Wegovy, the weight loss medication, became accessible in the United Kingdom, signaling a potential solution for individuals grappling with obesity, including those with type 2 diabetes or at risk of developing the condition. The introduction of Wegovy is set to follow a “controlled and limited launch,” as per Novo Nordisk’s announcement. This article offers comprehensive insights into Wegovy, its recommended usage, and its rollout.
Understanding Wegovy
Wegovy, a proprietary name for semaglutide, a GLP-1 analogue, is a weight loss medication developed by Danish pharmaceutical giant Novo Nordisk.
This year, the National Institute for Health and Care Excellence (NICE) issued guidelines suggesting that Wegovy should be prescribed to individuals with a specific BMI, typically exceeding 30 kg/m², who also present at least one weight-related health condition.
NICE advises that Wegovy can be considered for prescription to individuals with prediabetes or type 2 diabetes within specialized weight management services. The eligibility for this prescription depends on individual circumstances, current treatment plans, and the risk of potential side effects.
Wegovy’s Availability in the UK
As of September 4, 2023, Novo Nordisk has announced a restricted allocation of Wegovy for individuals accessing specialized NHS weight management services, provided they meet NICE’s eligibility criteria. Additionally, it can be obtained privately through registered healthcare professionals. Those prescribed Wegovy within these specialized NHS services will receive dietary advice and exercise support.
It is worth noting that Wegovy cannot yet be prescribed outside of specialized weight management services. However, in June 2023, the Department of Health initiated a two-year pilot program aimed at addressing obesity. This pilot explores the feasibility of prescribing Wegovy beyond specialized services, which are primarily hospital-based.
The government anticipates that following NICE’s recommendations, approximately 35,000 individuals will gain access to Wegovy. To broaden its availability to eligible individuals, the pilot program seeks to investigate how General Practitioners (GPs) can safely provide Wegovy and how the NHS can offer community or digital support.
At present, in the UK, Wegovy, Saxenda, and Orlistat are the only licensed and approved medications for weight loss.
Current Challenges in GLP-1 RA Supply
Throughout this year, there have been supply constraints concerning glucagon-like peptide receptor agonists (GLP-1 RAs). More information on this issue can be found in our response here.
Novo Nordisk has cautioned that supply constraints are likely to persist in the foreseeable future. Consequently, a portion of the available supply will be exclusively allocated for use within the NHS. Novo Nordisk is closely monitoring the demand for Wegovy.
The introduction of Wegovy aims to alleviate some of the supply pressures on GLP-1 medications, which have been prescribed off-label for type 2 diabetes.
Wegovy and Weight Management
Medications such as Wegovy play a crucial role in weight management for individuals living with or at risk of type 2 diabetes. It is our perspective that individuals should receive support tailored to their specific needs, whether through medication, dietary modifications, or bariatric surgery, coupled with comprehensive weight loss management services.
Differentiating Semaglutide Brand Names
Semaglutide is also available under the brand names Ozempic and Rybelsus, both recommended by NICE and accessible through the NHS to manage blood glucose levels in individuals with type 2 diabetes.
While Ozempic and Rybelsus are prescribed for blood glucose management in type 2 diabetes patients, Wegovy is specifically recommended for weight management in individuals with or without type 2 diabetes.
How Wegovy Promotes Weight Loss
Wegovy promotes weight loss by suppressing appetite, leading to reduced food consumption. It emulates the actions of the gut hormone GLP-1, released after meals, slowing down food movement in the gut and prolonging the feeling of fullness.
The extent of weight loss achieved with Wegovy varies depending on individual factors, the level of support received, and the duration of medication use. In a pivotal study, the STEP 1 clinical trial, individuals on the maximum dose of Wegovy lost 12% more body weight compared to those not taking the medication. Importantly, both groups received advice on calorie reduction and increased physical activity, underscoring the importance of incorporating these changes for optimal outcomes with weight loss medications.
Like other weight loss medications, evidence suggests that individuals may experience weight regain upon discontinuation of Wegovy. Therefore, continuous su
pport in terms of dietary and physical activity modifications remains crucial.
Possible Side Effects of Wegovy
Common initial side effects of Wegovy include nausea, along with potential issues such as constipation and diarrhea. Notably, if an individual has diabetic eye disease (retinopathy) and is using insulin, Wegovy may lead to worsened vision, potentially necessitating treatment. It is essential to inform a healthcare provider of diabetic eye disease or any eye-related concerns during Wegovy treatment.
Detailed information about potential side effects can be found in the Patient Information Leaflet (PIL) included with the medication.
Before initiating a new Wegovy prescription, it is vital for individuals to seek personalized advice from their healthcare team and promptly report any side effects.
Seeking Prescription for Weight Loss Medication
While certain blood glucose-lowering medications, such as GLP-1 analogues and SGLT2 inhibitors, may contribute to weight loss, they are not designated as weight loss drugs.
Currently, there are two other weight loss medications available through the NHS: Xenical (generic name Orlistat), which is administered in capsule form, and Saxenda, a brand name for liraglutide, a GLP-1 analogue administered via daily injections.
In the NHS, Wegovy and Saxenda prescriptions are limited to specialized weight management services. Those interested in these medications should consult their GP to explore a referral to an appropriate service in their locality.
Orlistat functions by reducing the amount of dietary fat absorption, and it can be prescribed by GPs. Another brand name for Orlistat is alli, which can be purchased without a prescription.
Individuals are strongly encouraged to engage in discussions with their GP, nurse, or dietitian to assess weight management options, including weight loss medication, that align with their unique needs.
