If you have struggled to lose weight and keep it off and have been researching treatment options, you have probably heard about Wegovy or Ozempic through social media, the news, a celebrity, friends or TV commercials. It’s important to know what these medications are and if they’re the right fit for you!
This article covers some of the most common questions I get about these medications along with information I think is important for anyone considering them to know.
What are Wegovy and Ozempic?
Both of the medications are a peptide called semaglutide generically. Ozempic is the name of semaglutide that is FDA approved for the treatment of type 2 diabetes. Wegovy is the name of semaglutide that is FDA approved as an anti-obesity medication. Wegovy is available in a higher dose than Ozempic.
How does semaglutide work?
Wegovy and Ozempic are in a class of medications called glucagon-like peptide receptor agonists, GLP-1 RA for short. They bind to GLP receptors in the brain and gut to decrease appetite and increase satiety. They also improve insulin secretion in response to sugar that is you eat which improves sugar levels.
All these effects combined work to decrease food cravings, decrease hunger, and help people maintain the lifestyle goals that they set for themselves and lose weight! With Wegovy, on average people will lose 15% of their total body weight, with around a third of people losing 20% or more of their total body weight.
Who is eligible for semaglutide?
Ozempic is FDA approved for people with a diagnosis of type 2 diabetes.
Wegovy is FDA approved for people who have ongoing difficulty with weight loss/maintenance despite lifestyle efforts and:
- Have obesity (BMI body mass index≥30)
- OR
- Have excess weight (BMI ≥27) with a weight related health condition (e.g pre-diabetes, diabetes, high blood pressure, high cholesterol, sleep apnea)
How are they taken?
Both Wegovy and Ozempic are once weekly injections, starting at a low dose and gradually increasing the dose monthly to the goal dose.
How long does treatment last?
This is one of the most common questions I get! Obesity is a chronic relapsing condition, just like diabetes and high blood pressure. Medication is a tool to help with losing and maintaining weight loss along with lifestyle modification and it is not a “quick fix”.
After reaching and maintaining a weight that is metabolically healthy, a discussion can be had about long term goals and what is the best for each individual. Studies do show that most people will regain weight with stopping medications as despite ongoing lifestyle efforts people’s hunger hormones do increase with stopping the medication.
What are common side effects?
There is a lot of variability with side effects that people experience with semaglutide, with some people having none or minimal, and some having more significant side effects. It is important to have close communication with your provider to manage any side effects you have!
The most common side effects are nausea, diarrhea, constipation, headache, vomiting, low blood sugar, injection site reaction, upset stomach, tiredness, dizziness, and stomach pain.
A lot of the side effects are more prominent with starting the medication, and for the first few days after a dose or a dose change, and improve. We can usually manage them with some dietary changes and medications.
Serious side effects reported in the studies include gallstones, pancreatitis, kidney failure, depression or suicidal thoughts.
Who should not take Wegovy or Ozempic?
If you have a personal or family history of medullary thyroid cancer or MEN2 syndrome you should not take GLP-1 RA medications. This is because when the medication was studied in rats, there was an increase in this type of cancer. This type of thyroid cancer is rare. The more common type of thyroid cancer is papillary thyroid cancer so it is important to get a thorough family history.
If you have a personal history of allergy to semaglutide, pancreatitis, current gallstones, you are pregnant or plan to become pregnant soon you should also avoid starting Wegovy or Ozempic.
If you have excess weight and have struggled with difficulty with weight management, you know that maintaining weight loss is difficult despite ongoing lifestyle modifications. It’s important to understand the underlying physiology leading to this so you can select the best treatment options for you. GLP-1RA are a great option, but there are many other options available as well if you are not eligible or if the cost is too high at this time. Obesity is a chronic, relapsing condition and you should have medical supervision by physicians who can support you in its management.
Author
Dr. Suneye Koohsari is a Diplomate of the American Board of Obesity Medicine and is committed to helping patients lose weight and improve their health by empowering them with education. She practices in midtown NYC at her private practice Manhattan Medical Weight Loss.