Too busy to read in full? Here are the take-home messages:
Semaglutide is sold as Wegovy, a weight loss injection, for people with or without type 2 diabetes and works by suppressing appetite
The use and availability of Wegovy are causing controversy due to its unknown long-term effects and fuelling the rise of eating disorders and body image concerns
Always speak to your doctor before taking any weight loss medications to talk about the risks and benefits
Bonus message: please be discerning about who is promoting any weight loss medications even if it has been approved to use safely
Weight loss is a common goal for many individuals. The motivations to lose weight can differ from person to person but there is one thing that’s the same for all: weight loss is challenging and complex for many reasons, and keeping the weight off is even more of a battle.
Unless you’ve had no internet access, I’m pretty sure you’ve heard and seen the hype around the ‘miracle’ weight loss injection or the ‘’skinny jab’’, Wegovy. In this blog, I’m going share what Wegovy is, its impact on the body, its side effects, and how to decide if it’s right for you.
What is Wegovy and how does it work?
Semaglutide is a medication that’s suggested for people living with type 2 diabetes (known as ‘ozempic’) and also for those that are seeking weight management support with or without type 2 diabetes (known as Wegovy). The latter is manufactured by Novo Nordisk, a pharmaceutical company based in Denmark.
A systematic review published in The Lancet concluded that semaglutide might be the most effective in reducing weight in adults with overweight and obesity compared with other weight loss medications .
Wegovy is a glucagon-like peptide 1 receptor agonist (GLP-1RA). It works by reducing appetite and makes you feel full most of the time so you eat a lot less than before.
Who is Wegovy recommended for?
The National Institute of Health and Care Excellence (NICE) has recommended the use of semaglutide (Wegovy) ''alongside a reduced-calorie diet and increased physical activity to adults'' :
a) Who has a least 1 weight-related comorbidity and a BMI of least 35kg/m2
b) A BMI of between 30-34.9kg/m2 with 1 weight-related comorbidity who are eligible for referral to specialist weight management services
A weight-related comorbidity could be prediabetes or type 2 diabetes, high blood pressure, dyslipidaemia (abnormal balance of good versus bad cholesterol), obstructive sleep apnoea (OSA), or cardiovascular disease.
Who shouldn’t take Wegovy?
Wegovy is not recommended for children or pregnant or breastfeeding women
Wegovy should not be used by people living with an eating disorder such as anorexia or bulimia.
According to Novo Nordisk, the efficacy and safety of Wegovy have not been investigated in patients:
Limited experience in patients aged 75 years or more.
Treated with other products for weight management
With type 1 diabetes
With severe renal impairment
With severe hepatic impairment
With congestive heart failure New York Heart Association (NYHA) class IV.
Wegovy side effects
Wegovy may cause nausea, vomiting, diarrhoea, constipation, headache, fatigue, dizziness, flatulence, and bloating. These side effects are mainly due to the action of the medication (it delays gastric emptying).
Like with most medications, it may interact with other medications so always check and ask your doctor.
It may also lead to drug dependency and cause withdrawal symptoms, so again, it’s crucial to talk to your doctor about the risks and benefits to help make an informed decision.
Weight loss goals and Wegovy
In a randomised, double-blind clinical study, the STEP 1 clinical trial, showed participants on the maximum dose (2.4mg, weekly injections) lost on average 12% more of their body weight in comparison to those with a placebo . All participants in the clinical study also received dietary advice and support to increase exercise.
Depending on your circumstances, the duration of which you take the medication and the support you receive all will impact the amount of weight lost.
What to consider before using Wegovy
Is it just a short-term effect? Part of the STEP clinical trial concluded that after stopping Wegovy for 1 year, participants regained two-thirds of their prior weight loss 
What are the long-term implications? The long-term safety is still unknown so while there might be improvements in blood sugar levels, blood pressure, and cholesterol levels; there is still not enough evidence to indicate how these variables may change in the long run.
How long should I use Wegovy? Some medical professionals recommend it needs to be taken continually to ensure that the weight does not return. The National Health Service is offering Wegovy for only two years.
Is this contributing to body image issues and eating disorders? Another consideration is the added pressure on people, especially young women, to look a certain way. With ''patient influencers'' on TikTok, ''what I eat in a day Instagram influencers,'' the availability of weight loss injections privately through online consultations, and its impact on eating disorders are also fuelling questions.
Final thoughts on Wegovy and UK obesity...
Wegovy is not a ''miracle drug'' and should not be used as a substitute for healthy lifestyle changes including physical activity
Healthcare professionals must consider an individual’s overall health and well-being before suggesting the use of Wegovy.
Are we doing enough at a population level to understand the root causes of obesity? With highly processed foods widely available and at a lower cost compared to whole foods, many people are tempted by food and overeat, leading to excess weight linked to type 2 diabetes, heart disease, and some cancers.
Wegovy is recommended for people living with (severe) obesity that’s complicated by pre-diabetes, type 2 diabetes and/or heart disease. It’s not to just lose a few pounds but for those with significant complications of obesity and a significant amount of weight to be lost.
It’s not black and white when it comes to deciding if Wegovy is right for you. It’s useful to deeply reflect if you’ve tried therapy, nutritional counselling, understand your relationship with food, assessed your sleep, stress and quality of nutrition and questioned your mindset. Research confirms ongoing dietary and lifestyle changes are required to maintain good health and improvements in weight once Wegovy is stopped. Clinical obesity is more than just about having strong willpower. I’ll finish here by sharing the wise words of George Bray, Professor Emeritus and obesity researcher, ''Genes load the gun and the environment pulls the trigger.''
This article is written for informational purposes only and does not replace advice from your doctor.
Maybe you're tired of yo-yo diets and confused about how to lose weight in a sustainable way. You also know that comfort eating and your habits with food and exercise are making you feel more stuck in a vicious cycle! Book your free 15 minute discovery call to find out how I can help.
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