What is the consultation for Wygovy (semaglutide)?

From the Guidelines

I strongly recommend consulting with a healthcare provider before starting Wygovy (semaglutide), as it requires a prescription and medical supervision, and the most recent evidence from 2023 suggests that semaglutide is effective for chronic weight management in adults with obesity or overweight with at least one weight-related condition, with a mean weight loss of 14.9% at 68 weeks 1.

Key Considerations

• Wygovy is an injectable medication that mimics the effects of GLP-1, targeting areas of the brain involved in appetite regulation, and helping individuals feel fuller longer and consume fewer calories.
• The typical regimen begins with 0.25 mg injected subcutaneously once weekly for the first month, then increases gradually (0.5 mg, 1 mg, 1.7 mg) to the maintenance dose of 2.4 mg weekly, as recommended in the 2022 aga clinical practice guideline on pharmacological interventions for adults with obesity 1.
• Side effects commonly include nausea, diarrhea, vomiting, constipation, and abdominal pain, and individuals with a history of pancreatitis, gallbladder disease, kidney problems, or personal/family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 should be cautious when using Wygovy, as noted in the 2023 obesity in south and southeast asia-a new consensus on care and management study 1.

Important Safety Information

• Wygovy is contraindicated in individuals who are or may become pregnant, and individuals of reproductive potential must be counseled regarding the use of reliable methods of contraception, as stated in the 2023 obesity management in adults: a review study 1.
• The medication may cause cholelithiasis and gallstone-related complications, and individuals with a history of kidney disease should use caution when initiating or increasing doses due to the potential risk of acute kidney injury, as reported in the 2023 8. obesity and weight management for the prevention and treatment of type 2 diabetes: standards of care in diabetes-2023 study 1.

Lifestyle Modifications

• For best results, Wygovy should be used alongside lifestyle modifications, including a reduced-calorie diet and regular physical activity, such as 150 minutes of physical activity per week, as encouraged in the STEP trials examining the efficacy of semaglutide 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Wygovy Consult

• Wygovy, also known as semaglutide, is a glucagon-like peptide-1 receptor agonist (GLP-1 RA) used for glycaemic management in adults with type 2 diabetes and for chronic weight management 2, 3, 4.
• The efficacy and safety of oral semaglutide have been compared to subcutaneous semaglutide, placebo, and other GLP-1 RA comparators in several studies, showing that oral semaglutide can significantly reduce glycated haemoglobin (HbA1c) and body weight in people with uncontrolled type 2 diabetes 2.
• Semaglutide has been shown to be effective in reducing HbA1c and body weight, with a significant reduction in HbA1c levels (MD: -1.30% [95%CI: -1.44, -1.16], P < 0.05) and body weight (MD: -3.17 kg [95%CI: -3.89, -2.45], P < 0.05) compared to placebo 2.
• The adverse events associated with semaglutide are primarily gastrointestinal, including nausea, vomiting, obstipation, or diarrhea, which can often be mitigated by slow up-titration 2, 3, 5.
• Switching from liraglutide or dulaglutide to semaglutide has been shown to achieve further reductions in HbA1c and weight in patients with type 2 diabetes mellitus, with a mean reduction in HbA1c of 0.65% (7.1 mmol/mol) and a mean weight reduction of 1.69 kg 5.
• Semaglutide has been approved by the Food and Drug Administration for weight loss, with clinical trials demonstrating its superior efficacy compared to placebo and other antidiabetic medications in weight reduction 4.
• Long-acting GLP-1RA, including both injectable and oral formulations, have been shown to reduce the incidence of major adverse cardiovascular events, hospitalization for heart failure, and kidney events, as well as all-cause mortality in individuals with type 2 diabetes 6.