Wegovy Shows Weight-Loss Effectiveness in Real-World Study
It's a social media darling and one of the hottest prescription medications on the U.S. market. But does Wegovy really help patients lose weight?
Yes, a new study suggests.
Investigators analyzed data on more than 100 people using Wegovy (semaglutide). They found that after a year participants had shed more than 13% of their body weight on average.
“This medication showed superior weight-loss outcome to all previously approved anti-obesity medications that were tested,” said study lead author Dr. Wissam Ghusn, a research fellow in gastroenterology and hepatology with the Precision Medicine for Obesity Program at the Mayo Clinic in Rochester, Minn.
Semaglutide was approved by the U.S. Food and Drug Administration in 2017 to help control blood sugar levels and reduce the risk for heart attacks, stroke and death among patients with type 2 diabetes.
For this purpose, the once-weekly injectable medication -- sold under the brand name Ozempic -- helps the body make more insulin, which lowers blood sugar levels for people with diabetes.
But the drug was also associated with weight loss, and the FDA approved it for that purpose in 2021.
Sold as Wegovy, the self-administered injectable is given at a higher once-a-week dosage of 2.4 mg. It is intended as a weight-loss medication for adults with an "overweight" body mass index (BMI) between 27 and 29 who also struggle with at least one weight-related health issue, such as high blood pressure, high cholesterol or type 2 diabetes.
It is also prescribed for obese adults and kids -- those with a BMI of 30 or up -- with or without additional health concerns.
To test Wegovy's effectiveness, the study authors focused on 305 patients, average age 49. None was taking any other medication for obesity, and none had had weight-loss surgery.
Average BMI was 41 -- a figure indicating morbid obesity.
A year out, investigators had full weight loss data on 110 people. Among this subset they determined that on average, patients had lost 13.4% of their pre-treatment body weight. That figure hit almost 17% among those without diabetes, compared with about 10% among those with diabetes.
Digging deeper, the team noted that more than 8 in 10 of these patients lost more than 5% of their pre-drug body weight, while more than 65% lost 10% or more.
About 40% lost 15% of their body weight, and 1 in 5 shed more than 20% of their body weight.
There were other health benefits as well.
Wegovy, made by Novo Nordisk, appeared to trigger a significant drop in high blood pressure. Total cholesterol numbers also fell.
Still, among all 305 patients about half experienced side effects, such as nausea and diarrhea. Most side effects were mild, but 16 participants stopped taking Wegovy as a result.
“Only a small proportion of patients had to stop taking the medication because of these side effects,” Ghusn said. “We didn't notice any severely dangerous effects over the period of follow-up.”
How Wegovy works
Ghusn explained the drug mimics a gastrointestinal hormone -- called glucagon-like peptide-1 (GLP-1) receptor 1. It induces weight loss “by a combination of suppressing appetite and slowing gastric emptying, which results in decreased food intake.”
But Wegovy isn't cheap. Out-of-pocket costs are about $1,400 a month for those whose insurance won't cover it, National Public Radio reported in January.
And Ghusn noted that insurance denial of Wegovy for weight loss is a “major problem.”
“Without insurance, many patients cannot afford paying,” he said. He called this regrettable given that the drug's apparent impact on overall health “will benefit both patients -- most importantly -- and insurance companies in the long run.”
Because of its popularity -- thanks in part to media stars like Kim Kardashian and Elon Musk -- Wegovy also can be hard to obtain, even for folks who can afford it.
One big question is whether the weight loss achieved on Wegovy is sustainable. A study from the University of Liverpool in the United Kingdom (published in Diabetes Obesity and Metabolism) found that a year after ceasing Wegovy treatment, patients gained back about two-thirds of the weight they had lost on average.
Ghusn stressed that Wegovy is intended to be used alongside a reduced calorie diet and sustained physical activity. “Studies have shown that part of the weight might return if the lifestyle interventions are not continued,” he acknowledged.
When medication is stopped, "patients must continue to follow a healthy lifestyle and behavioral interventions, to try and prevent the recurrence of weight gain and obesity,” he noted.
Connie Diekman is a food and nutrition consultant and former president of the Academy of Nutrition & Dietetics.
“This category of drug appears to be an option for those who have significant weight to lose, those who have tried many other weight loss methods, or those who have multiple health complications due to their weight," Diekman said. She was not involved in the study.
But she cautioned that any decision to embark on a drug like Wegovy should only be made following a discussion between a patient and their doctor -- “not guidance from the latest social-media influencer.”
“Making this decision involves an assessment of current health status, discussion about previous attempts to decrease body fat, ability and willingness to make changes in eating patterns and activity, and an understanding of how the meds work and possible side effects,” Diekman said.
The findings were presented last week at a meeting of the European Congress on Obesity, in Dublin, Ireland. Research presented at meetings is usually considered preliminary until published in a peer-reviewed medical journal.
There's more on Wegovy at the U.S. Food and Drug Administration.
SOURCES: Wissam Ghusn, MD, research fellow, gastroenterology and hepatology, Precision Medicine for Obesity Program, Mayo Clinic, Rochester, Minn.; Connie Diekman, RD, MEd, CSSD, LD, FADA, FAND, food and nutrition consultant, and former president, Academy of Nutrition & Dietetics; European Congress on Obesity meeting, Dublin, Ireland, May 17-20, 2023