine that stimulates insulin secretion, lowering blood glucose. GLP-1 also reduces glucagon secretion, a naturally occurring hormone that raises glucose levels. Ozempic, an earlier formulation of semaglutide, was approved by the FDA in 2017 for use in patients with diabetes because it lowers blood glucose.

In addition to lowering blood glucose, GLP-1 and its agonists activate receptors in the hypothalamus, a part of the brain that regulates appetite and food intake. The effect is a reduction in hunger and an increased feeling of fullness. As part of a weight management program, this can help people achieve and sustain weight loss.

What are the health benefits of Wegovy?

Wegovy can help people with obesity first lose weight and then help with the second critical step of maintaining that healthier weight. Doing so has numerous health benefits.

The health risks accompanying obesity are well known and include heart disease, high blood pressure, type 2 diabetes, stroke, certain types of cancer, and a shortened life span. In pre-menopausal women, obesity is also associated with polycystic ovary syndrome (PCOS), a condition characterized by hormonal changes resulting in irregular menses, difficulty getting pregnant, and excess body hair.

Losing weight can prevent, treat, and in some cases, even reverse obesity-related health conditions. It is important to note that a patient does not have to become ‘slender’ to benefit from weight loss; just 5-10% (10-20 lbs in a 200 lb person) can result in very significant health improvements, including lowering blood pressure, lipids, blood glucose, and hemoglobin A1c. There can also be physical benefits (more energy, better mobility, diminished joint pains) and mental/emotional benefits (reduced stress and anxiety and increased confidence and self-esteem).

What are the clinical trial weight loss results for Wegovy?

Clinical trials have shown that Wegovy is highly effective for losing weight. In one 68-week trial with over 1,900 obese participants, those who took Wegovy lost an average of 15% of their initial body weight compared to only 2.4% weight loss in the placebo group.

Additionally, more than 60% of Wegovy-treated participants in this trial achieved at least 10% weight loss, compared to 17% of participants in the placebo group. ¹

What are the potential side effects of Wegovy?

Like all medications, Wegovy can have side effects. Because Wegovy and other GLP-1 drugs work by mimicking hormones in your gut, the most common side effects are typically limited to digestion and include:

• Nausea with or without vomiting
• Abdominal pain
• Diarrhea
• Constipation

If you have type 2 diabetes, there is also the risk of hypoglycemia (low blood sugar level). This is particularly true if you are taking insulin or other diabetes medications.

Signs of low blood sugar include:

• Blurry vision
• Headache
• Dizziness
• Irritability
• Shakiness
• Sweating

Fortunately, the vast majority of side effects with Wegovy are relatively mild and frequently resolve with time or adjustment of the dose; it is uncommon for Wegovy to be discontinued due to side effects. However, Wegovy should only be used under the supervision of a healthcare provider who will review it with you and then monitor the risks and benefits of including Wegovy in your weight management program.

Am I a good candidate for Wegovy?

You may be a good candidate for Wegovy if you have the following:

• Body mass index (BMI) over 30
• BMI over 27, plus a weight-related health condition such as high blood pressure, diabetes, or elevated lipids.
• Due to lack of data on safety in pregnant humans, women who are pregnant or planning to become pregnant should not take a GLP-1 agonist.

How is Wegovy taken?

To take Wegovy, follow carefully the instructions provided by your healthcare provider. Wegovy comes as a prefilled injection pen. Each pen contains a single dose. Your healthcare provider will prescribe the appropriate dose for you, and you should use a new pen with each weekly injection.

Here are the general steps for taking Wegovy:

1. Check the pen before use to ensure the medication is clear and free from particles or discoloration.
2. Choose a site for your injection. Your healthcare provider will recommend the best places to inject the medication, usually just under the skin in the abdomen, thigh, or upper arm.
3. Clean your injection site with an alcohol swab to ensure the area is sterile, and let it dry.
4. Remove the cap from the pen and attach a fresh needle each time.
5. Prime the pen by turning the dose selector until the dose counter shows zero. Then press the injection button until a drop of medication appears at the needle tip.
6. Inject the medication into your chosen site according to your healthcare provider’s instructions.
7. Always dispose of the used needle and pen safely according to instructions from your provider.

Keep track of your injection schedule and attend all appointments with your healthcare provider to ensure proper progress monitoring and make any necessary adjustments to your care plan.

How long will I take Wegovy?

How long you take Wegovy or any other weight-loss drug initially depends on whether the prescribed drug is proving effective in helping you lose weight. If weight loss is progressing well and you are not experiencing any bothersome or serious side effects, your health care provider may suggest that you take Wegovy long term. Conversely, if your care plan is not working well, the plan should be modified, and the changes may include discontinuing Wegovy and possibly substituting a different weight loss medication.

What happens if I stop taking Wegovy?

It is an unfortunate fact that most people who lose weight regain much or all of the weight that they lost. On the one hand, this should be expected if after losing weight someone stops everything they did to lose weight and goes back to doing everything exactly as they did while gaining weight.

However, making very important lifestyle changes like eating a healthy diet and getting more physically active often are not enough to prevent regaining weight. The reason for this is that when you have obesity, the regulation of your body weight is dysfunctional. Your body will try to push you back to your previous weight. In this situation, Wegovy or some other long-term weight loss medication may be a necessary part of the care plan needed to keep your weight in a healthier place.

It is as important to work with your health care provider after a weight loss program as it is during the weight loss program!

Footnote:

1. FDA, https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014  

Sources:

1. Mayo Clinic: https://www.mayoclinic.org/healthy-lifestyle/weight-loss/in-depth/weight-loss-drugs/art-20044832  
2. U.S. Food and Drug Administration: https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014  
3. National Library of Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8717485/  
4. Cleveland Clinic: https://health.clevelandclinic.org/weight-loss-drugs/ 

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