Wegovy is a recent entry into the expanding group of prescription drugs used to help people lose weight. In fact, Wegovy is one of the few drugs on the market approved by the FDA for that purpose. But how do you know if Wegovy is right for you?

This article will detail some basic facts about Wegovy, including how it works, its recommended dosage, and its side effects.

What is Wegovy?

Wegovy is a prescription medication manufactured by Novo Nordisk. They also make Ozempic and Rybelsus, two other drugs used for weight loss. These three drugs all contain the same active ingredient: semaglutide. Unlike the other two drugs, however, Wegovy is approved by the U.S. Food and Drug Administration (FDA) to help individuals with obesity or overweight individuals with a weight-related health condition lose weight.

Semaglutide is the active compound in Wegovy. It is classified as a glucagon-like peptide-1 receptor agonist. GLP-1 receptor-agonist medications replicate the actions of GLP-1. It's a hormone produced in the intestines in response to food. When you ingest food, your intestines release GLP-1, which acts as a signal to the pancreas. In response, the pancreas releases insulin, a hormone. Insulin facilitates the absorption of glucose (sugar) from the bloodstream into cells. Cells use glucose for energy or store it for later. GLP-1 ensures insulin is released as needed, particularly after meals when blood sugar levels spike.

Furthermore, GLP-1 diminishes the secretion of another pancreatic hormone called glucagon. Glucagon has the opposite effect of insulin. It raises blood sugar levels by telling the liver to release stored glucose into the blood. GLP-1 helps prevent an excessive release of glucose from the liver by inhibiting glucagon. That excessive release can lead to elevated blood sugar levels.

Wegovy also exerts an impact on the speed at which the stomach empties. This effect regulates the pace at which nutrients from your meal enter the bloodstream. It helps to prevent abrupt spikes in blood sugar levels after eating. Slower stomach emptying can also make you feel fuller for longer, which may reduce your overall calorie intake.

How does Wegovy cause weight loss?

Wegovy, unlike other GLP-1 drugs, is explicitly indicated for use as a chronic weight management aid. Wegovy has two distinct mechanisms of action that help with weight loss. It regulates blood sugar levels and reduces appetite.

Semaglutide is the active ingredient in Wegovy. It encourages the pancreas to release insulin. Insulin is the hormone that transports glucose (sugar) from the bloodstream into cells. Glucose is utilized for energy and helps maintain stable blood sugar levels. Stabilized blood sugar levels significantly reduce the likelihood of sudden energy fluctuations. These fluctuations can lead to cravings for high-calorie foods.

In addition, semaglutide effectively suppresses the production of glucagon. Glucagon is another pancreatic hormone that raises blood sugar levels. Semaglutide prompts the liver to release stored glucose into the bloodstream. Wegovy helps maintain consistent blood sugar levels by controlling the release of glucagon. It also prevents excessive hunger associated with low blood sugar.

Wegovy's impact extends beyond blood sugar control; it also regulates calorie intake.

GLP-1 receptors are present in various parts of the brain. They include the hypothalamus. The hypothalmus is responsible for governing hunger and feelings of fullness. When GLP-1 binds to these receptors, it sends signals to the brain. These alerts reduce appetite and food cravings. This translates to feeling less hungry and more satisfied with smaller meals.

Wegovy slows down the rate at which the stomach empties its contents into the small intestine. This delay in gastric emptying means that food remains in the stomach for longer. As a result, individuals feel full for longer after eating. This reduces the desire to eat more.

Wegovy is prescribed in conjunction with lifestyle changes. This includes a reduced-calorie diet and increased physical activity. It is not intended as a standalone treatment for obesity or excess weight.

Is Wegovy safe?

Wegovy has been FDA-approved for use in adults and children over 12. Wegovy's safety and effectiveness were tested in four clinical trials. The trials involved around 4,500 people who were either obese or overweight. In three of these studies, some participants received Wegovy, while others received a placebo.

n these three studies, between 67.4% and 84.8% of people who took Wegovy lost 5% or more of their body weight over 68 weeks. In comparison, fewer people who took the placebo (between 30.2% and 47.8%) achieved this weight loss.

In another study, some participants took Wegovy and others took a placebo. Those on Wegovy experienced a 7.9% drop in body weight from week 20 to week 68. In comparison, the placebo group's weight dropped by 6.9%.

Overall, Wegovy was found to be safe and well-tolerated. However, it may cause side effects in some people.

Wegovy's most common side effects are gastrointestinal issues. These issues include nausea, vomiting, diarrhea, constipation, heartburn, and belching.

More serious side effects may occur, but they are uncommon. Some serious adverse effects of Wegovy use include:

• Increased heart rate
  
• Low blood sugar (hypoglycemia)
  
• Allergic Reactions: Rash, swelling, breathing difficulties
  
• Pancreatitis (inflammation of the pancreas)
  
• Gallbladder problems, including gallstones
  
• Increased risk of thyroid cancer
  
  

If you experience any side effects while taking Wegovy, immediately seek medical attention from a licensed healthcare provider.

What should I consider before taking Wegovy?

While Wegovy is safe and effective for most patients, it can cause side effects in some. It may also interact with certain medical conditions or substances in the body, causing adverse reactions.

Before starting treatment with any prescription medication, tell your doctor about any medical conditions you have. Also, let your doctor know about any prescription drugs or supplements you are taking, and any allergies you may have. This information will help reduce the risk of any adverse reactions.

You should mention:

• A history of pancreatitis
  
• Gallbladder problems
  
• Kidney disease
  
• Medullary thyroid carcinoma (MTC) (thyroid tumors)
  
• Multiple endocrine neoplasia 2 (MEN2)
  
• Diabetic retinopathy (eye problems)
  
• Any digestive disorders
  
  

Wegovy may not be prescribed to pregnant women, women who are trying to conceive, or women who are breastfeeding.

Who should take Wegovy for weight loss?

Unlike other GLP-1 drugs, Wegovy is FDA-approved as a weight loss drug. It can be prescribed to adults or children over the age of 12.

Wegovy is specifically indicated for use in adults with obesity (with a body mass index— BMI—of 30 kg/m2 or greater) or overweight adults (a BMI of 27 kg/m2 or greater) who also have weight-related health conditions such as hypertension (high blood pressure), high cholesterol, or obstructive sleep apnea.

Wegovy is approved for use in children over 12 with an initial BMI in the 95th percentile for their age.

By helping patients lose weight, Wegovy can also lower the risk of cardiovascular events like heart attack or heart disease.

What is the recommended dosage of Wegovy?

Wegovy is a once-weekly subcutaneous injection. It is delivered just below the skin using a pre-filled injection pen. Healthcare providers will usually prescribe a lower dosage of Wegovy at first, which will be increased over several weeks.

The recommended starting dose is 0.25 mg weekly for the first 4 weeks. After the initial 4-week period, the dose should be increased to 0.5 mg weekly for the next 4 weeks. After another 4 weeks, the dose should be increased to 1 mg weekly. Finally, after an additional 4 weeks, the dose should be increased to the maintenance dose of 2.4 mg per week.

Wegovy should be injected into the abdomen, thigh, or upper arm. It can be taken at any time of the day, with or without food.

Talk to your healthcare provider if you experience side effects while taking Wegovy. They may elect to reduce your dosage or try an alternate therapy to help you lose weight.

What’s the difference between Wegovy and other weight loss medications?

Wegovy stands apart from other medications used for weight loss because it is FDA-approved for precisely this purpose. Ozempic and Rybelsus also contain semaglutide, the active ingredient in Wegovy. However, these drugs are only approved to treat type 2 diabetes. Their use as a weight loss aid is off-label.

Wegovy is not approved to treat type 2 diabetes.

What are the alternatives to Wegovy?

Wegovy is specifically indicated as a chronic weight management aid. However, it may not be suitable for everyone. If you are looking for an alternative to Wegovy, discuss these options with your healthcare provider:

Tirzepatide (available as Mounjaro or Zepbound): Tirzepatide, a GLP-1 receptor agonist, is utilized to manage both type 2 diabetes and obesity. It helps regulate blood sugar levels, curbs appetite, and slows stomach emptying. The brand name Zepbound contains tirzepatide. It is specifically approved to treat obesity in patients who do not have type 2 diabetes.

Liraglutide (available as Saxenda): Liraglutide, also a GLP-1 receptor agonist, has FDA approval for treating obesity in adults and adolescents aged 12 and above. It reduces blood sugar levels, suppresses appetite, and delays stomach emptying.

Metformin: Metformin, a prescription diabetes medication, can lead to weight loss in some individuals. It achieves this by regulating blood sugar levels and enhancing insulin sensitivity. Increased insulin usage helps lower the amount of sugar circulating in the bloodstream.

Topiramate (available as Topamax): Topiramate is an anticonvulsant drug that has demonstrated weight loss effects in certain patients. The way it works is not entirely understood. It is believed to reduce calorie intake through appetite suppression. It is also believed to prevent excess fat storage and lower particular fat and cholesterol levels. It may also impact the brain's reward system, potentially reducing binge eating. It's important to note that Topiramate is not FDA-approved as a weight loss medication. Still, clinical trials have shown it can lead to significant weight loss in individuals who take it compared to those on a placebo.

Contrave (bupropion/ naltrexone): Contrave is a combination drug consisting of two active ingredients, bupropion and naltrexone. Both of these drugs have a distinct mechanism that contribute to its weight loss effects. Contrave primarily works on the brain to control appetite and reduce cravings for high-calorie foods. Contrave may cause some serious side effects, including suicidal thoughts.

How do I get a prescription for Wegovy?

Wegovy is a prescription drug, meaning that you must have a written order from a licensed healthcare provider to get it. It cannot be purchased over the counter.

Wegovy is available under its brand name. There are no generic versions of Wegovy currently available.

Weight loss drugs are prescribed to individuals with obesity or individuals who are overweight and managing a weight-related health condition. If you are curious about Wegovy or any other weight loss drug, talk to your healthcare provider. Ask whether these treatment options are right for you. You should also discuss the cost, potential side effects, and any concerns you may have.

Can I get Wegovy on Sesame?

Sesame offers a comprehensive online weight loss program to help you get started on your weight loss journey.

Sesame’s online weight loss program is a subscription which renews every 3 months and includes a video consultation with a weight loss doctor or specialist, a GLP-1 prescription (if appropriate), insurance coordination for medication coverage, and 90 days of unlimited messaging with your provider.

Note that all prescriptions are at the discretion of your healthcare provider.

Sources:

• Bald, E., & Raber, H. (2023). Semaglutide (Wegovy) for the Treatment of Obesity. American Family Physician.
  
• McCrimmon, K. K. (2023). Wegovy vs. Ozempic: The truth about new ‘weight-loss’ drugs. UC Health.
  
• Singh, G., Krauthamer, M., & Bjalme-Evans, M. (2022). Wegovy (semaglutide): a new weight loss drug for chronic weight management. Journal of investigative medicine : the official publication of the American Federation for Clinical Research.