What is Wegovy?
You may have heard about a new medication called Wegovy, which has just been FDA approved for chronic management for weight. What should you know about this medication?
First, it is important to understand how the brain and human body controls eating behaviors. There are complex hormonal connections between the brain, the gut, and other organs that control feelings of hunger, fullness, and cravings.
One of these hormones is called glucon like peptide , or GLP1. It is a hormone humans naturally make. It is released from the gut during eating and talks to a part of the brain that helps to shut off feelings of hunger. It also slows down the speed at which food moves through the digestive tract.
Think of it like a light switch that helps to control your weight set-point. This specific one helps with feeling full and satisfied. For some, it may be stuck in the “on” position, causing one to be hungry often, struggle with feeling full when they sit down to eat, and lead to struggles with implementing nutritional guidance.
Wegovy is a medicine that is 94% similar to the GLP1 hormone humans naturally make, with a few changes that cause it to have a longer presence after being released (longer half-life), and helps to turn off that light switch to help an individual feel full and satiated, and more in control of their eating behaviors.
If you are someone who struggles with feeling full and satisfied, or feels like their life is controlled by food, this medication may be a great tool to utilize in conjunction with lifestyle management.
Interested in learning more? Reach out to an Enara staff member today.
Who is not a candidate for Wegovy: if you have a family or personal history of medullary thyroid cancer, a very rare thyroid cancer, Wegovy is contraindicated.
Wegovy Vs Saxenda.
You may have heard of a medication called Saxenda that has been available for chronic management of excess weight. Wegovy was approved and is now on the market as well. How do these medications compare?
| Medication | Class | Dosing | Age Approved for | Common Side Effects | Reduction in Weight with Diet and Exercise | Other Health Benefits |
| Saxenda | GLP1 | 3mg daily | 12-17 pediatric population + 18 and older. | Nausea, constipation | 12.8% reduction in weight | Reduction in waist circumference, improvement in blood pressure, improvement in cholesterol panel. |
| Wegovy | GLP1 | 2.4mg weekly | Currently approved for 18 and older. | Nausea, constipation | 17.4% reduction in weight | Reduction in waist circumference, improvement in blood pressure, improvement in cholesterol panel. |
As you can see, there are a lot of similarities between these two molecules. They are both in the class of medications called GLP1 that is a hormone that talks to the brain to quiet down areas that control hunger, fullness, and satiety. Wegovy lasts longer, with what we call a longer half-life. It is taken once weekly, vs daily. The dosing is 2.4mg weekly for Wegovy vs 3mg daily for Saxenda . The side effects are similar between the two, with the most common being nausea and constipation.
Both medications are great options in conjunction with optimizing lifestyle management, and we will likely see Wegovy prescribed more frequently in the upcoming months vs. Saxenda due to the improved efficacy and once weekly dosing.
Wegovy Vs Bariatric Surgery
Wegovy has been a breakthrough in a class of FDA approved medications used for chronic management of excess weight. Up until Wegovy came to market, there was no medication that came close to the reduction in weight seen in bariatric surgery.
You just learned how Wegovy works, so how does bariatric surgery work?
The two most common bariatric procedures are the gastric bypass and the gastric sleeve. These surgeries help to create a metabolic shift and impacts many of the hormones that control hunger, fullness, and satiety. The success of bariatric surgery is not simply in restriction, but the metabolic shift that occurs.
How do the two compare?
| Medication/Surgery | Hormones Impacted | Who is a candidate? | Reduction in Weight |
| Wegovy | change in hunger and satiety hormone, GLP1 | BMI >27 with obesity related complication, or BMI >30 | 17.4% reduction in total body weight |
| Gastric Bypass | Change in gut microbiome, change in multiple hunger and satiety hormones, | BMI >35 with obesity related complication, or BMI >40 | 27%-32% reduction in total body weight |
| Gastric Sleeve | Change in gut microbiome, change in multiple hunger and satiety hormones | BMI >35 with obesity related complication, or BMI >40 | 17%-23% reduction in total body weight |
Who would benefit from each of these treatment options? Much of this is determined by the health impact of excess weight carried, and the stage of disease state an individual is in. Below is a table that shows the different stages of obesity and the treatment options that are available. As you can see, as the disease state progresses, the level of treatment options become more aggressive, however, the foundation of care is optimization of lifestyle with nutritional, activity, and behavioral support.
Interested in learning more? Reach out to an Enara staff member today or checkout our homepage here.
By Amy Ingersoll
Amy Ingersoll, PA-C, MMS, FOMA is a nationally respected obesity medicine PA. She has received the highest level of training in obesity medicine for PAs with the Advanced Education of Obesity Medicine from the Obesity Medical Association (OMA) that demonstrates her extensive knowledge of evidence-based obesity treatment approaches and an ongoing commitment to patient’s health.
