INJECTION WEGOVY
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Dr. AMAR VENNAPUSA

WEGOVY FOR WEIGHT LOSS

Wegovy® (Semaglutide) injection is a prescription medication developed by Novo Nordisk, approved by the DCGI and US FDA for chronic weight management. It is designed for use in conjunction with a calorie deficit healthy diet and increased physical activity to assist adults and adolescents aged 12 years and older in achieving and maintaining weight loss. This medication is the first weight-management medication FDA-approved to lower risks of major cardiovascular events—such as heart attack, stroke, or death—in adults with known heart disease, obesity, or overweight, based on a 3.5-year clinical study with standard care.

Wegovy® is indicated for chronic weight management in:

1. Adults with obesity (body mass index [BMI] ≥ 30) or (BMI ≥ 27) accompanied by at least one weight-related comorbidity, such as type 2 diabetes mellitus, hypertension or dyslipidemia.

2. Adolescents aged 12 years and older with a BMI at or above the 95th percentile for their age and gender.

3. Additionally, Wegovy® has been shown to lower the risk of major adverse cardiovascular events, including heart attack, stroke, or death, in adults with known heart disease and either obesity or overweight.

Semaglutide, the active ingredient in Wegovy®, is a glucagon-like peptide-1 (GLP-1) receptor agonist. By mimicking GLP-1, semaglutide reduces appetite, increases metabolism, enhances insulin secretion, suppresses glucagon release, and slows gastric emptying. This leads to effective, sustained weight reduction when combined with diet and exercise.

Clinical trials have demonstrated the efficacy of Wegovy® in promoting significant weight loss:

In a 68-week study of 1,961 adults with obesity or overweight comorbidities (average starting weight 232 lb), Wegovy® users achieved 15% average weight loss (~35 lb) versus 2.5% (~6 lb) on placebo. Notably, 83% lost ≥5% weight, 66% ≥10%, and 48% ≥15%; about 1 in 3 reached 20% loss.

Long-term data shows continued loss with ongoing use: adults staying on Wegovy® kept losing weight over 68 weeks, unlike placebo regain, while a 2-year study confirmed ~15% maintenance versus placebo.

Adolescents aged 12-17 with obesity saw 16.1% BMI reduction after 68 weeks versus 0.6% increase on placebo, alongside lifestyle therapy.

  1. Wegovy® is administered as a once-weekly subcutaneous injection. The dosing schedule is designed to minimize gastrointestinal side effects and is as follows:

    • Week 1-4: 0.25 mg once weekly

    • Week 5-8: 0.5 mg once weekly

    • Week 9-12: 1 mg once weekly

    • Week 13-16: 1.7 mg once weekly

    • Week 17 and onward: 2.4 mg once weekly (maintenance dose)

    Individuals should be instructed on proper injection techniques and advised to rotate injection sites to reduce the risk of lipodystrophy.

Wegovy® pens should be refrigerated between 36°F to 46°F (2°C to 8°C) until use. If needed, they can be kept at room temperature (up to 86°F or 30°C) for up to 28 days.

Common side effects associated with Wegovy® include: 

  • Nausea
  • Diarrhea
  • Vomitings
  • Constipation
  • Abdominal pain
  • Abdominal Bloating
  • Weakness
  • Headache

These events are typically transient and occur during initial dose and dose escalation.   

  • Thyroid C-Cell Tumors: Semaglutide causes thyroid C-cell tumors in rodents; however, the relevance to humans is unknown. Wegovy® is contraindicated in patients with a personal or family history of Medullary Carcinoma of Thyroid or Multiple Endocrine Neoplasia syndrome type 2 (MEN Type 2).   
  • Pancreatitis: Acute pancreatitis has been reported in patients using GLP-1 receptor agonists. Individuals should be monitored for signs and symptoms of pancreatitis, and Wegovy® should be discontinued if pancreatitis is suspected.   
  • Hypoglycemia: When used in combination with insulin or insulin secretagogues, there is an increased risk of hypoglycemia. Dose adjustments of the concomitant medications may be necessary.
  • Gall Bladder Stones: There is an increased risk of gallbladder disease, including cholelithiasis. Monitor for signs and symptoms of gallbladder disease.  
  • Blurring of Vision and Blindness
  • Acute kidney injury: There have been reports of acute kidney injury in patients treated with GLP-1 receptor agonists. Monitor renal function when initiating or escalating doses.
  • Reduced stomach emptying: You are advised to stop medication 2 months before elective surgeries to prevent aspiration pneumonia.
  • Avoid during pregnancy: Females on Wegovy are advised to stop 2 months before planning pregnancy.
  • Hypersensitivity: Serious hypersensitivity reactions, including anaphylaxis and angioedema, have been reported. Discontinue Wegovy® and promptly seek medical advice if hypersensitivity reactions occur. 

Wegovy® represents a significant advancement in chronic weight management, offering effective weight loss and cardiovascular benefits for individuals with obesity or overweight. Its once-weekly administration and comprehensive support programs make it a valuable option for patients seeking sustainable weight management solutions.

It is essential for individuals to consult with healthcare providers to determine the appropriateness of Wegovy® based on individual health profiles and to receive guidance on proper use and monitoring during treatment.

Dr. Amar Vennapusa, renowned bariatric and metabolic surgeon and director at Dr. Amar Bariatric & Metabolic Center in Hyderabad, offers Wegovy® (semaglutide) as part of a holistic approach to managing obesity and diabetes. This FDA-approved GLP-1 receptor agonist supports chronic weight loss alongside lifestyle changes, medications, and surgeries tailored to individual needs.

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