Prescription weight loss medicine is a class of drugs that are medically proven and approved by the FDA to help obese adults. In 2021, the FDA added Wegovy injection to the category of drug treatments for chronic weight management in adults with obesity or overweight with at least one weight-related condition. This under-the-skin injection is the first approved drug for chronic weight management since 2014.
Before its approval, Wegovy’s safety and efficacy were studied in four 68-week trials. In the largest trial involving adults without diabetes, individuals who received Wegovy lost an average of 12.4% of their initial body weight compared to individuals who received placebo. In the trial with adults with type 2 diabetes, 6.2% of the initial body weight of Wegovy-takers was lost, compared to those who received placebo.
This tells us that prescription weight loss medicine can effectively help people lose weight, but it may not be available to everyone. There’s a clear distinction when comparing overweight vs obesity, and a physician is more likely to prescribe medical solutions in the case of the latter. A person is considered overweight if their body mass index (BMI) is between 25 to 29.9. In that instance, you may first be asked to undertake dieting or exercise rather than going to the medical option. However, a BMI of 30 or more is classed as obese, and that’s when medical solutions are more likely to come into play. That’s not to say those who are overweight cannot get a Wegovy injection, just that there may be other steps prior to a physician prescribing the jab.
If you have reached a point when Wegvoy is being considered, here is some pertinent information you may need to know.
Understanding the effects of prescription medications
Wegovy’s class of medications is called GLP-1 agonists. These are known to mimic a hormone that helps reduce appetite.
Wegovy is often compared to Ozempic, an antidiabetic and anti-obesity prescription medication developed in 2012, as they are different doses of the same drug: semaglutide. When injected into the body, semaglutide boosts the release of insulin and blocks sugar production in the liver. Tests done on semaglutide or Ozempic have shown that adults may lose an average of 10-15% of their total body weight. Dr. Andres Acosta, director of the nutrition obesity research program at Mayo Clinic, explains that the medicine works for many people—but your results may not be the same as someone else’s.
Otherwise, other prescription medicines include orlistat, liraglutide, phentermine-topiramate, and naltrexone-bupropion, for chronic weight loss in the general population. Orlistat prevents fat absorption in the intestines and liraglutide improves metabolic functions by helping the pancreas release insulin correctly. On the other hand, phentermine-topiramate and naltrexone-bupropion helps to reduce appetite by increasing the levels of neurotransmitters in your brain. The influx of norepinephrine, serotonin, and dopamine in your body causes you to feel full and satisfied for longer.
Meanwhile, there are currently two prescription drugs approved by the FDA that specifically target patients with genetic causes of obesity. This is metreleptin and setmelanotide. The former is used to treat leptin-deficient patients with mutations in the leptin gene — which regulates hunger by providing the sensation of satiety. The latter is used in obese patients with genetic mutations in POMC, PCSK1, or LEPR genes and Bardet Biedl syndrome.
Improving the effectiveness of prescription medications
It is important to note that medication does not help you lose weight forever. Dr. Acosta additionally notes that, “We know from the years of work we have done at Mayo Clinic and the studies of each of these medications that not all patients respond to them.”
Weight loss from medication tends to plateau after 3-6 months, but that can be enough time for people to adopt the right motivation for weight loss. One of the biggest challenges is seeing a weight loss plan as a journey, not a destination, and if you’re already 3-6 months down the line, your motivation is likely to have become clear and fixed in your mind. Medical weight loss interventions must therefore complement healthy lifestyle programs and a nutritious diet, becoming part of the journey and not replacing healthy eating and exercise practices. The medication will help address one’s biology to make weight loss easier and allow an individual to achieve and maintain their target weight thereon after.
In fact, a 2021 experiment confirmed that a combination strategy of liraglutide and exercise decreased body-fat percentage by 3.9 percentage points. This was approximately twice the decrease from the groups that did solely exercise and solely medication. Furthermore, only the group that did the combination strategy experienced improvements in the glycated hemoglobin level, insulin sensitivity, and cardiorespiratory fitness — one year after the experiment.
Luckily, newer medications are continuously being created. These are noted to be more effective, producing an average of 15% weight loss. The diabetes drug Mounjaro, or tirzepatide, is currently going through tests at the FDA, and initial trials found that participants lost up to 22.5% of their body fat while on the medication. The weight loss community can anticipate its approval for weight loss this 2023.
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