Overview

You may have heard of the excitement surrounding the latest weight-loss treatment, Wegovy. People have been battling weight and obesity for a long time and Wegovy seems to be the miracle answer for some. Achieving healthy weight loss has always been a challenging goal, but now it seems much more achievable thanks to the help of a weekly injection. It all sounds too good to be true and raises a key question. Is Wegovy dangerous? Continue reading to learn more about Wegovy and explore the potential risks that people are concerned about.

What is Wegovy?

Wegovy is the brand name for the drug semaglutide. Semaglutide is part of a group of drugs called glucagon-like peptide-1 agonists (GLP-1 agonists).¹

GLP-1 agonists were primarily used as a treatment for type 2 diabetes, with semaglutide being marketed for diabetes under the brand name Ozempic. Recently, Wegovy has been licensed as a new treatment for weight loss in obesity where healthy eating and exercise alone fail to achieve weight loss.

How does Wegovy (semaglutide) work?

Diabetes

Normally, the body can regulate blood sugars by making and using hormones like insulin and glucagon. Hormones bind to receptors and exert an effect on the body. For example, when the body has too much sugar in the blood, it uses the hormone insulin. When insulin binds to its receptor, the extra sugar is moved from the blood and stored in the body’s cells.

In type 2 diabetes, the body loses sensitivity to insulin and may even lose the ability to produce enough insulin. This leads to trouble controlling the amount of sugar in the blood. Diabetics use medicines like semaglutide to regulate a healthy level of blood sugar.¹

As a GLP-1 agonist, semaglutide can be used to copy the activity of the hormone GLP-1. Semaglutide binds to GLP-1 receptors in the pancreas. This allows semaglutide to help diabetics control their sugar levels by:²

• Stimulating the release of insulin, to use up sugar present in the blood and reduce blood sugar levels.
• Suppressing the secretion of glucagon, preventing the release of sugar into the blood.

As a known side effect, semaglutide reduces body weight in people with diabetes.¹

Weight loss

In addition to the pancreas, GLP-1 receptors can also be found in the brain and stomach. The GLP-1 hormone is naturally released after a meal and regulates appetite by making us feel satiated, reducing hunger, and slowing the emptying of the stomach.²

GLP-1 agonists like semaglutide can take the place of GLP-1 hormone and bind to GLP-1 receptors, mimicking the hormone’s action in the brain and stomach. This is why weight loss is a side effect of using semaglutide in type 2 diabetes.²

This means that Wegovy can be used to suppress appetite by making the user feel fuller or less hungry, reducing food cravings. When people eat less food, their body weight decreases. Wegovy should be used alongside diet and exercise to lose weight.

What are the dangers of Wegovy?

As with all medicines, drugs may produce various side effects alongside the intended benefits. Sometimes the side effects can be beneficial. For example, semaglutide was originally developed as a diabetes treatment, but its weight loss side effect has been repurposed as a weight loss treatment in the form of Wegovy.

All drugs are tested for their safety before they are allowed to enter the market, and semaglutide is no exception. As part of investigating drug safety, thousands of patients are exposed to the drug and any side effects that arise are reported during rigorous clinical trials. This gives a good picture of the side effects that can be expected from taking a medicine.

Common side effects

Very common side effects that may occur in 1 in 10 people include:³

• Headaches
• Vomiting
• Diarrhoea
• Constipation
• Nausea
• Abdominal pain
• Fatigue

Most of these side effects tend to be mild and only last a short while. It can be normal to expect side effects when doses are increased, as the body needs to adjust to the new dose. These side effects tend to settle once the dose is stable.³

The side effects can be managed by:

• Following the directions of the prescriber and increasing the dose gradually
• Eating slowly and reducing meal sizes
• Avoiding high-fat foods
• Drinking plenty of water and fluids to prevent dehydration

Pancreatitis

Pancreatitis is the inflammation of the pancreas, which can be very painful and serious. It can present with symptoms of nausea, fever, and intense abdominal pain.

When GLP-1 agonists like semaglutide were first introduced, concerns about pancreatitis were raised. Studies that have been completed since then have been unable to definitively find out whether these medicines cause pancreatitis, due to conflicting results.⁴

Clinical trials for Wegovy found pancreatitis to be an uncommon side effect, affecting between 1 in 1,000 to 1 in 1 in 100 individuals. If symptoms of pancreatitis develop, it is important to seek further medical attention and notify the prescriber.³

Hypoglycaemia

Hypoglycaemia is a state where the body’s blood sugar levels are too low. Symptoms of hypoglycaemia can include hunger, dizziness, sweating, shaking, blurred vision and feeling weak.

When used as a diabetes treatment, semaglutide aims to reduce high blood sugar. There may be concerns about semaglutide working too well, to the point that it causes hypoglycaemia. However, with semaglutide, hypoglycaemia is only likely to happen if semaglutide is used alongside other medicines that lower blood sugars (like insulin). This means that the risk of hypoglycaemia can be managed by carefully considering the doses used.⁴

When used alone in weight loss treatment, Wegovy has a low risk of hypoglycaemia. It is important to follow the dose directions of the prescriber and understand what to do if a dose is missed to avoid accidentally overdosing.

Gallbladder disease

Gallstones are small stones that form in the gallbladder. They do not tend to be life-threatening. People can have gallstones without seeing any symptoms or requiring treatment. Rarely, gallstones can become more serious if they are dislodged and block the duct, where they can cause inflammation and pain.

Data from clinical trials showed that gallstones have been found to occur in 1 in 100 to 1 in 10 individuals using semaglutide.³

Thyroid cancer

Tumours were found in the thyroids of rats and mice during early safety studies with GLP-1 agonists. However, the tumours were non-lethal. The way by which the tumours developed was also specific to the biology of mice and rats.⁴

Although the relevance to humans is deemed to be very low, the development of thyroid tumours cannot be completely ruled out.^3,4

Increased heart rate

All GLP-1 agonists were found to increase heart rate. Clinical trials with semaglutide saw a slight increase in heart rate from 1 in 1,000 to 1 in 1 in 100 individuals, making it an uncommon side effect.³

If the patient takes heart medications or has existing heart conditions, they should consult with their prescriber to decide whether Wegovy is suitable. Wegovy would be safe for otherwise healthy patients.

Injection injuries

Wegovy is available in the form of an injection that requires the user to inject themselves under the skin using sharp needles. To prevent injuries from incorrect injection, it is best to follow the directions of the manufacturer and the prescriber.

Advice for safety with injections includes:

• Always use a new needle for each injection, to prevent infections from a dirty needle.
• Change the injection site regularly between the abdomen, thigh or upper arm, to prevent skin reactions and irritation.
• Store Wegovy pens without the needle attached, to prevent blocked needles and leakage of the pen.
• Dispose of used needles in a designated sharps bin, to prevent other people from accidentally injuring themselves with the needles.
• Keep medicines and needles out of the reach and sight of children.

Summary

When taking any drug, it is important to consider the safety and risks. As with any drug, Wegovy has plenty of side effects. Many, like headaches, vomiting, diarrhoea, constipation, nausea, abdominal pain and fatigue can be expected as they are common. Nevertheless, these symptoms tend to be relatively harmless and resolve with time. Other side effects, like pancreatitis and hypoglycaemia, can be more serious. However, these cases are rare.

Any drug can be dangerous if not used responsibly. To reduce the dangers when taking medicines, it is important to work with the prescriber to decide whether a medicine is safe for the individual to use. Always follow the advice and guidance of the prescriber and manufacturer.