The FDA recently approved the first new weight loss medicine in seven years. New might not be exactly the best way to describe Wegovy (pronounced wee-GOH’-vee), though. The name is new and so is the dose, but this drug, known generically as semaglutide, was first approved for type 2 diabetes in 2017 under the brand name Ozempic.
How Does the New Weight Loss Medicine Work?
This self-injectable drug helps control blood sugar by increasing insulin release from the pancreas and reducing the amount of glucose released from the liver. Because semaglutide slows stomach emptying and reduces appetite, the manufacturer tested it for weight loss.
In studies, it seems more effective than other weight loss medications (Diabetes, Obesity & Metabolism, Feb. 2021). Over 16 months, people taking Wegovy lost an average of 15% of their body weight (around 35 pounds). Those on placebo lost 2.5%, on average. All of the participants in the trial exercised regularly and followed a healthful diet.
In addition, Wegovy may have another advantage. An earlier trial demonstrated that people taking semaglutide were more likely to overcome nonalcoholic fatty liver disorder (New England Journal of Medicine, March 25, 2021).
Adverse Effects of Semaglutide:
Like any medication, the new weight loss medicine has some side effects. Adverse reactions associated with semaglutide include nausea, vomiting, diarrhea and stomach ache. About 5 percent of volunteers in clinical trials dropped out because of these side effects. A cynical person might suggest that such side effects in themselves could make a person drop a few pounds. However, they do not seem to be a major factor driving the weight loss associated with Wegovy (BMJ Open Diabetes Research & Care, Oct. 2020).
Wegovy might also cause some more serious complications. Semaglutide has been linked to thyroid tumors, pancreatitis, gallbladder problems, kidney trouble and depression.
What Will It Cost?
One other possible pitfall: It is not yet clear how much Wegovy will cost, but Ozempic can run over $800 a month for people without insurance. Many insurance companies do not pay for weight loss medicine; it remains to be seen if they will cover Wegovy.
New Data on Gallbladder Problems with Related Medicines:
Whether you take it for type 2 diabetes or as a new weight loss medicine, semaglutide is part of a category of drugs called glucagon-like peptide-1 receptor agonists. Thesy include dulaglutide (aka Trulicity), exenatide (Byetta & Bydureon), and lixisenatide (Lyxumia) as well as semaglutide. Recently, FDA scientists conducted an analysis of serious side effects reported to the FDA Adverse Event Reporting System (FAERS). Unfortunately, the FDA scientists found a number of reports of acute gallbladder attacks associated with these drugs (JAMA Internal Medicine, Aug. 29, 2022).
Not only is such an attack extremely painful, they can be dangerous. Most of the 36 cases in the database required surgery, and some of them resulted in patient death. According to the authors, FAERS data may represent no more than the tip of the iceberg (“underreporting”). However, this case series supports the findings of an earlier meta-analysis of randomized controlled trials (JAMA Internal Medicine, March 28, 2022). As a result of these findings, doctors and patients should weigh the potential for benefit vs. harm very carefully before deciding whether to use any of these medications.