Wegovy-Injection is causing quite a stir
To create a hype around a medication is rare. But it has happened with Wegovy: people show in social media how they use it for weight loss and report side effects. What has happened since its introduction one year ago? An overview:
What is Wegovy?
Wegovy is a prescription medication that is supposed to help with weight loss and maintaining weight by reducing appetite and increasing feelings of fullness. Doctors in Germany have been able to prescribe this medication from Novo Nordisk, a Danish company, since mid-July 2023. Patients inject it once a week under their skin with a pen that resembles a pen.
The active ingredient Semaglutid in Wegovy has been used for diabetes treatment for a long time under the name Ozempic. Wegovy contains a higher dosage of the active ingredient and was approved for use in people with obesity, or excessive body fat, with a Body Mass Index (BMI) of 30 or higher. The therapy should be combined with a diet and exercise.
How does Wegovy work?
The active ingredient Semaglutid in Wegovy mimics the effect of the gut hormone GLP-1 (glucagon-like peptide-1), explains Matthias Laudes, Vice President of the German Obesity Society (DAG) and Director of the Institute for Diabetology and Clinical Metabolic Research at the University Hospital Schleswig-Holstein.
The hormone signals the pancreas to produce insulin. "That's the antidiabetic effect," says Laudes. The second effect is that the brain is informed that something has been eaten and can develop a feeling of fullness. "That's the weight-regulating effect."
The third effect is that the stomach is signaled that there is still enough food in the small intestine, which delays gastric emptying. Patients and patients have reported this effect as a side effect - namely nausea. This usually goes away when people get used to eating smaller portions, says Laudes.
What are other side effects?
Nausea occurs frequently at the beginning of therapy, in addition to other gastrointestinal symptoms such as vomiting, diarrhea, and constipation, says Karsten Müssig from the German Society for Endocrinology (DGE), Chief Physician of the Clinic for Internal Medicine, Gastroenterology, and Diabetology at the Franziskus Hospital Harderberg. Therefore, treatment is started with a low dose, which is gradually increased. Rare side effects include pancreatitis and intestinal obstruction. "Treatment should only be carried out under medical supervision," warns Müssig.
A recently published study in the professional journal "JAMA Ophthalmology" suggests that Semaglutid may in very rare cases be associated with a serious eye disease - non-arteritic anterior ischemic optic neuropathy (NAION). Although this has not been proven, it should be taken seriously, says Horst Helbig from the German Ophthalmological Society (DOG) and the University Hospital Regensburg. Clarification of this question requires further investigations and careful observation of patients and patients.
Reports suggest another phenomenon, known as "Ozempic Face": In general, the face can sink in and look much older when weight loss occurs rapidly.
Do I have to take Wegovy for the rest of my life?
Obesity and Diabetes are chronic conditions, says Laudes, therefore the medication must be taken for life. With a Diabetes medication, no one would say that it can be stopped after six months, says Laudes. "Every obese person has a lifelong problem that they can keep gaining." This is also evident after gastric bypass surgeries.
What should patients pay attention to?
An obesity therapy should always include a lifestyle change, such as balanced nutrition and regular physical activity, says DGE expert Müssig. The diet should be calorie-reduced and rich in fiber and also contain less saturated and more unsaturated fatty acids - similar to the Mediterranean diet.
What does Wegovy cost?
The cost of obesity therapy is approximately 300 Euros monthly, according to Müssig. Patients must bear the costs themselves, as the medication is not covered by statutory health insurance.
Does Wegovy affect fertility in women?
During treatment with Semaglutid - that is, Wegovy or Ozempic - pregnancies have occurred in women who had an unfulfilled desire to have a child for a long time, says Ulrich Knuth, Chairman of the German Association of Reproductive Medicine Centers (BRZ). However, there are no valid figures on this. It is known that obesity reduces the likelihood of pregnancy.
During pregnancy and breastfeeding, the medication should not be used. Women who want to have a child should discontinue Semaglutid with a lead time of at least two months, according to the European Medicines Agency (EMA).
What can be concluded after one year?
The diabetes medication Ozempic has been used off-label - that is, for weight reduction purposes - for a long time, says diabetologist Müssig. The introduction of Wegovy a year ago was accompanied by the hope that Ozempic would no longer be used as an obesity medication and would be more readily available for diabetes patients. Although the availability of Ozempic has improved, there are still supply issues. Obesity expert Laudes says that the demand for Wegovy is greater than the production.
This situation increases the risk of counterfeit products - the EMA explicitly warns against buying medicines on the black market. The medicines should only be used for their respective indications - Type-2 diabetes and obesity. If non-obese people use such medications solely for figure optimization, they exacerbate existing shortages.
Is Novo Nordisk the only supplier of weight loss injections?
No. The US pharmaceutical company Eli Lilly now markets a weight loss injection under the name Mounjaro, which contains the active ingredient Tirzepatide, which is also a GLP-1 receptor agonist like Semaglutid. It has been approved in the EU since the end of last year.
A study has shown that a significant greater weight loss can be achieved with this than with Semaglutid. The side effect risks of both substances are comparable, reports the research team in the journal "JAMA Internal Medicine". Long-term effects and the achievement of important goals such as a reduced risk of heart attacks could not be determined from the analysis.
Despite the benefits of Wegovy for managing weight and diabetes, it's essential to be aware of potential side effects, such as nausea and gastrointestinal issues. Medical supervision is crucial during treatment to mitigate these side effects.
The use of Wegovy for weight loss has led to increased demand, potentially causing supply issues and increasing the risk of counterfeit products. The European Medicines Agency strongly advises against purchasing medicines on the black market.
The introduction of Wegovy a year ago was accompanied by hope that it would alleviate the shortage of Ozempic for diabetes patients, but availability issues persist. Novo Nordisk is not the only supplier of weight loss injections; Eli Lilly's Mounjaro, containing the active ingredient Tirzepatide, is now available in the EU, offering an alternative with comparable side effect risks but potentially greater weight loss.
