It’s rare for a drug to become a real hype. But with the drug “Wegovy” it happened: people show on social media how they lost weight with it – and report side effects. What has happened since it was introduced a year ago? An overview:
What is “Wegovy”?
“Wegovy” is a prescription medicine intended to help you lose and maintain weight by suppressing appetite and increasing satiety. For this use, doctors have been able to prescribe the drug from Danish company Novo Nordisk in Germany since mid-July 2023. Patients inject it under the skin once a week using a pre-filled pen that resembles a pen.
The active ingredient “Wegovy” semaglutide has long been used to treat type 2 diabetes – under the trade name “Ozempic”. “Wegovy” contains the active ingredient in higher doses and is approved for people with obesity, that is, obesity, with a body mass index (BMI) equal to or greater than 30. Therapy should be combined with diet and exercise.
How does the medicine work?
O Active ingredient “Wegovy” semaglutide mimics the effect of the gut hormone GLP-1 (glucagon-like peptide-1). This is released from the small intestine after eating, explains Matthias Laudes, vice-president of the German Obesity Society (DAG) and director of the Research Institute for Diabetology and Clinical Metabolism at the University Hospital of Schleswig-Holstein.
The hormone signals the pancreas to produce insulin. “That’s the antidiabetic effect,” says Laudes. The second effect is that the brain is informed that something has been eaten and can develop a feeling of fullness. “That’s the weight-regulating effect.”
The third effect is to signal to the stomach that there is still enough food in the small intestine, thus slowing gastric emptying. Patients have noticed this particular effect as a side effect — namely nausea. But this usually goes away once people get used to eating smaller portions, Laudes says.
What other side effects are there?
In addition to nausea, other gastrointestinal complaints such as vomiting, diarrhea and constipation often occur at the beginning of therapy, says Karsten Müssig from the German Society for Endocrinology (DGE). Therefore, we start with a low dose and gradually increase it. Rare side effects include inflammation of the pancreas and intestinal obstruction. “Therefore, treatment should only be carried out under medical supervision,” warns Müssig.
A recent study published in the journal Jama Ophthalmology suggests that in very rare cases, semaglutide may be associated with a serious eye condition called non-arteritic anterior ischemic optic neuropathy (NAION). This has not been proven, but should be taken seriously, says Horst Helbig of the German Ophthalmological Society (DOG) and the University Hospital Regensburg. Clarifying this issue requires further investigation and careful observation of patients.
Reports point to another phenomenon known as “ozepic face”: in general, rapid weight loss can make the face appear sunken and significantly aged.
Should “Wegovy” be carried for the rest of your life?
Obesity, like diabetes, is a chronic disease, says Laudes. So the medication must be taken for life. “With a diabetes medication, no one would say you can stop taking it after six months,” says Laudes. “Every obese person has the problem of gaining weight over the course of their life.” You can also see this after gastric bypass surgery.
What should patients pay attention to?
Obesity therapy should always include a change in lifestyle, for example towards a balanced diet and regular exercise, says DGE expert Müssig. The diet should be low in calories and rich in fiber and also contain fewer saturated and more unsaturated fatty acids – similar to the Mediterranean diet.
How much does “Wegovy” cost?
According to Müssig, the price of obesity treatment is around 300 euros per month. Patients have to bear the costs themselves because the medication is not covered by statutory health insurance companies.
Does “Wegovy” affect women’s fertility?
During treatment with semaglutide – i.e. “Wegovy” or “Ozempic” – pregnancies have occurred in women who had long had an unfulfilled desire to have children, says Ulrich Knuth, President of the Federal Association of Centers for Reproductive Medicine in Germany (BRZ). However, there are no reliable figures on this. According to the expert, a reduction in body weight may play an important role here. It is known that obesity reduces the likelihood of pregnancy.
The product should not be used during pregnancy or breastfeeding. Anyone wishing to have a child should stop taking semaglutide at least two months in advance, writes the European Medicines Agency (EMA).
Is Novo Nordisc the only supplier of weight loss injections?
No. US pharmaceutical company Eli Lilly now also sells a weight-loss injection under the name “Mounjaro”. It contains the active ingredient tirzepatide, which, like semaglutide, is a GLP-1 receptor agonist. It has been approved in the EU since the end of last year.
A study has just shown that significant weight loss is much more likely to be achieved with semaglutide than with placebo. The research team reports in the journal “JAMA Internal Medicine” that the risks of side effects of both substances are comparable. No statements about long-term consequences or the achievement of important goals, such as reducing the risk of heart attacks, could be derived from the analysis.
What conclusion can be drawn after one year?
The diabetes drug “Ozempic” has long been used for weight loss beyond its actual approval – i.e. against type 2 diabetes – says diabetologist Müssig. The introduction of “Wegovy” a year ago was accompanied by the hope that “Ozempic” would no longer be used as an obesity drug and would increasingly be available to diabetes patients. Although the availability of “Ozempic” has improved, there are still bottlenecks in delivery.
This situation increases Risk of counterfeit products – The EMA explicitly warns against buying preparations on the black market. Furthermore, the preparations should only be used for their respective approved purposes – type 2 diabetes and obesity. If non-obese people only use these drugs to optimize their body, this will exacerbate the already existing shortages.
With information from dpa