Wegovy is a brand-name medication, not currently available as a generic, that has garnered attention for its potential in weight loss and related health benefits. This article delves into the specifics of Wegovy, exploring its mechanisms, applications, side effects, and how it compares to other weight loss alternatives, using data from Ovi weight loss studies and other relevant sources.
How Wegovy Works
Wegovy functions by reducing appetite and slowing the rate at which food moves from the stomach to the intestines. This leads to a prolonged feeling of fullness and helps in reducing blood sugar levels.
Approved Uses for Wegovy
The Food and Drug Administration (FDA) has approved Wegovy for several specific uses:
Weight Loss and Weight Management
- Adults and children 12 years and older with obesity.
- Adults who are overweight and have a health condition related to their weight, such as high blood pressure, type 2 diabetes, obstructive sleep apnea, or high cholesterol.
Reducing Cardiovascular Risks
- Used in conjunction with exercise and a low-calorie diet to reduce the risk of cardiovascular problems, such as heart attack, stroke, and death, in adults with cardiovascular disease who are overweight or have obesity.
Treating MASH
- Used with exercise and a low-calorie diet to treat metabolic dysfunction-associated steatohepatitis (MASH) in adults with moderate to advanced liver fibrosis (scarring), but not cirrhosis. Wegovy's effects on metabolism can help lower liver inflammation and keep liver scarring from getting worse. Specifically, Wegovy helps to reduce appetite and blood sugar, and helps with weight loss. These effects can help reduce or slow fat buildup in the liver.
It is important to note that doctors generally do not prescribe Wegovy with other GLP-1 receptor agonists or drugs containing semaglutide, the active ingredient in Wegovy, such as the diabetes medications Rybelsus and Ozempic.
Dosage and Administration
Wegovy is administered as a liquid solution via prefilled, single-dose pens, injected under the skin. The pens come in various strengths:
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- 0.25 mg/0.5 mL
- 0.5 mg/0.5 mL
- 1 mg/0.5 mL
- 1.7 mg/0.75 mL
- 2.4 mg/0.75 mL
Recommended Dosages
- Weight Loss and Reducing Cardiovascular Risks: For adults and children 12 years and older, the starting dosage is 0.25 mg once per week. The dosage is gradually increased every four weeks until the maintenance dosage of either 2.4 mg or 1.7 mg once per week is reached, depending on individual response.
- MASH: The starting dosage is 0.25 mg once per week, gradually increased every four weeks to a maintenance dosage of 2.4 mg once per week. If a patient cannot tolerate 2.4 mg per week, the dosage may be lowered to 1.7 mg per week.
Important Dosage Considerations
- Missed Dose: If a dose is missed and the next dose is more than 48 hours away, take the missed dose as soon as remembered. If the next dose is less than 48 hours away, skip the missed dose and take the next dose at the usual scheduled time.
- Long-Term Use: Wegovy is typically used long-term if it is deemed safe and effective by the doctor and patient.
- Onset of Action: Wegovy starts working immediately after injection, but noticeable weight loss or appetite decrease may take several weeks or months.
- Duration in System: Wegovy remains in the body for approximately 5 to 7 weeks after the last dose.
Side Effects of Wegovy
Like all medications, Wegovy can cause side effects, which can range from mild to serious.
Mild Side Effects
Common mild side effects include:
- Bloating or abdominal pain
- Burping
- Diarrhea
- Dizziness
- Gas
- Headache
- Indigestion, heartburn, or gastroesophageal reflux disease (GERD)
- Fatigue
- Stomach flu
- Vomiting
- Constipation
- Nausea
These side effects often subside within a few days to weeks.
Serious Side Effects
Although less common, serious side effects can occur:
- Gallbladder problems, including gallstones or gallbladder inflammation
- Increased heart rate
- Low blood sugar
- Pancreatitis (inflammation of the pancreas)
- Kidney problems, including kidney injury caused by severe dehydration
- Severe gastrointestinal problems such as nausea, vomiting, or diarrhea
- Eye problems in people with type 2 diabetes
- Low blood pressure
- Appendicitis
- Increased risk of fractures
- Mood changes, including depression and suicidal thoughts and behaviors
- Allergic reaction
Boxed Warning
Wegovy has a boxed warning, the most serious warning issued by the FDA, regarding the risk of thyroid cancer. Semaglutide, the active ingredient in Wegovy, has been shown to increase the risk of cancerous thyroid tumors in animal studies. Symptoms of a thyroid tumor may include trouble swallowing, hoarse voice, a lump or swelling in the neck, and shortness of breath.
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Doctors typically avoid prescribing Wegovy to individuals with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2.
Managing Specific Side Effects
- Nausea: Nausea is a common side effect that may decrease over time. Medications to reduce nausea can be prescribed if it becomes bothersome.
- Constipation: Constipation may also occur and can be managed with medication. Lowering the Wegovy dose may also help.
- Allergic Reaction: Allergic reactions, though not reported in initial studies, have occurred since the drug's approval. Symptoms can range from mild skin rash and itchiness to severe swelling and difficulty breathing. Immediate medical attention is required for severe allergic reactions.
Cost and Availability
The cost of Wegovy can vary based on the treatment plan and pharmacy. Insurance coverage can significantly reduce the cost, but the exact price depends on the insurance plan. Wegovy is not available as a generic drug.
Novo Nordisk has introduced NovoCare® Pharmacy, offering Wegovy at a reduced cost of $499 per month for cash-paying patients, with convenient home delivery.
Wegovy vs. Alternatives
Wegovy vs. Ozempic, Trulicity, and Victoza
Wegovy and Ozempic both contain semaglutide, while Trulicity and Victoza contain dulaglutide and liraglutide, respectively. All these drugs are used to reduce the risk of serious cardiovascular problems and death in certain adults with cardiovascular disease. However, Ozempic, Trulicity, and Victoza are primarily used to treat type 2 diabetes and manage blood sugar levels. Ozempic is also used to treat chronic kidney disease in people with type 2 diabetes.
Wegovy vs. Saxenda and Phentermine
Wegovy and Saxenda are both GLP-1 receptor agonists that regulate appetite and calorie consumption. Phentermine is an appetite suppressant used short-term for weight loss. Wegovy and Saxenda can be used for long-term weight loss and weight management.
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Ovi Weight Loss Study: AT2R Agonist C21 and its Effects on Adiposity
The Ovi weight loss study investigated the effects of the angiotensin type 2 receptor (AT2R) agonist C21 on adiposity and body weight in female mice. The study found that pharmacological activation of AT2R by C21 reduces adiposity and body weight gain, independent of estrogen, in female mice. Improvement in fatty acid metabolism is a potential mechanism by which the AT2R exerts anti-adiposity effects.
Key Findings from the Ovi Study
- Reduced Adiposity and Body Weight Gain: C21 treatment attenuated the increase in parametrial white adipose tissue (pWAT) weight, plasma free fatty acid and triglycerides, and liver/body-weight ratio induced by a high-fat diet (HFD).
- Improved Fatty Acid Metabolism: C21 treatment attenuated the decrease in liver expression of carnitine palmitoyltransferase 1 (CPT1-A), a key enzyme in mitochondrial fatty-acid β-oxidation.
- Long-Term Effects: Long-term C21 treatment lowered the HFD-induced body weight gain, increase in pWAT weight, parametrial adipocyte size, and hyperinsulinemia.
The Ovi study suggests that AT2R activation could be a potential therapeutic target for obesity and related metabolic disorders in females.
Additional Research and Considerations
MTHFR Gene Polymorphism
Research has explored the relationship between the methylenetetrahydrofolate reductase (MTHFR) gene polymorphism and obesity. A study involving young individuals found no overall difference in the distribution of the MTHFR 677C>T polymorphism between individuals with normal weight and those with overweight/obesity. However, gender-specific analysis showed a significant protector effect of the TT genotype against obesity in males and elevated waist circumference in females.
Semaglutide and Alzheimer's Disease
Emerging research suggests that semaglutide, the active ingredient in Wegovy, may have potential benefits in easing symptoms of Alzheimer's disease. Studies in mouse models have shown that semaglutide can reduce amyloid-beta protein build-up, improve memory and learning, and reduce inflammation in the brain.
Precautions and Warnings
Before starting Wegovy, patients should inform their healthcare provider about any existing medical conditions, including:
- Personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2
- Pregnancy or plans to become pregnant
- Breastfeeding or plans to breastfeed
- Other medications, including diabetes medications
- History of pancreatitis, gallbladder problems, or depression
Patients should also be aware of the potential for increased heart rate, low blood sugar, dehydration leading to kidney problems, and severe stomach problems.