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Novo Nordisk - Wegovy®

New revolutionary weight loss drug!

Photographs: Unsplash

Text: Mariano Anthony Davies

Wegovy® was recently introduced to the market by Novo Nordisk and looks like being one of the most effective anti-obesity drugs to date. This product could result in Novo Nordisk becoming a leading global pharmaceutical manufacturer.

Obesity can lead to severe health problems and many obese people experience difficulty trying to lose weight. This new product is effective at reducing weight, and the side effects are manageable.

It is an example of a new generation of medications based on a better understanding of the biological underpinnings of obesity. While previous pharmaceutical treatments resulted in weight loss of 5-10%, clinical trials of this new wave of drugs are reporting initial weight loss of 15-20%. They work by suppressing appetite and slowing down digestion, so we feel full for longer. One of these medications is “semaglutide” and is sold under the brand name Wegovy®.

These drugs are so effective because they address one of the many complex causes of obesity. When we eat, our bodies usually release “satiety hormones” to make us feel full. However, for people living with obesity, this doesn’t always happen, which can result in uncontrolled hunger and heightened responsiveness to food. Prolonged restriction of food – also known as dieting, and something most people living with obesity will face pressure to do – can further weaken that satiety hormone response. It contains the satiety hormone GLP1, which steps in where the body’s hormones may have failed, boosting sensations of fullness, suppressing reward-driven eating and increasing feelings of control.

However, caution is needed. Semaglutide side-effects can include nausea, bloating, diarrhoea and wind (potentially others), which is why close medical supervision is advised as the dose is increased beyond the first four weeks.

While there is no doubt that these drugs are an important tool in managing obesity, they are only that – one tool. The drug fulfils a biological function but doesn’t provide mental health support or treatment for an eating disorder. Drastic weight loss can have unpredictable effects on mental health. One study found that almost one in five people who receive bariatric surgery (gastric bypass) later experience depression.

Some people living with obesity have used food as a coping mechanism to deal with stress or underlying mental health issues – they will need support once that coping mechanism is removed. Weight-loss treatments should be implemented as part of a much wider support programme that includes advice on nutrition and eating behaviour, psychological support and supported physical activity.

Obesity is complex and is becoming widely recognised as a lifelong, chronic, relapsing disease. We can get better at management, but scientists have not yet found a robust cure – not even with this new product.

Healthcare practitioners need training in obesity management, access to a range of clinical tools and options to work with, and an evidence base to help inform treatment plans to meet individuals’ needs. We also require considerable investment in specialised weight management services within the communities which need them most.

And while most people appropriately prescribed the drug will experience some benefits, clinical tests have shown that the new drug will not work for everyone. The drivers of obesity are diverse, and no drug addresses situational and psychology factors. Structural health inequalities, poverty, mental health issues and the impact of trauma (all shown to drive weight gain) will never be fixed by a jab.

Nevertheless, the European Medicines Agency decided that the drug’s benefits outweigh its risks and has been authorised for use in the EU. This authorisation was given on 6 January 2022.

On 30 March 2023, the Committee for Medicinal Products for Human Use (CHMP) also adopted a positive opinion, although recommending a change to the terms of the marketing authorisation for the medicinal product.

After one year’s availability in Europe, December 2022 was an important benchmark for Novo Nordisk, who announced that the FDA had approved Wegovy® for the treatment of obesity in teens who are 12 and older, while making clear that the product is not meant for recreational or short-term use, so a person who wants to lose weight to look better for a vacation or a high school reunion would not be a candidate for this product.

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