The FDA recently approved a new drug for weight loss, called Wegovy. Its chemical name is semaglutide. It’s said to be so effective and innovative, some experts are calling it a “game-changer” for people suffering from obesity-related conditions. What is Wegovy, and how does it work?
What is Wegovy?
Wegovy is a glucagon-like peptide-1 receptor agonist or GLP-1 receptor agonist. This means that it’s a medication that binds to GLP-1 receptors found throughout the GI tract leading to increases in the satiety hormone GLP-1.
How does it work?
As a GLP-1 receptor agonist, Wegovy slows down digestion. When digestion slows down, the stomach feels fuller for longer periods of time. This can help overweight or obese people lose weight by reducing appetite, thereby decreasing their caloric intake. When coupled with a healthy diet and exercise program, Wegovy can dramatically improve weight loss. Since many patients with obesity also suffer from diabetic or pre-diabetic symptoms, Wegovy may help them control their blood sugar as well as increase their ability to lose weight.
How is Wegovy a “game-changer” for weight loss?
The FDA’s approval of Wegovy came after a phase III clinical trial involving over 4,500 overweight or obese adult study participants. These participants were given either a reduced-calorie diet and increased physical activity alone, or these lifestyle changes plus Wegovy. The subjects who were using Wegovy experienced 15-18% weight loss over the course of the trial. These results are unprecedented, and no other weight loss medication has ever come close to mimicking them.
Unfortunately for many people with obesity, lifestyle changes alone can be challenging to keep up. The impact and treatment of mental conditions like binge eating or compulsive overeating disorder are lacking in some areas as well. There aren’t many medications available for helping people treat their obesity, and those that are typically aren’t able to produce results anywhere near Wegovy’s.
Wegovy is very similar to a naturally occurring compound in the human body called glucagon-like peptide-1, or GLP-1. This is a hormone produced by the intestines, which is responsible for increasing satiety, that is the feeling that one is not hungry. Wegovy differs from GLP-1 only due to the substitution of a few amino acids. One of these is lysine, combined with stearic acid in a process called acylation. Acylation helps improve the way Wegovy bonds to proteins in the blood, which keeps it from being flushed out of the body right away. One injection of Wegovy can be effective for seven days, so patients using this medication only require a once-weekly shot.
Is it safe?
Though this medication’s use for weight loss is relatively new, the drug itself is not. Semaglutide has been used for several years to help diabetic patients control their blood sugar, and the FDA approved an oral form of the drug for diabetes in 2019. Like any medication, it can potentially cause side effects in some susceptible individuals, but these are mostly mild.
Since semaglutide works for weight loss by slowing digestion and increasing the feeling of fullness, most side effects observed during the course of the study were gastrointestinal in origin — things like nausea, constipation, indigestion, or stomach aches. Since it also stimulates insulin production, some people may experience low blood sugar. Other potential side effects include kidney problems, retinopathy, pancreatitis, or allergic reactions.
What obstacles remain for Wegovy?
The only thing really standing in this medication’s way is insurance approval. While the FDA has essentially given doctors the go-ahead to prescribe Wegovy for the treatment of obesity, some insurers may be hesitant to cover it. If the drug can be kept to a low cost, with widespread coverage, then it may be our best pharmacological weapon yet against obesity and obesity-related health conditions.
At the moment, there aren’t many medications out there to help people with obesity lose excess fat. Outside of specialty weight loss centers, it can be a real challenge to get any kind of pharmaceutical help at all. As long as manufacturers are willing to keep prices down and insurers are willing to cover it, Wegovy could make a difference in the lives of millions of people.