Listen to this article on Spotify, watch it on YouTube, 或者用中文读。
Recently, the FDA approved a promising new drug for weight loss, called Wegovy.
But is it really a game-changer for weight loss? And how does it compare with other drugs that cause weight loss like Saxenda?
Let’s take a look at how it works and how it performed in trials, to shed some light into what you might expect if you end up trying it yourself.
What is it?
Wegovy is the drug semaglutide. Semaglutide is actually already being used off-label for weight loss by many clinicians, under the brand name Ozempic, which is officially a drug for type 2 diabetes.
Semaglutide actually started as a drug for diabetes, and was found to have very potent weight loss effects.
So Novo-Nordisk, the current owner of the drug, jacked up the dose, and marketed it as the weight loss drug Wegovy.
This is very similar to the marketing of the drug liraglutide.
While it was first being used for diabetes under the name Victoza, it was found to have good weight loss effects as well. So they cranked up the dose and marketed it for weight loss. We now know this drug under the name Saxenda.
How does it work?
Semaglutide is a GLP-1 agonist. These drugs work by mimicking the effects of a hormone called Glucagon-like peptide-1 or GLP-1.
This hormone stimulates the release of insulin, and also makes us feel full. So Wegovy works primarily like an appetite suppressant.
Like most other GLP-1 agonist drugs, it needs to be injected. However, Wegovy only needs to be injected once per week.
Side effects of Wegovy
The most commonly reported side effects from trials are nausea, vomiting, and diarrhea, which is pretty typical of GLP-1 agonists like Ozempic. From research studies, an outline of the common and rare side effects associated with Wegovy is as follows:
Common side effects (reported in more than 1% of patients):
- Nausea (84-91%)
- Diarrhea (28-34%)
- Vomiting (23-27%)
- Constipation (12-16%)
- Abdominal pain (7-12%)
- Headache (6-9%)
- Fatigue (4-7%)
- Dyspepsia (3-6%)
- Dizziness (2-4%)
- Gastroenteritis (2-4%)
Rare side effects (reported in less than 1% of patients):
- Acute pancreatitis (frequency unknown)
- Gallbladder disease (frequency unknown)
- Renal impairment (frequency unknown)
- Hypersensitivity reactions (frequency unknown)
- Medullary thyroid carcinoma (frequency unknown)
- Diabetic retinopathy (frequency unknown)
The higher dose given in Wegovy likely produces stronger side effects than in Ozempic. So if you’ve tried Ozempic and couldn’t tolerate it, you probably won’t enjoy Wegovy either.
Studies on Wegovy showed that about 5% of people dropped out due to the side effects.
It’s important to note that Wegovy is a GLP-1 receptor agonist, which means it can increase the risk of thyroid tumors and pancreatitis. As a result, it is contraindicated in patients with a personal or family history of medullary thyroid carcinoma or a history of pancreatitis. So you’ll need to check with your doctor if you decide to try it.
Wegovy diet plan
Although there is no specific diet you need to follow with Wegovy, you might want to implement a stricter dietary plan, since Wegovy will make it easier to follow such plans.
Combining other appetite suppressing strategies such as having more protein and fat or consuming a soluble fiber supplement like glucomannan before meals might also help improve Wegovy’s effects.
But avoid extreme diets. You should make sure your dietary plan has a good variety of macronutrients, like protein and fat, and micronutrients, like vitamins and minerals, for example by following a calorie controlled Mediterranean Diet.
All these nutrients are necessary for proper fat metabolism, and inadvertently depriving yourself of these nutrients by following too extreme a diet, will make it harder for your body to burn fat, and potentially cause long-term problems like increasing your risk of weight rebound once you stop the drug.
How effective is Wegovy?
In one clinical trial, participants who took Wegovy for 68 weeks lost an average of 16.0% of their initial body weight, compared to an average weight loss of 5.7% in the placebo group.
Studies that compare semaglutide and liraglutide also seem to show that semaglutide is slightly more effective for weight loss than liraglutide. This would suggest that Wegovy may be more effective than Saxenda, although exactly how much is unknown.
Altogether, this makes Wegovy one of the stronger weight loss medications we have seen to date.
A game changer?
Although it’s great to hear about a drug that seems to show a lot of promise, I’m not sure if I’d call it a game-changer.
Wegovy is not really a new drug, and semaglutide was already being used as Ozempic off-label for weight loss.
It seems Novo-Nordisk just took Ozempic, more than doubled the dose, and called it Wegovy.
The significantly increased dose makes it a better appetite suppressant, but is likely to come with increased side effects, and decreased drug tolerability.
But the larger problem for patients will likely be the cost. Wegovy is being priced at around $1400 per month, similar to Saxenda.
That’s almost $17,000 a year. That’s about the cost to do lap band surgery.
So it’s not cheap by any means, and like Saxenda, many patients end up turning to cheaper alternatives, especially when their insurances refuse to cover these weight loss medications.
So while it might be a game changer in research trials, whether it will be in real life remains to be seen.
Nevertheless, a big upside of Wegovy is really being able to have more options of FDA approved weight loss drugs.
It’s good to see the FDA taking obesity more seriously, and this latest approval for an effective weight loss drug will continue to help clinicians and patients in the fight against obesity.
Should you try Wegovy?
Wegovy is best used if you have a hard time with controlling hunger and tend to overeat and snack too often.
Focus on developing good dietary and lifestyle habits whenever you take weight loss medication of any kind, as it will produce more permanent results if implemented properly.
That being said, here are a few things to keep in mind before you try Wegovy.
- The way it works as a weight loss drug is not much different from other GLP-1 agonists. This means that if you’ve tried any of the other GLP-1 agonists, particularly Saxenda or Ozempic before, and it didn’t work for you at all, Wegovy may not work too well for you either.
- Stalled weight loss and rebound weight gain upon discontinuing the drug is common in most weight loss drugs if you don’t control your diet. While Wegovy appears to have slightly stronger effects, it’s not immune to these problems. I recommend doing your best to develop good dietary and lifestyle habits while on the drug, to minimize these issues.
- Wegovy is quite expensive if paid entirely out-of-pocket, around 1-2 thousand dollars per month depending on your dose, and is not often covered by insurance. So might want to consider trying Ozempic first if you have the chance to do so, since it might tell you if Wegovy would be effective for you in the first place.
I wouldn’t be surprised if most patients opted to try the much cheaper and identical drug Ozempic first, just to get an idea of how Wegovy might work for them.
Learn more about
- Ozempic vs Rybelsus vs Saxenda vs Victoza for Weight Loss
- Other Forms of Semaglutide
- Comparing GLP-1 Agonists for Weight Loss
- 5 Things To Know Before Starting Weight Loss Medication
- Other weight loss medications
Citations
Efficacy of First-Time Intragastric Balloon in Weight Loss: a Systematic Review and Meta-analysis of Randomized Controlled Trials https://pubmed.ncbi.nlm.nih.gov/27465936/
Efficacy and safety of once-weekly semaglutide 1.0 mg vs once-daily liraglutide 1.2 mg as add-on to 1–3 oral antidiabetic drugs in subjects with type 2 diabetes (SUSTAIN 10) https://www.sciencedirect.com/science/article/abs/pii/S1262363619301326
Health Canada approves RYBELSUS® (semaglutide tablets) the first and only GLP-1 analogue in a pill for the treatment of adults with type 2 diabetes https://www.newswire.ca/news-releases/health-canada-approves-rybelsus-r-semaglutide-tablets-the-first-and-only-glp-1-analogue-in-a-pill-for-the-treatment-of-adults-with-type-2-diabetes-814386455.html
Highlights of prescribing info (FDA). https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/215256s000lbl.pdf
liraglutide (Rx) https://reference.medscape.com/drug/victoza-saxenda-liraglutide-999449
Once-Weekly Semaglutide Versus Once-Daily Liraglutide for the Treatment of Type 2 Diabetes: A Long-Term Cost-Effectiveness Analysis in Estonia https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6349296/
Patrick M O’Neil et al. Efficacy and safety of semaglutide compared with liraglutide and placebo for weight loss in patients with obesity: a randomised, double-blind, placebo and active controlled, dose-ranging, phase 2 trial. The Lancet. 392 Issue 10148 (August 2018): 637-649. https://doi.org/10.1016/S0140-6736(18)31773-2
semaglutide (Rx) https://reference.medscape.com/drug/ozempic-rybelsus-semaglutide-1000174
Semaglutide vs Liraglutide for Weight Loss in Patients With Obesity https://www.endocrinologyadvisor.com/home/topics/obesity/semaglutide-vs-liraglutide-for-weight-loss-in-patients-with-obesity/
Superior weight loss with once-weekly semaglutide versus other glucagon-like peptide-1 receptor agonists is independent of gastrointestinal adverse events https://drc.bmj.com/content/8/2/e001706
Wilding JPH, Batterham RL, Calanna S, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021;384(11):989-1002.
Attributions
“Saxenda (Liraglutide) Weight Loss Injection Pen – Image 3” by Doctor4U_UK is licensed with CC BY 2.0. To view a copy of this license, visit https://creativecommons.org/licenses/by/2.0/
“Saxenda (Liraglutide) Weight Loss Injection Pen – Image 1” by Doctor4U_UK is licensed with CC BY 2.0. To view a copy of this license, visit https://creativecommons.org/licenses/by/2.0/
“Semaglutide (Ozempic) 0.5mg Weekly Weigh Loss Injections – Image 4” by Doctor4U_UK is licensed with CC BY 2.0. To view a copy of this license, visit https://creativecommons.org/licenses/by/2.0/
“Semaglutide (Ozempic) 0.5mg Weekly Weigh Loss Injections – Image 5” by Doctor4U_UK is licensed with CC BY 2.0. To view a copy of this license, visit https://creativecommons.org/licenses/by/2.0/
See also
- 3 Tips to BEST Use RybelsusIt’s more important than you might think to take Rybelsus with minimal water on an empty stomach and waiting at least 30 minutes before eating.
- Comparing Weight Loss Drugs in 2024Ozempic and Mounjaro are highly effective at treating obesity, however there are many other approved and off-label options that also work.
- Bupropion vs Contrave vs NaltrexoneContrave is a synergistic combination of buproprion and naltrexone, which can be replicated to some degree using the generics individually.
- New Obesity Drugs in 2024New obesity drugs target more than just GLP-1 and do much more than suppress appetite for a more nuanced approach to weight loss.
- Mounjaro: Who Loses the Most Weight?White or Asian younger women who use metformin and have lower sugar and lipid levels tend to experience more weight loss with Mounjaro.
I started Wegovy about two months due to Mr pre-diabetic status. Initially, the GI side effects were not good; however, there have been some great results. I cannot get my next dosage of 1.7 because all pharmacies are out of stock. I am going on the 2nd week without the continuity of taking my prescribed dosage. Feeling disappointed about the interruption of my treatment.
I have been on Wegovy for 3 weeks. So far I have lost 13.4 lbs. I had diarrhea one day the second week but otherwise no side effects. I love that I don’t constantly crave snacks and that I eat about half of what I used to at a meal. I feel more like a “normal” person as far as eating goes. I had forgotten what it is like to not think about food constantly.
I started wegovy 02/26 and lost almost 4 pounds the 1st week. I did make some changes. I’m doing whole wheat bread and pasta. Have you cut out any cheese? I have not had pork in over a week.
Good morning, I was just reading your side effects and they are identical to mine. The nausea since Wednesday has been awful, then diarrhea on 4th day. I had my gallbladder removed so I feel that my metabolism is slower than others. I did not remember to ask my doctor about that though. I think it may be olive oil that I am using. Congrats on your weight loss journey!
It’s great that you pointed out how Wegovy is best used if you have a hard time controlling hunger and tend to overeat and snack too often. I was chatting with my friend yesterday and it looks like she wants to lose some weight. I heard before that Wegovy for weight loss is actually pretty effective, so I’ll try to suggest it to her later.
Have had two doses of wegovy, first one no side effects but I think I took the pen out too fast and I lost some of the medicine. Second injection I’ve been sick all week, stomach pain and could barely eat. Sitting here trying to decide if I should take the third dose which I’m supposed to take today. Just wondering how long it takes for the side effects to go away. Not sure this is going to be worth it even though I’ve lost 12 lbs. Most people seem to have nausea as a side effect not stomach pain. Anyone else have stomach pain?
Hi Angela- you might want to try Saxenda first. It’s a smaller dose and a little different active ingredient. I lost 35 lbs on it and have plateaued. The first two weeks were kinda difficult, not intolerable though. I just switch to Wegovy in an attempt to lose more.
No stomach pain, but I have been nauseous and extremely fatigued. I’m on my second week and I don’t know if there will be a third.
question…. my Dr and I thought this would be beneficial to me . currently 204. the most I’ve ever weighed. I’m 55.
I am on seizure medication. twice daily. am and pm.
wouldn’t this make my medication stay in my stomach longer ? would there be any absorption issues ? thank you.
just started my very first dose of the 0.25 mg today at 9 am. no site reactions, didn’t hardly feel the injection. I’ve been nauseous most of the day. I only ate about 3/4 of my lunch. it’s 6 pm nausea is easing up.
Just started 2nd dose. Zero side effects with dose #1 administered in the doctor’s office with nurse supervision. 2nd dose at home seemed successful. By end of day after 2nd dose, belly pain was moderate. After eating dinner, pain became severe and I became sick. After vomiting, the pain was not as severe and 2nd day after 2nd dose, pain is mild to moderate. Interesting, when I press on my belly, it is sore like I’ve been punched. Side effects are tolerable to date. Craving raw veggies which is not normal for me. Keeping a diary for doc. Hope to have a tracking app built for my phone soon.
I would like to know if an allergic reaction would happen immediately or later. Also for those who get nausea, does it happen right away or later?
I have had minimal side effects. No nausea, diarrhea, vomiting, etc..
I do get a little more fatigued after the injection, but it doesn’t last that long
So years ago I had my gallbladder removed, after that I would have bowl movements many times a day generally whenever I went to the restroom. This means my stomach is always emptying very quickly which left me always hungry. Then after getting mono my thyroid bottomed out and became extremely sluggish. Then here came the pounds! I tried so many diets and meds, Phentermine worked but I couldn’t continue due to the danger of hurting my heart. I’ve been on wegovy for 4.75 months and have lost 40 lbs so far. Starting weight 341! I’ve had many/most of the side effects (sulfur burps being the worst, I’d rather deal with vomiting! ) and have learned how to deal with them. My two most consistent being nausea and constipation(which I’ve never had before). I feel the side effects are Worth it as long as the weight is coming off. One other thing wegovy does is slow down your digestion so food empties into your small intestine at a much slower rate therefore you actually are still full. At least this is what on doc explained to me and it seems to be doing for me. I also have strong reactions to sugar, makes me feel sick. I’m hoping once I get the weight off to go to a lower dose for maintenence.
I’ve been on semaglutide for almost 2 weeks I get hungry but I eat a few bites I’m done, I’m excersing now at least 3xweekly, I do get tired so I take small nap, I’m juicing help to go to Pooh. But I think it’s all good I lost 6 lbs so far. Wish me luck
So I thought I would try this medication to combat my BMI. My first flub up was with my first injection, I couldn’t see the yellow thingy disappearing so I ended up squirting the medicine all over myself and did not believe any had been injected, therefore I injected the second pen successfully. Maybe I’m a big baby, but i thought the side effects were very unpleasant. I had horrible heartburn/reflux fairly immediately, whatever I ate seemed to “come back” in burps for about 12 hours or so, nausea, dizziness and constipation. It reminded me of morning sickness or a hangover. Not sure if there was a dose effect since perhaps i received a partial dose from the first pen, but I cannot imagine feeling like this on purpose for any length of time. And then I got to wondering about the sustainability. Wouldn’t I just gain the weight back if I were not on the medicine. Finally, I really enjoy food and was starting to have aversions to the thought of eating anything with flavor that would reflux later. I am willing to modify my diet and move more to make lasting changes more naturally.
i trying Purelief clip weight loss is effective
I want to know why medicare want pay for this med. I need to have 2 major surgeries and I have thyroid issues and it’s hard for me to lose weight. I am 74 years old and I am afraid to have surgery. If I could get help for paying for this it would be great. I know if you get Medicaid they will pay. I hear people say they get coupons for this medicine. I worked with Novo Nordisk for 11 years and retired from their faculty in Clayton NC. So if I can get help it would be greatly appreciated.
Hi, I started three days ago so far so good down 5 pounds. Here is the Novo Nordisk coupon site, it can really help save a lot! https://www.novocare.com/wegovy/savings-card.html
How is the medicine released and metabolized? IF an allergic reaction to the drug would occur would it be immediately or could a late response occur because of the metabolism of the drug?
The minute you get off wegovy you gain weight .. why is that ? Within 3 days gained five pounds and not because I over ate .. so no it is not worth it … I loved being on it but to gain it back the minute you are off is not good … and why would you want to take this a lifetime? So going to try another way and hope I don’t gain it all back .
Started Wegovy 2 weeks ago so far so good down a few pounds. I did have slight nausea and acid reflux but short lived. It can be tolarated. Loving the wegovy!
I’m on wegovy for 4 months I got a Urinary track infection could that be from the wegovy ? Should I be concerned
It’s an unusual symptom, not typically associated with Wegovy use, but you should still go see your doctor about it.