More people are troubled with weight gain.

Despite several diets, meal replacements, medications and increasing knowledge of healthy eating, the prevalence of obesity is increasing worldwide .

Scientists across the globe are working hard to bring in effective medications for sustained weight loss.

Medications which are now licensed to be used in the UK for weight loss include:

  • Orlistat®
  • Saxenda®
  • Mysimba®

and now semaglutide has been approved for chronic weight management by FDA.

Wegovy® (semaglutide) approved for weight loss

The U.S. Food and Drug Administration (FDA)  approved Wegovy® (semaglutide), which is a once weekly injection for chronic weight management in adults with obesity or overweight with at least one weight-related condition (hypertension, type 2 diabetes, or elevated cholesterol) on 4th June 2021. This medication for weight loss is expected to be available in July/August 2021.

The Food and Drug Administration is responsible for protecting public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices. You can read more about the FDA on https://www.fda.gov/about-fda.

The FDA approved Ozempic® (semaglutide) for treatment for people with type 2 diabetes in 2017. You can read about Saxenda® (liraglutide) and semaglutide in this blog: What is the difference between saxenda® and semaglutide (Ozempic®)?

Wegovy is indicated for chronic weight management in adults with a BMI of 27kg/m2 or greater, who have at least one of the weight related medications or who have a BMI of over 30kg/m2.

Injection Wegovy® is advisable to be used along with a reduced-calorie diet and increased physical activity.

In the Novonordisk funded research study participants taking injection Wegovy® had an average weight loss of 15%, around 34 pounds (15.3 kilograms). Participants lost weight steadily for 16 months before weight loss started plateauing. In the placebo group, that is people who were not given the weight loss injection, the average weight loss was about 2.5%( 6 pounds).

It is extremely important to note that all the research into weight loss medications shows that outcomes are good only if accompanied by lifestyle changes and regular monitoring by the research team.

Compared to all the weight loss medications available, injection Wegovy® resulted in the most significant weight loss (15%) so far.

How Wegovy® (semaglutide) works in the body and helps lose weight?

Wegovy® mimics a naturally produced hormone called glucagon-like peptide-1 (GLP-1). Glucagon-like peptide (GLP) acts on the hunger and fullness centres in the brain and regulates your appetite and the quantity of food you can consume. It also affects the motility of the gut and the secretion of insulin in the body. The dose of this medication is gradually increased depending on how you tolerate over 5 months until you reach maximum dose of 2.4mg once a week.

People can quickly obtain this medication like other weight loss medications over the internet. You should be assessed for suitability and should be monitored regularly by a specialist.

As mentioned above the medication on its own may not be effective in the long run. In order to lose weight and sustain weight loss you should adopt a healthy lifestyle and be regularly monitored. It is recommended that Wegovy® should not be used in combination with other GLP-1 products, semgalutide preparations, weight loss products including over the counter weight loss medications and herbal products.

Your specialist will monitor you for tolerability, kidney disease, diabetic retinopathy, depression or suicidal behaviours and thoughts whilst you are on injection Wegovy®.

 

What are the side effects of Wegovy® (Semaglutide)?

Wegovy® has not been studied in patients with a history of pancreatitis.

Wegovy’s safety and efficacy were studied in four 68-week trials. One of these studies was a double-blind, placebo-controlled, randomised withdrawal trial in which patients receiving Wegovy® either continued with the treatment or switched to a placebo (STEP4). More than 2,600 patients received Wegovy® for up to 68 weeks in these four studies, called STEP and more than 1,500 patients received placebo.

The average age was 55 years and 51% were female. The average body weight was 220 pounds (100 kg) and the average BMI was 36 kg/m2.

 

The most common side effects of Wegovy® include:

  1. Nausea and Indigestion
  2. Diarrhoea
  3. Vomiting
  4. Constipation
  5. Abdominal pain and bloating
  6. Belching and reflux
  7. Headache
  8. Tiredness
  9. Dizziness
  10. Hypoglycaemia (low blood sugar) in people with type 2 diabetes
  11. Flatulence

Who should not take Wegovy® ?

  • People with risk of thyroid C-cell tumours.
  • Personal or family history of medullary thyroid carcinoma
  • People with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
  • History of severe allergic reactions to semaglutide or any of the other components of Wegovy®.

Following warning has been provided by manufacturers of Wegovy®:

  • Risk inflammation of the pancreas (pancreatitis)
  • Gallbladder problems (including gallstones)
  • Hypoglycaemia (low blood sugar)
  • Acute kidney injury
  • Diabetic retinopathy
  • Increased heart rate
  • Suicidal behaviour or thoughts

The above was noted in the studies and people on Wegovy® should be aware of it. People planning to start Wegovy® should discuss with their specialist if they have symptoms of pancreatitis or gallstones. If you have diabetes it is important to discuss with your doctor and later blood sugar lowering medication/insulin if required.

  • Will Wegovy® help you lose weight?
  • Will Wegovy® work for every one?
  • How much will I lose?
  • How long should continue with Wegovy® ?

These are the usual questions asked in my clinic. 

Always consult a diabetes specialist or endocrinologist when starting any weight loss medication or when altering the dosage.

Simplyweight’s Specialist Online Weight Loss Plan has been designed to bring decades of clinical experience to people at an affordable price. To learn more, start your 7-day free trial today: https://app.simplyweight.co.uk/subscribe/free-trial

 

Dr C. Rajeswaran FRCP(UK);MSc
Consultant Physician
Obesity, Diabetes & Endocrinology