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How does Wegovy work? The weight-loss injections explained, side effects list and how to get it on the NHS

Wegovy has now been made available in the UK and thousands of people living with obesity including some people with type 2 diabetes, or at risk of type 2 diabetes, will be able to get the weight loss jab through a “controlled and limited launch”, its Danish manufacturers Novo Nordisk have said.

Wegovy is a brand name for semaglutide, a GLP-1 analogue. It acts in the same way as GLP-1 (a natural hormone in the body) and, among other things, appears to regulate appetite by increasing a person’s feelings of fullness, while reducing their food intake, hunger and cravings.

The National Institute for Health and Care Excellence (Nice) issued guidelines this year recommending Wegovy be prescribed to people who have a particular BMI (usually 30kg/m2 and over) and at least one weight-related health condition, such as diabetes, high blood pressure, abnormal levels of fats in the blood, breathing problems during sleep called “obstructive sleep apnoea” or a history of heart attack, stroke or blood vessel problems.

Nice recommends that Wegovy – a once-weekly injectable pen – can be prescribed to people with prediabetes or type 2 diabetes as an option for weight management within a specialist weight management service. This will depend on a person’s personal circumstances, and factors such as their current treatment plan and risk of side effects.

Studies have shown that Wegovy is effective in helping people lose weight, with a significant proportion of them achieving at least a 5 per cent weight loss. The amount of weight you lose on Wegovy would depend on your personal circumstances, the support you receive and how long you are on the medication for, experts say.

In a major study, the STEP 1 clinical trial, people on the maximum dose lost 12 per cent more of their body weight compared to those who were not on the medication.

Crucially, both groups received advice to reduce their calorie intake, and increase their physical activity levels, which shows the importance of making those changes to get the best out of any weight-loss medications.

Like other weight loss medications, there is evidence of weight regain when people stop using Wegovy so it is important to continue to receive support in making changes to your diet and physical activity levels. Nice recommends taking the drug for a maximum of two years.

The results of a large five-year study carried out by Novo Nordish, called SELECT, were published last month and revealed that the highly effective obesity treatment also had a clear cardiovascular benefit. Patients on Wegovy had a 20 per cent lower incidence of heart attack, stroke or death from heart disease compared to those on a placebo.

On 4 September, Novo Nordisk announced that a limited supply of Wegovy will become available to people in specialist NHS weight management services who meet the Nice eligibility criteria, or privately through a registered healthcare professional. People who are prescribed Wegovy within these specialist NHS services will also receive support with dietary advice and exercise.

Wegovy cannot yet be prescribed outside specialist weight management services, but in June 2023 the Department of Health announced a two-year pilot to tackle obesity, which will explore how Wegovy can be prescribed beyond these services, which are largely hospital based.

The Government says the Nice recommendations mean that around 35,000 people will have access to Wegovy, but to make it available to more people who could be eligible, the pilot will explore how GPs could safely offer Wegovy, and how the NHS can provide support in the community or digitally.

However, as i revealed last month, the pilot is yet to start, due to ongoing supply problems of the drug. Novo Nordisk has said it expects those issues to continue until at least 2025 because of the soaring global demand for semaglutide.

Currently, Wegovy, Saxenda and Orlistat are the only medications that are licensed and approved for weight loss in the UK. The most common side effects with Wegovy, which may affect more than 1 in 10 people, are headache, nausea, vomiting, diarrhoea, constipations and abdominal pain.

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