If you've struggled with weight loss, you're not alone. The Centers for Disease Control and Prevention report that nearly three-quarters of Americans are overweight or obese. The human body's regulatory system is designed to maintain a certain set point. While weight may fluctuate, it's often designed to return to its highest level. According to Dr. Scott Cunneen, a bariatric surgeon at Cedars-Sinai, being overweight means your body has a higher energy storage set point than necessary for optimal functioning. Finding safe and effective drugs for chronic weight management has been a challenge, with many producing only marginal benefits and troubling side effects. Some drugs have even been pulled from the market by the Food and Drug Administration (FDA) due to safety concerns. However, the approval of semaglutide (Wegovy) in June marked a turning point. This under-the-skin injection is the first weight loss drug approved by the FDA for chronic weight management since 2014, and it boasts a higher rate of weight loss with fewer side effects than other approved medications.
How Wegovy Works
Wegovy works by suppressing your appetite and making you feel fuller for longer. The active ingredient, semaglutide, targets the body’s GLP-1 receptors. Dr. Scott Cunneen explains that Wegovy mimics glucagon-like peptide-1 (GLP-1), a hormone naturally produced in the body. GLP-1 prompts the body to produce more insulin after eating. This mechanism helps readjust your set point over time, enabling you to eat less and lose weight without constant hunger. Semaglutide isn't entirely new. It has been used since 2017 to treat Type 2 diabetes at doses of 0.5 to 1 mg per week. In June, the FDA approved a higher dose of semaglutide, 2.4 mg weekly, specifically for weight loss. Unlike oral medications, Wegovy is administered as an under-the-skin injection, a tiny shot (like a pinprick) into your leg or stomach once a week.
Expected Weight Loss with Wegovy
In a 68-week double-blind trial involving nearly 2,000 obese adults without diabetes, weekly 2.4 mg semaglutide injections, combined with a healthy diet and exercise, resulted in a 15% to 20% loss of body weight for most patients. This was significantly higher than the 2.4% weight loss observed in patients who received placebo injections. Most other weight loss drugs typically lead to about a 5% loss of body weight.
Wegovy Timeline and Expected Weight Loss Month by Month
The first few months of Wegovy treatment are crucial for adjusting to the medication and incorporating healthier habits into your lifestyle. Wegovy patients tend to lose around 4% of their body weight after two months, 6% after three months, and 8% after four months. After 17 months, you can expect to lose around 17% of your starting body weight.
Here's a monthly breakdown of what to expect from Wegovy, based on trial data. Individual results may vary, and your clinician may adjust your dose based on your specific needs.
Read also: Sustainable weight loss using Wegovy
- Month 1: Dose: 0.25mg
- Month 2: Dose: 0.5mg | Expected weight loss: 4% body weight
- Month 3: Dose: 1mg | Expected weight loss: 6% body weight
If your dose is increased beyond 1mg:
- Month 4: Dose: 1.7mg | Expected weight loss: 8% body weight
- Month 5: Dose: 2.4mg | Expected weight loss: 10% body weight
- Month 6 onwards: Dose: 2.4mg | Expected weight loss after 17 months: 17% body weight
Who is Wegovy For?
Wegovy is intended for adults with:
- A BMI of 30 or higher.
- A BMI of 27 or higher, plus one weight-related health condition, such as high blood pressure, high cholesterol, or Type 2 diabetes.
It's important to note that more than 70% of Americans fall into one of these categories.
Who Should Not Take Wegovy?
You should not take semaglutide if:
- You or anyone in your family has a history of medullary thyroid carcinoma (MTC).
- You have an endocrine disorder called multiple endocrine neoplasia syndrome type 2 (MEN 2).
- You are pregnant or breastfeeding.
Important Considerations and Potential Side Effects
Like many weight loss drugs, Wegovy can cause gastrointestinal side effects, including gas, bloating, indigestion, nausea, diarrhea, constipation, and vomiting. To minimize these effects, doctors typically start patients on a low dose and gradually increase it to 2.4 mg weekly over four months.
Read also: Weekly Wegovy Progress
Potential Side Effects and Precautions:
- Possible thyroid tumors, including cancer: Tell your healthcare provider if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath, as these may be symptoms of thyroid cancer.
- Pancreatitis: Stop using Wegovy® and call your healthcare provider right away if you have severe pain in your stomach area (abdomen) that will not go away, with or without nausea or vomiting.
- Gallbladder problems: Wegovy® may cause gallbladder problems, including gallstones.
- Increased risk of low blood sugar (hypoglycemia): This is especially important for those who also take medicines for diabetes such as insulin or sulfonylureas.
- Dehydration leading to kidney problems: Diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration), which may cause kidney problems.
- Severe stomach problems:
- Increased heart rate: Wegovy® can increase your heart rate while you are at rest.
- Depression or thoughts of suicide:
- Risk during surgery: Wegovy® may increase the chance of food getting into your lungs during surgery or other procedures that use anesthesia or deep sleepiness (deep sedation).
Cost and Coverage
Currently, Wegovy isn't covered by most insurance plans, including Medicare. The standard out-of-pocket cost is about $1,400 per month. However, it's anticipated that Medicare and private insurance plans will eventually cover Wegovy, given that overweight and obesity can exacerbate various health conditions.
Wegovy Compared to Other Medications
Interestingly, Eli Lilly’s new medication called Mounjaro has shown even better weight-loss results than Wegovy in clinical trials. One study found that Mounjaro supported average weight loss of nearly 25% after one year.
The Importance of Lifestyle Changes
It's crucial to remember that Wegovy is most effective when used in combination with lifestyle changes, such as a reduced-calorie diet and increased physical activity. In one study, people lost an average of about 6% of their starting weight after using Wegovy for 12 weeks, about 10% of their starting weight after 20 weeks of Wegovy, and about 15% after one year.
Read also: Duration of Wegovy Treatment