Wegovy (semaglutide) š is a GLP-1 agonist, similar to Ozempic (0.25 mg-1 mg) but titrated to 2.4 mg weekly for weight loss. Patients can lose ~10-12% more weight than with placebo (~9 kg for a 90 kg pt). Double the weight loss of Saxenda (liraglutide).
- Start at 0.25 mg/wk for 4 wks, increase to 2.4 mg by week 17. If SEs occur, delay dose ⬆️. GI SEs are common but manageable with slow titration. Stop if pts don’t lose 5% of their body weight after 12 weeks at 2.4 mg.
- Don't š« combine Wegovy with other wt loss meds or GLP-1 agonists like Rybelsus. Avoid using with DPP4 inhibitors (e.g., Januvia).
- š” Wegovy is more effective than Saxenda and requires only weekly dosing, making it preferable. Keep in mind, it's NOT available in Egypt šŖš¬ yet.
- Lifestyle changes first! š Consider bariatric surgery if BMI ≥35. Only discuss meds for pts with BMI ≥30, or ≥27 with weight-related conditions like HTN or T2DM.
- Be aware: Wegovy & Saxenda are pricey!š²But worth considering for pts committed to long-term weight mgmt.
References
- Wadden TA, Bailey TS, Billings LK, et al. Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy on Body Weight in Adults With Overweight or Obesity: The STEP 3 Randomized Clinical Trial. JAMA. 2021;325(14):1403-1413.
- Rubino D, Abrahamsson N, Davies M, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA. 2021;325(14):1414-1425.
- Wilding JPH, Batterham RL, Calanna S, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021;384(11):989-1002.
