Introduction
What is Wegovy and for whom it is indicated?
Wegovy, the brand name of a medication containing the active compound semaglutide, is prescribed alongside diet and exercise for weight management. It's recommended for:1,2
- Adults with obesity - Body Mass Index (BMI) of 30 kg/m² or greater,
- Adults who are overweight - BMI between 27 kg/m² and 30 kg/m² - with weight-related health issues, for example, diabetes, high blood pressure, blood vessel problems, high levels of fat in the blood, and breathing problems during sleep.
- Adolescents with obesity (BMI greater than that of 95% of adolescents of the same age and gender) and who weigh more than 60 kg.
Studies show that combined with diet, exercise, and behavioural support, Wegovy can result in up to a 15% reduction in body weight.2
Attention! There is another semaglutide brand, named Ozempic, which treats type 2 diabetes and shouldn't be prescribed solely for weight loss.2
Wegovy’s mechanism of action
Wegovy's active substance, semaglutide, works like a Glucagon-like peptide-1 (GLP-1), a hormone produced in the gut that regulates appetite by increasing feelings of fullness and reducing hunger, cravings, and food intake. It also stimulates insulin release, lowering blood sugar levels.1,3,4,5
Understanding side effects
Although medicines are tested to be safe and effective, there are still risks associated with taking them. Some people may experience side effects, which are unwanted effects that are possibly related to a medicine. They can be minor issues like a runny nose or even severe events like heart attacks or liver damage. Side effects can vary among people because of factors such as:6
- Age
- Kidney/liver issues
- Other diseases you may have
- Conditions like immune system disorders
- Use of other medications and vitamins
You may have side effects when you:6
- Start taking a new medicine
- Stop a medicine that you’ve been taking for a while
- Increase or decrease the dose of the medicine that you take
If you experience a side effect, it is important to talk to your doctor to eliminate or ease the side effect. For example, they can adjust the dosage, switch to a different medication, or suggest a change in your diet.6 We will talk about Wegovy's side effects and how to manage them below.
Common side effects of Wegovy
The most common (more than 1 in 10 people may experience it) side effects of Wegovy are:1,5,7
- Nausea (feeling sick)
- Vomiting
- Diarrhoea
- Constipation
- Stomach pain
- Upset stomach
- Gas
- Belching (burping)
- Feeling bloated
- Heartburn
- Viral gastroenteritis (stomach flu)
- Dizziness
- Headache
- Tiredness (fatigue)
- Runny nose or sore throat
Managing Wegovy's common gastrointestinal side effects
To reduce your risk of experiencing a side effect, ask your healthcare provider about the possible side effects and what to do to reduce the risk.6 Gastrointestinal side effects are common, but usually, they are mild or moderate and pass with time. Following dietary recommendations may help with those symptoms:3,6
| Improving eating habits | Adapt food composition | Lifestyle tips |
| - Eat only if you are hungry and stop eating in case you feel full - Eat slowly - Increase meal frequency and in smaller portions - Eat without distractions and savour the food - Avoid drinking with a straw - Avoid lying down after a meal - Don’t be too active after eating - Avoid eating too close to bedtime | - Choose food that is easy to digest - Consider low-fat diets - Use the oven, cooking griddle or boiling - Healthy food that contains water (for example, soups, liquid yoghurt, and gelatin) - Increase fluid intake (in small sips) - Avoid sweet meals - Avoid canned food, spicy foods, dressings, and sauces that are not home-cooked | - Get some fresh air and do some light exercise - Keep a food diary, it may be useful to identify foods that make side effects worse |
Additional recommendations according to specific side effect:8
| Nausea | Vomiting | Diarrhoea | Constipation |
| - 30 min after the last dose, eat foods that ease the symptoms, such as: Crackers Apples Mint Ginger root or ginger-based drinks - Avoid strong smells | - Be careful with hydration - Eat more frequently, but in smaller portions of food | - Stay hydrated, but avoid isotonic drinks intended to be used for sport - Avoid dairy products, coffee, alcoholic drinks, soft drinks, very cold or very hot foods, and products with sweeteners ending in “ol” (sorbitol, mannitol, xylitol, maltitol) - Avoid high fibre content (restore gradually after improvement), such as grain and seed products, vegetables such as asparagus, beans, cabbage, garlic, lentils, onions, and skinned fruits - Eat chicken broth, rice, carrots, very ripe fruit without skin | - Ensure your diet is healthy and balanced - Consume an adequate amount of fibre - Drink generous amounts of water (or sugar-free liquids) - Increase physical activity |
If nausea and/or vomiting persist, avoid drinks during meals, and have them between 30 to 60 min before/after your meals. In case nausea, vomiting, diarrhoea and/or constipation persist even after following all the recommendations above, tell your doctor as soon as possible.8
Serious side effects of Wegovy and what to do
In some people, Wegovy may cause serious side effects, including:7
- Pancreatitis (inflammation of your pancreas): If you have severe pain in your stomach area that will not go away, stop using Wegovy and call your doctor.
- Gallbladder problems, including gallstones: If you have any symptoms such as pain in your upper stomach, yellowing of skin or eyes, fever, clay-coloured stools, or some gallbladder problems, you should call your doctor because you may need surgery.
- Hypoglycemia (low blood sugar) in patients with type 2 diabetes, especially those who take medicines to treat the disease: You should check your blood sugar before starting and while you take Wegovy. Ask your doctor about recognising and treating low blood sugar.
- Change in vision in people with type 2 diabetes: If you have changes in vision during treatment with Wegovy, tell your doctor.
- Kidney problems: In people with kidney problems, loss of fluids due to diarrhoea, nausea, and vomiting may worsen kidney problems. Therefore, it is important to drink fluids to reduce your chance of dehydration.
- Serious allergic reactions: If you have any symptoms of a serious allergic reaction including swelling of your face, lips, tongue or throat, severe rash or itching, very rapid heartbeat, problems breathing or swallowing, fainting or feeling dizzy, stop using Wegovy and get medical help immediately.
- Increased heart rate: If you feel your heart racing or pounding that lasts for several minutes while you are at rest, tell your doctor.
- Depression or thoughts of suicide: If you have any mental changes, especially sudden changes in your mood, feelings, thoughts, or behaviours, call your doctor right away.
Contraindications and precautions on using Wegovy
Do not use Wegovy if you:7
- Or anyone in your family has ever had medullary thyroid carcinoma, a type of thyroid cancer
- Have Multiple Endocrine Neoplasia syndrome type 2, an endocrine system condition
- Have had a serious allergic reaction to semaglutide or any other of the ingredients in Wegovy
Before starting to use Wegovy, tell your doctor if you have or had medical conditions, including:7
- Problems with your kidney or pancreas
- Type 2 diabetes and a history of diabetic retinopathy
- Mental health issues, depression or suicidal thoughts
- If you are pregnant or plan to become pregnant. You should stop using Wegovy 2 months before you plan to become pregnant.
- If you are breastfeeding or plan to breastfeed. Talk to your doctor about the best way to feed your baby while you are using Wegovy.
Also tell your doctor about all the medicines you take, because Wegovy may affect the way they work and/or they may affect the way Wegovy works.7
Summary
Wegovy is a medication containing semaglutide as an active compound, prescribed for weight management alongside diet and exercise. It is indicated for adults with obesity, overweight with weight-related health issues, and adolescents with obesity who weigh more than 60 kg. Combined with lifestyle changes, Wegovy reduces up to 15% of body weight. It works as the hormone GLP-1 to regulate appetite and blood sugar levels.1,2,3
Although this medication appears to be beneficial for weight management, some people can have side effects, such as nausea, vomiting, and diarrhoea. Usually, these common side effects can be managed with dietary, eating habits and lifestyle adjustments. However, serious side effects may occur, including pancreatitis, gallbladder problems, hypoglycemia, changes in vision, kidney problems, allergic reactions, increased heart rate, and mental health issues. In these cases, get in contact with your doctor.3,5,7,8
Attention! Wegovy is contraindicated for people with certain medical conditions and precautions must be taken regarding its use during pregnancy and breastfeeding. It is also important to inform your doctor about all medications you are taking due to potential interactions with Wegovy.7
References
- European Medicines Agency. Wegovy [Internet]. [cited 2024 Feb 09]. Available from: https://www.ema.europa.eu/en/medicines/human/EPAR/wegovy
- Department of health and social care media centre. Accessing wegovy for weight loss: everything you need to know [Internet]. 2023 [cited 2024 Feb 09]. Available from: https://healthmedia.blog.gov.uk/2023/09/04/accessing-wegovy-for-weight-loss-everything-you-need-to-know/
- Bergmann NC, Davies MJ, Lingvay I, Knop FK. Semaglutide for the treatment of overweight and obesity: A review. Diabetes Obesity Metabolism. 2023;25(1):18–35. Available from: https://dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/dom.14863
- Wang JY, Wang QW, Yang XY, Yang W, Li DR, Jin JY, et al. GLP−1 receptor agonists for the treatment of obesity: Role as a promising approach. Front Endocrinol. 2023;14:1085799. Available from: https://www.frontiersin.org/articles/10.3389/fendo.2023.1085799/full
- Alorfi NM, Algarni AS. Clinical impact of semaglutide, a glucagon-like peptide-1 receptor agonist, on obesity management: a review. Clin Pharmacol. 2022;14:61–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357557/
- FDA. Finding and learning about side effects (Adverse reactions) [Internet]. 2022 [cited 2024 Feb 09]. Available from: https://www.fda.gov/drugs/information-consumers-and-patients-drugs/finding-and-learning-about-side-effects-adverse-reactions
- Wegovy®. Prescribing information. [cited 2024 Feb 13]. Available from: https://www.novo-pi.com/wegovy.pdf
- Gorgojo-Martínez JJ, Mezquita-Raya P, Carretero-Gómez J, Castro A, Cebrián-Cuenca A, De Torres-Sánchez A, et al. Clinical recommendations to manage gastrointestinal adverse events in patients treated with glp-1 receptor agonists: a multidisciplinary expert consensus. JCM. 2022;12(1):145. Available from: https://www.mdpi.com/2077-0383/12/1/145
