The most effective medication for overweight and obesity that we’ve seen, semaglutide 2.4 mg (released under the trade name Wegovy®) has just been approved by the FDA for chronic weight management.
This is the first medication for obesity approved by the FDA since 2014.
Compared to other weight loss drugs currently on the market which result in an average weight loss of 6 to 11% at 1 year, participants in the semaglutide 2.4 mg research studies lost an average of 15-17% body weight at 68 weeks, and about one-third of subjects lost at least 20% or more body weight.
This amount of weight loss was associated with improvements in cardiovascular risk factors that included a decrease in blood pressure, blood sugar, lipids and a marker of inflammation, along with improvement in quality of life.
What is the Drug?
Wegovy® is a higher dose of a diabetes drug, Ozempic®, that is already on the market.
It mimics a naturally occurring gut hormone, called glucagon-like peptide-1 (GLP-1), that helps to control blood sugar and appetite.
The medication is given by a weekly self-injection, under the direction and orders of a healthcare provider.
How Does it Work?
By boosting the levels of GLP-1, Wegovy® targets areas of the brain that controls appetite.
By helping you feel less hungry, more full, more content between meals and to have less cravings, it allows you to follow a calorie-controlled diet more consistently and successfully.
The other effects are to slow stomach emptying and improve your body’s control of blood sugar by increasing the release of insulin.
How is it Taken?
The medication is self-administered once a week by using an auto injector pen starting at a low dose of 0.25 mg.
The dose is then gradually increased every month over 16 weeks to 2.4 mg once weekly in order to reduced gastrointestinal side effects.
The most common side effects include nausea, diarrhea and constipation that are more commonly experienced during the dose escalation period and described as mild to moderate in severity.
Am I a Candidate to Take It?
Wegovy® is approved for adults with a body mass index (BMI) over 30 or a BMI over 27 with a weight-related medical problem like type 2 diabetes, high blood pressure or high cholesterol.
To see if you qualify, I encourage you to talk to your primary care provider about your weight and available treatment options.
Know that not everyone with a higher BMI has a medical problem or needs drug therapy.
When Will it Be Available?
The medication will be available at retail pharmacies on June 17.
However, due to the expected high out of pocket cost, insurance coverage for the drug will be necessary.
How to Get More Information?
You can visit the commercial website Wegovy.com (coming June 17) or talk to your health care provider.
It’s also important to remember that lifestyle modification is foundational to all treatment modalities for overweight and obesity.
Building skillpower, not willpower is the key to success.
Conflict of interest statement: I receive compensation as a member of the Medical Advisory Board for Novo Nordisk.
Robert Kushner, MD
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