Wegovy for Weight Loss

Are you curious about adding Wegovy to your weight loss plan? Scroll down to learn more and see if it is the proper medication for you.

What is Wegovy?

Wegovy is an FDA-approved prescription medication used to help with weight management in adults who are obese or overweight and have at least one weight-related condition, such as high blood pressure, type 2 diabetes, or high cholesterol. It uses the active ingredient, semaglutide, which can also be found in other brand medications like Ozempic and Rybelsus.

How Does Wegovy Work?

As mentioned, Wegovy uses the active ingredient “Semaglutide,” which belongs to a class of drugs called GLP-1 receptor agonists. These drugs mimic the effects of the naturally occurring hormone GLP-1. Semaglutide works by increasing insulin secretion, slowing digestion, and reducing appetite, which helps control blood sugar levels and promote weight loss.

GLP-1 stands for "glucagon-like peptide-1," a hormone naturally produced in the human body. It is secreted by the cells in the intestines in response to food intake and helps to regulate blood sugar levels by stimulating insulin secretion from the pancreas.GLP-1 also slows digestion, reduces appetite, and promotes feelings of fullness, which can help with weight management

Along with regulating insulin secretion and appetite, there are also anti-inflammatory effects. Semaglutide. There are GLP-1 receptors in a multitude of organs. When activated, they lead to a decrease in the amount of pro-inflammatory receptors and an increase of anti-inflammatory cells in the body. This anti-inflammatory effect may benefit from reducing the risk of atherosclerosis (plaque formation in the arteries) and improving cardiovascular conditions (1).

This may also open avenues for using Semaglutide in other inflammatory conditions such as arthritis, polycystic ovarian syndrome, and psoriasis. However, more studies are needed to say for sure.

Who Qualifies for Wegovy?

Wegovy has been FDA-approved in the management of obesity. If you have a BMI greater than 30 or a BMI greater than 27 and have an obesity-related condition (diabetes, hypertension, dyslipidemia), you may be eligible to take Wegovy.

Due to the weight loss and anti-inflammatory effects, Wegovy may also be used in patients with Polycystic Ovarian Syndrome (PCOS). A narrative review of evidence published in 2021 reviewed over 800 articles and found that there may exist a promising therapeutic role of GLP-1 agonist medications, like Wegovy, in managing PCOS (2). However, more extensive clinical trials are needed to establish a possible role.

The weight loss effects may also benefit other weight-related conditions such as high cholesterol, high blood pressure, and obstructive sleep apnea. You may be eligible for Wegovy if you have one of these conditions and are struggling with obesity. Call your insurance provider if you qualify based on these conditions.

Can Wegovy Be Used for Weight Loss?

Wegovy has been shown to help people struggling with obesity lose weight. It should be noted that Wegovy should not substitute but be supplemented with a calorie-restricted diet and regular exercise. Regular exercise (150 minutes/week) and a calorie-restricted diet have led to the best results in all of the clinical trials with Wegovy, so make sure to add this to your plan or continue doing this if you have been when using Wegovy.

The most popular study on Wegovy for obesity is the STEP 1 Trial, a large randomized control trial with about 1900 participants that examined how effective Wegovy (semaglutide) was at treating obesity in non-diabetic patients (3). Wegovy was given as a once-weekly pen injection starting at a low dose, gradually increasing to a maximum of 2.4mg over 68 weeks. After 68 weeks, they found that participants taking Wegovy along with diet and exercise experienced a significant reduction in body weight (around 15%) compared to the placebo group.

Wegovy vs Other GLP-1 Medications

Wegovy vs. Mounjaro

Mounjaro (Tirzepatide) is a new dual-action GLP-1 and GIP agonist medication to treat type 2 diabetes. It has gained a lot of popularity in its off-label use for obesity. It is slightly different from semaglutide since it also works on the GIP (Gastric Inhibitory Peptide) receptors in the body, which increases the effectiveness of GLP-1. Mounjaro is also given as a once-weekly injection.

The popularity of the use of Mounjaro in obesity came from the SURMOUNT-1 Trial published in 2022. In this trial, participants struggling with obesity were given Mounjaro for 72 weeks in combination with regular exercise and diet (4). They found that people taking Mounjaro lost an average of 15% of their body weight after 72 weeks, with some people losing as high as 20% with higher doses (50-55% of people taking Mounjaro)! When comparing these results with the results of the STEP-1 trial for Wegovy, we see that these medications are very similar in effectiveness! Both had a similar average weight loss at the end of the trial (14.9% for Wegovy vs 15% for Mounjaro), and both had a similar amount of participants who achieved at least a 5% decrease in body weight (86.4% for Wegovy vs 85% for Mounjaro). It is important to note that the best results for both medications were seen when the participants dieted and exercised regularly.

Wegovy vs Saxenda

Saxenda is another GLP-1 agonist medication with the active ingredient, Liraglutide.  Liraglutide works very similarly to semaglutide and also has weight loss benefits. Saxenda is FDA-approved for the treatment of obesity. It is a once-daily injection.

When comparing Wegovy to Saxenda, Wegovy has been shown to have a more significant weight loss effect. In a study published in 2022 called the STEP-8 clinical trial, researchers compared the weight loss effect of Wegovy vs. Saxenda for non-diabetic patients struggling with obesity (5). Participants were given either Wegovy or Saxenda, were started on a calorie restriction diet and regular exercise, then were followed for 68 weeks. The researchers found that participants taking Wegovy noticed a 15.8% change in body weight, while participants taking Saxenda noticed a change of 6.4%. Therefore, Wegovy showed a more significant weight loss effect when compared to Saxenda.

Wegovy Side Effects

The most common side effects when taking Wegovy are gastrointestinal, but there are other commonly reported side effects. This includes:

• Abdominal pain (10%)
• Nausea (44%)
• Vomiting (24%)
• Diarrhea (31%)
• Constipation (23%)
• Headache (15%)
• Sore throat or throat pain (21%)

The side effects are usually mild to moderate in severity and went away over time.

Wegovy Dosage and Administration

Wegovy is given as a once-weekly pen injection starting at 0.25mg over four weeks. After four weeks, the dose will be increased to 0.5 mg. Each four-week treatment period, the dose can be increased to 1 mg, 1.7mg to a maximum of 2.4mg. A dose of 2.4 mg is considered the “maintenance dose” that you would continue on with.

Wegovy can be injected into the abdomen, thigh, or upper arm. Make sure to rotate the injection locations with each dose. It can be taken with or without a meal. If you miss a dose and there is more than two days until the next dose, take the missed dose as soon as possible. If the next dose is within two days, move on to the next dose. Do NOT double dose!

Wegovy Contraindications and Warnings

Pancreatitis

Pancreatitis occurs when the pancreas becomes inflamed. This is an infrequent but potential side effect of Wegovy. If you have a history of pancreatitis, please inform your provider before starting Wegovy.

Hypoglycemia (Low Blood Sugar)

Since Wegovy increases insulin secretion, there is a risk that your blood sugar can be lowered to dangerous levels. This is known as hypoglycemia. If you have a history of hypoglycemia or are currently using insulin, you must inform your provider before starting Wegovy.

Serious Allergic Reaction

You may experience a severe allergic reaction to Wegovy when first taking it. Signs of a severe allergic reaction include swelling of your face, lips, tongue, or throat, problems breathing or swallowing, severe rash or itching, fainting or feeling dizzy, and very rapid heartbeat. Let your provider know immediately if you have experienced this with other GLP-1 medications or are currently experiencing this when taking Wegovy.

Kidney Disease

Though Wegovy is safe for people with kidney disease, the stomach problems associated with Wegovy may lead to fluid loss by vomiting, nausea, or vomiting. If you do have kidney problems, it is essential to stay hydrated while on Wegovy. If the gastrointestinal side effects of Wegovy are preventing you from adequately staying hydrated, then let your provider know immediately.

Severe Stomach Problems

The most common side effect of Wegovy is gastrointestinal upset, which includes stomach ache, nausea, diarrhea, vomiting, and loss of appetite. If these symptoms become so severe that they significantly affect your daily life or ability to eat regularly, then let your provider know.

Changes in Vision

For patients with a history of diabetic retinopathy, there is a chance that your vision can worsen when taking Wegovy. If you do have a history of diabetic retinopathy, then let your provider know before starting Wegovy.

Gallbladder Disease

Wegovy can cause gallbladder issues and other gastrointestinal side effects. Since Wegovy can decrease food movement through the gastrointestinal system, it can also reduce the gallbladder's function. This can lead to gallstone formation, which can block the release of bile, leading to the inflammation of the gallbladder.

If you have a history of gallstones or cholecystitis (inflammation of the gallbladder), then let your provider know before starting Wegovy. If you have had your gallbladder removed in the past, then you can still take Wegovy.

Thyroid Cancer or Family History of MEN-2

Though very rare, there is a risk of developing a specific type of thyroid cancer when taking Wegovy, called Medullary Thyroid Cancer. If you have a history of medullary thyroid cancer or a family history of Multiple Endocrine Neoplasia Cancer Syndrome Type 2 (MEN-2), let your provider know before starting Wegovy. MEN-2 is a genetic cancer syndrome that puts a patient at risk for developing Medullary Thyroid Cancer, so patients with this syndrome should avoid taking Wegovy.

Pregnancy

The use of Wegovy in pregnant people is not well studied. The current guidelines suggest that the weight loss effects of Wegovy may not benefit you during pregnancy and can potentially cause harm to the fetus. Therefore you should avoid taking Wegovy if you are pregnant or are planning on becoming pregnant.

Wegovy Coverage and Cost

The cost of Wegovy can be very expensive.Wegovy can cost upwards of $1400. Therefore, you should discuss which medication your plan covers with your insurance provider or if you qualify for any benefit plans.

You may be eligible for a Wegovy Savings Coupon to help lower the price of a 28-day supply to $0 for up to 12 refills depending on your insurance plan. You can use the following link to check if your insurance plan covers Wegovy.

Where Can I Get Wegovy?

If you want to learn more about GLP-1 medications or see if you might be eligible for medication-assisted weight loss, check out Mochi Health, where board-certified obesity medicine physicians can offer expertise in this realm!

Mochi Health is a virtual obesity medicine practice that connects you with medical providers, like licensed physicians and nurse practitioners, to help you optimize your weight loss journey. We provide monthly video chats with actual medical providers to provide guidance about weight management and to get you started on prescription weight loss medications to supplement your weight loss plan.

Frequently Asked Questions

Check out our Mochi Health Blogs to learn about different topics on weight loss medications.

‍Who should avoid taking Wegovy?

‍‍What is the best diet while taking Wegovy?

‍‍Can Wegovy lower my blood sugar?

‍‍Does Wegovy cause thyroid cancer?

‍‍Can Wegovy prevent me from having babies?

‍Get started at Mochi Health today!

References

1. Jensen JK, Binderup T, Grandjean CE, Bentsen S, Ripa RS, Kjaer A. Semaglutide reduces vascular inflammation investigated by PET in a rabbit model of advanced atherosclerosis. Atherosclerosis. 2022 Jul;352:88-95. doi: 10.1016/j.atherosclerosis.2022.03.032. Epub 2022 Apr 4. PMID: 35400496; PMCID: PMC9241989.
2. Abdalla MA, Deshmukh H, Atkin S, Sathyapalan T. The potential role of incretin-based therapies for polycystic ovary syndrome: a narrative review of the current evidence. Ther Adv Endocrinol Metab. 2021 Jan 27;12:2042018821989238. doi: 10.1177/2042018821989238. PMID: 33552465; PMCID: PMC7844452.
3. Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, McGowan BM, Rosenstock J, Tran MTD, Wadden TA, Wharton S, Yokote K, Zeuthen N, Kushner RF; STEP 1 Study Group. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021 Mar 18;384(11):989-1002. doi: 10.1056/NEJMoa2032183. Epub 2021 Feb 10. PMID: 33567185.
4. Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, Kiyosue A, Zhang S, Liu B, Bunck MC, Stefanski A; SURMOUNT-1 Investigators. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022 Jul 21;387(3):205-216. doi: 10.1056/NEJMoa2206038. Epub 2022 Jun 4. PMID: 35658024.
5. Rubino DM, Greenway FL, Khalid U, et al. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial. JAMA. 2022;327(2):138–150. doi:10.1001/jama.2021.23619

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