Wegovy(Semaglutide) : FDA Approved -Weekly Injection for Rapid Weight Loss

What is Wegovy and Why is it a Revolutionary Treatment for Obesity–Wegovy vs. Ozempic

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Wegovy  weight loss injection is a newly FDA approved  medication belonging to the GLP-1 receptor antagonists group of drugs. It obtained FDA approval in June 2021 for the short and long term treatment of obesity.  Surprisingly, it’s  not a new drug at all, but simply an increased dosage of the diabetic drug Ozempic (chemical name semaglutide).

Ozempic  has been used successfully for the past several years for the treatment of type 2 diabetes. Its origin comes from the observation that  most overweight diabetics treated with Ozempic experience significant weight loss despite the major difficulties diabetics have with obesity.  Ozempic standard dose is a 1 mg injection once a week, while Wegovy dose is 2.0-2.4mg injection once a week. Wegovgy, a higher dose of semaglutide  produces even greater weight loss than Ozempic. Although Ozempic comes in an oral form, much greater weight loss is observed when  injections are administered once a week. The Wegovy Weight Loss Injection done once a week with 2.4 mg produces the max weight loss.

How Much Weight Loss Can You Expect from Wegovy- Ozempic?

Wegovy helps patients lose an average of about 15-20% of their body weight, almost double the rates produced by other prescription treatments. More than a third of overweight patients lost 20% or more of their body weight when taking Wegovy.  Because people start at different weights and the marked difference in weight loss between men and women its best to evaluate weight loss as a % of weight loss from starting or baseline weight.

In a recent trial, 40% of participants lost 20% or more of their body weight over a year ( an example might be  a 40 lb. weight loss in a 200 lb. individual.) The amount of weight loss depends on the dose of medications, initial weight and duration of treatment.  This approaches the weight loss found in costly bariatric surgery!

Effect of Wegovy on Body Weight

Note in the graph above, after 10 weekly injections,  the average participant who took Wegovy lost 16% of their body weight and those receiving placebo lost only 4% of body weight on the same diet and exercise plan. Note the weight regain after 52 weeks with placebo.

Dr. Oz Interviews Dr. Robert Kushner Discoverer of Ozempic-Wegovy

Who Should Take Wegovy(Semaglutide)

Wegovy is indicated for adults who are obese (body mass index ≥30) or overweight (body mass index ≥27). It can also be used with a BMI >27 in patients with type 2 diabetes, hypertension, and high cholesterol. The drug can be used for short term weight management but has been especially designed and tested for long term weight loss and control. This is  in conjunction with a reduced calorie meal plan and increased physical activity. FDA approved Wegovy based on phase 3 data which showed that Wegovy helped 33% of patients lose more than 20% of their body weight over a 68-week clinical trial period. This high-dose version of  Ozempic -semaglutide is a first of its kind obesity medication in that it is dosed on a once-weekly basis by injection.

How Does the Wegovy Weight Loss Injection  Produce Weight Loss if its only once a week?

Wegovy, similar to its lower dose diabetes drug, Ozempic, acts on the GLP-1 receptors in the brain, stomach, liver, pancreas, muscle and the stomach. The most important effects are found in the brain where Wegovy attaches to GLP-1 receptors to reduce appetite, hunger and cravings especially for sweet and salty pleasure producing foods.  In the stomach it reduces gastric emptying time which produces fullness. This results in a reduction of hunger and early satiety. Wegovy effects muscles by increasing sugar uptake and the pancreas by increasing insulin production and reducing glucagon secretion (hormone that causes hunger.)  All of these effects result in less food intake and weight loss.

Here is how Wegovy – Ozempic produces such significant weight loss -note the interaction with many organs in the body, the final result being less food intake:

wegovy new weight loss medication

Wegovy Results in a Marked Decrease in Food Intake

 A recent study from Germany where participants consumed  as much food as they desired found that the placebo participants ate 2676 calories a day while the Wegovy participants ate only 1736 calories, a reduction in energy intake of more than 33%! The major effects in this study were an average of 10% reduction in hunger, 15% increase in satiety and 17%  increase in fullness. Note this finding is important in that there was no planned diet or exercise program. The weight reduction was from a marked decrease in daily food intake of more than 900 calories per day.(Most diet plans strive for a reduction of about 500 calories a day or 1 lb. weight loss.) WEIGHT LOSS REPORTS indicate MORE THAN 20% OF INDIVIDUALS LOSE 20% OF THEIR EXCESS WEIGHT. WEIGHT LOSS ALMOST AS GOOD AS A GASTRIC BYPASS.

Animal studies have shown that Wegovy effects the brain by blocking GLP-1 receptors in the hypothalamus and hindbrain that are involved in appetite regulation, food intake, food preferences, reward and meal termination. This is located in the lateral parabrachial nucleus.

How is Wegovy Taken?
Wegovy is supplied in a single dose pen injector.  It is self administered once a week on the same day of the week subcutaneously to the arm, abdomen or thigh. There are 5 doses ranging from 0.25 mg to 2.4 mg. Dosing starts at the lowest dose of 0.25 mg  weekly for 4 weeks. The dose is increased in 4 week intervals until the 2.4 mg dose is reached. This becomes the maintenance dose. It can be taken as long as needed, recent studies have participants taking it for 63 weeks.

Wegovy vs. Ozempic:  Same Drug- but Higher Dose

Both drugs are the same chemical but the Wegovy is taken at higher doses after the initial titration. Max dose of ozempic is 1 mg and max dose of Wegovy is 2.4 mg. that’s the only difference. Same side effects which are dose related as is the weight loss.

Using Ozempic Instead of Wegocy for Weight Loss

Lack of insurance coverage and high cost for Wegovy has prompted some overweight individuals to use Ozemic instead of Wegovy.
Detailed instructions are included in another posting.

The most common side effects reported by more than 5 % of patients include nausea, vomiting, constipation, abdominal pain, headache, fatigue, dyspepsia and reflux. The side effects are due to the effects of Wegovy on the stomach including delaying gastric emptying for hours. This results in fullness for long periods of time and less hunger.

What are Warnings about Wegovy?
Ozempic and Wegovy are the same drug–just a higher dose.  Like Ozempic, the higher dose Wegovy is contraindicated in patients  with Medullary thyroid cancer or in patients with Multiple Endocrine Neoplasia Syndrome. There is increase in thyroid nodules and possible Thyroid C-cell tumors.  Acute pancreatitis has also been reported in this group of medications but is extremely rare.  Wegovy should not be taken with insulin. All of these side effects are extremely rare as evidenced by the widespread use and safety of Ozempic which is the same chemical as Wegovy.

Wegovy is taken as a Single Injection Once a Week:
Four Wegovy pens are supplied.  The first month the once a week injection consists of 0.25 mg. There are 5 boxes for the 5 doses from 0.25 mg a week to the strongest of 2.4 mg a week. Each month the dosage is increased to a maximum of 2.4 mg/week. The is the “maintenance dose.” Wegovy is a prescription drug requiring a personal evaluation by a licensed physician.

Wegovy monthly escalation of doses

Reviews and Ratings of Wegovy from the Literature

Here are some of he early ratings of Wegovy when it first was released in the summer of 2021.
My patients have had excellent responses to the drug with several patients losing more than 50 lbs in 2-3 months. the average weight loss among the first 10 patients over 2 months was  3.5 lbs. per week. The maximum weight loss was
105 lb in a patient who started at 318 lbs.

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