Elon Musk recently said on Twitter, in response to a question about the secret to his thinness, that his secret was fasting and the drug “Wegovy” (semaglutide).
He has thus helped, along with other celebrities and influencers on social networks like Facebook and TikTok, to fuel a strong demand for this drug.
What is semaglutide?
Semaglutide, from the Danish laboratory Novo Nordisk, is a drug administered by weekly injections using pre-filled pens. It is injected once a week under the skin in the abdomen, thigh or upper arm. Users can self-administer the drug.
It is marketed under two names:
- Ozempic, used to treat type 2 diabetes;
- Wegovy, used to aid in weight loss.
It is an antidiabetic drug of the class of GLP-1 agonists (or analogues) (“ glucagon-like peptide “)that is to say that it acts in the same way as GLP-1 which is a hormone naturally present in the body. (Classes of drugs for the treatment of type 2 diabetes)
GLP-1 agonists for weight loss
Two drugs in this class have been approved, particularly in the United States and Europe, for chronic weight management.
Semaglutide is almost twice as effective as liraglutide for average weight loss, reports Dr. Adam Gilden, associate director of the University of Colorado Weight Management Clinic and associate professor of internal medicine.
A third GLP1 agonist drug for weight loss, tirzepatide (Mounjaro) from the Lilly laboratory, a potentially market approach, having obtained superior results to semaglutide in a phase 3 clinical trial, Medscape reported in November 2022. This superior effectiveness is attributed to the fact that it is a GLP1 agonist and also a another hormone, GIP (the drug is said to be a double agonist).
For whom is Wegovy indicated?
L’american agency medicine, theFood and Drug Administration(FDA), and the European Medicines Agency (EMA) have authorized the drug, alongside a low-calorie diet and increased physical activity, for people who have a body mass index (BMI) of 30 or more (obesity), or 27 (overweight) in the presence of a weight-related health problem. (Obese, overweight or healthy weight? QUICK CALCULATION of your BMI)
A drug intended for long-term use
This medication is intended for long-term use, Gilden says. “
So we don’t prescribe them for six months and then we stop them, because the patient would usually regain their weight. So we usually keep people on these drugs for years“.
You have to know, he says,
that if a person loses 10% of their body weight, their energy needs actually decrease by 15%, not 10%. So when a person loses weight, their body becomes more efficient at storing energy, which predisposes them to gaining weight back. So the idea that people regain weight because they revert to their old eating habits and exercise habits doesn’t tell the whole story.»
Modes of action
Antidiabetic mode of action
The drug acts like the blood sugar lowering hormone GLP-1 by stimulating insulin secretion and reducing glucagon secretion when blood sugar levels are high.
Mode of action promoting weight loss
The drug slows the emptying of the stomach. So people tend to feel full faster and eat smaller portions. There are also effects in the brain that reduce the urge to eatsums up Gilden.
Clinical studies show that semaglutide reduces energy intake, increases feelings of fullness, satiation and control over food intake, reduces feelings of hunger and the frequency and intensity of food cravingssays the summary of product characteristics. “
In addition, semaglutide reduces the preference for foods high in fat.»
The effectiveness of semaglutide
The European Medicines Agency reports, in a press release (2021-2022), the results of four studies showing greater weight loss with semaglutide than with a placebo (a dummy treatment). Here are, for example, the results of the 1st and 4th studies.
In the first, conducted with 1,961 overweight or obese people who did not have diabetes, those treated with Wegovy lost an average of 15% of their body weight after 68 weeks, compared with 2% in those on placebo. Additionally, 84% of people in the Wegovy group lost 5% of their weight, compared to 31% of people in the placebo group.
The fourth was conducted with 1,210 people with type 2 diabetes with a BMI of 27 or more who had tried unsuccessfully to lose weight in the past. After 68 weeks, those treated with Wegovy lost an average of 10% of their weight, compared to 3% in those on placebo. Additionally, 67% of people in the Wegovy group lost at least 5% of their weight, compared to 30% of those in the placebo group.
The side effects
Serious adverse side effects of these drugs, such as inflammation of the pancreas, are rare, Gilden reports.
The most common side effects are intestinal and are related to the slow emptying mechanism of the stomach.»
The most commonly seen (which may affect more than 1 in 10 people), reports the EMA, are:
- headaches ;
- nausea (feeling sick);
- diarrhea ;
- the constipation ;
- abdominal pain (stomach aches);
To reduce gastrointestinal symptoms, the weekly dose starts at 0.25 mg and gradually increases over a 16 week period to reach 2.4 mg.
The cost of this drug
Wegovy is generally not reimbursed by public health insurance plans and may or may not be covered by private insurers.
In the United States, the price of the treatment seems to vary between $1200 and $1500 per month. In Europe, it seems to exceed 1000 euros per month. Having to be taken for several years, this is a very high cost.
Summary of medicinal product characteristics and package leaflet
See the summary of product characteristics and package leaflet, on the European Medicines Agency (EMA) website, for more information, including indications, posology and method of administration, contraindications, interactions with other drugs and other forms of interactions, undesirable side effects, certain adverse reactions, etc.
For more information on losing weight, see the links below.
Psychomedia with sources: EMA, FDA, HAS, University of Colorado, Medscape.
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