Written on May 23, 2023 by Lori Mulligan, MPH. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
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On June 4, 2021, the U.S. Food and Drug Administration approved Wegovy® (semaglutide) injection (2.4 mg once weekly) for chronic weight management in adults with obesity or overweight with at least one weight-related condition (such as high blood pressure, Type 2 diabetes, or high cholesterol) for use in addition to a reduced calorie diet and increased physical activity.
This under-the-skin injection is the first approved drug for chronic weight management in adults with general obesity or overweight since 2014.
The drug is indicated for chronic weight management in patients with a body mass index (BMI) of 30 kg/m^2 or greater or 27 kg/m^2 or greater who have at least one weight-related ailment.
The reaction to the announcement was that this new drug was a “game changer” for weight loss among those qualified to take the medication. However, it’s important to consider the pros and cons of this drug that is so new to the general public. For example, one question that deserves deliberation is, how long do you take Wegovy® for weight loss?
Before we address that question, let’s describe what Wegovy® is and how it works, as that will give some insight into how long you need to take the medication.
Wegovy® is the brand name for the high-dose injectable peptide hormone molecule known as semaglutide, a medication that the FDA previously approved under the brand names Rybelsus® (oral) and Ozempic® (lower-dose injection) for the treatment of type 2 diabetes.
Injectable semaglutide eliminates the strict instructions for ingesting on an empty stomach required by oral semaglutide, while the higher-dose Wegovy® allows for better crossing of the blood-brain barrier, which increases its weight-loss efficacy.
Semaglutide is in a class of medications known as glucagon-like peptide-1 receptor agonists, or GLP-1 RAs. GLP-1 is a hormone naturally released in the gastrointestinal tract in response to nutrient intake. It has multiple effects, including increasing insulin release from the pancreas, slowing down stomach emptying, and targeting receptors in the brain that cause appetite reduction. This results in a sensation of satiety, or fullness, lasting much longer than possible with natural GLP-1 hormone levels.
The safety and efficacy of semaglutide 2.4 were studied in four 68-week randomized controlled trials. Two of these trials examined the safety and efficacy of semaglutide in patients with and without diabetes.
One looked at the effect of the medication with and without concurrent intensive behavioral therapy, and one determined the effect of continuing or withdrawing the drug after an initial period of weight loss.
In these four trials, more than 2,600 patients received semaglutide 2.4 for up to 68 weeks, and more than 1,500 patients received placebos.
Researchers found that adults with obesity (or overweight with one or more weight-related coexisting conditions) and without diabetes had a mean weight loss of 14.9% from baseline with semaglutide as an adjunct to lifestyle intervention. This loss exceeded that with the placebo plus lifestyle intervention by 12.4%.
The 14.9% mean weight loss that was observed in the semaglutide group is substantially greater than the weight loss of 4.0% to 10.9% from baseline with other approved anti-obesity medications.
Moreover, 86% of participants who received semaglutide, as compared with 32% of those who received a placebo, lost 5% or more of baseline body weight, a widely used criterion of clinically meaningful response.
Nausea and diarrhea were the most common adverse events with semaglutide. They were typically transient and mild-to-moderate in severity and subsided with time. More participants in the semaglutide group than in the placebo group discontinued treatment owing to gastrointestinal events.
Research showed that one year after withdrawal of once-weekly subcutaneous semaglutide 2.4 mg (Wegovy®) and lifestyle intervention, participants regained two-thirds of their prior weight loss, with similar changes in cardiometabolic variables. Findings confirm the chronicity of obesity and suggest ongoing treatment is required to maintain improvements in weight and health.
These findings indicate that obesity is indeed a chronic disease and reinforce the importance of continued, long-term treatment with effective medications to maintain weight loss and improvements in other measures.
However, this is a new drug, so one must be cautiously optimistic since long-term side effects and effectiveness remain to be seen.
Through weight management online, Everlywell will pair you with a clinician to discuss your weight goals and complete testing to determine if GLP-1 (weight loss medication) is right for you. If it is, you will meet with your clinician regularly to optimize your medication and achieve your health goals with 1:1 lifestyle support and recommendations.
Everlywell also provides support for high cholesterol and prediabetes and offers a heart health test. This test measures total cholesterol, HDL, calculated LDL, triglycerides, hs-CRP, and HbA1c.