How does Wegovy work for weight loss?

How does Wegovy work for weight loss?

How does Wegovy work for weight loss? Most people hear it suppresses appetite. But this prescription medication does much more—by mimicking a hormone naturally occurring in the gut.

Elizabeth Millard
Last updated:
September 11, 2024
5 min read
Medically reviewed by:
Rekha Kumar, MD, MS
Table of Contents
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After learning that Wegovy® is one of just a few receptor agonist medications (along with Zepbound® and Saxenda®) that are FDA-approved for weight loss, you might be wondering: How does Wegovy work, exactly? We’ve got answers to that and other commonly asked questions about this popular weight management medication.

What Is Wegovy?

In 2021, the U.S. Food and Drug Administration (FDA) approved Wegovy (semaglutide), along with a reduced-calorie diet and increased physical activity, as a treatment for chronic weight management in:

  • adults with obesity, defined as having a body mass index (BMI) of 30 or higher or
  • adults who are overweight (a BMI of 27 or higher) and have at least one weight-related condition—such as type 2 diabetes, high cholesterol, or high blood pressure.

In March 2024, the FDA also approved it as a treatment to reduce the risk of serious heart problems (such as heart attack, stroke, or death) in those who are obese or overweight and have previously diagnosed cardiovascular disease.

Manufactured by Novo Nordisk, the prescription drug is a once-per-week injection of semaglutide. That’s the same active ingredient in Ozempic®, produced by the same company. The difference is that Wegovy was specifically approved as an obesity and weight management treatment for those with excess weight. In contrast, Ozempic was approved for treating type 2 diabetes.

How does Wegovy work for weight loss?

According to the National Library of Medicine, semaglutide is in a class of medications called "incretin mimetics," meaning it mimics one of the body’s natural incretin hormones. Wegovy works by helping the pancreas release the right amount of insulin when blood sugar levels surge. Insulin helps move sugar out of the blood so it can be utilized for energy instead of being stored as fat. 

More specifically, Wegovy is a GLP-1 receptor agonist. That means it mimics glucagon-like peptide-1 (GLP-1), an incretin hormone that is naturally produced in the body and helps regulate appetite and satiety. By binding to and activating the same receptors as GLP-1, Wevogy slows digestion, regulates insulin response, curbs hunger, and helps you feel full longer.

Research suggests that Wegovy also promotes weight loss by changing a person’s preference for high-fat and high-sugar foods, which are often calorie-dense and may sabotage weight loss efforts. Additional research has found that Wegovy may prompt people to cut back on—or even eliminate— alcoholic drinks, another source of empty calories.

All of those actions combine to explain how Wegovy works for weight loss and why it’s become such a popular option since its FDA approval as an obesity and weight management treatment. 

How is Wegovy administered, and how long does it take to start working?

Wegovy is a weekly injection. As with other medications that treat obesity and excess weight or type 2 diabetes, the initial dose of Wegovy starts low and then steps up as your body gets used to the drug. People prescribed Wegovy typically start on the lowest dosage of 0.25 mg and then increase the dose after four weeks, based on their health care provider’s recommendation.

Wegovy has two "step up" dosages of 0.5 mg and 1 mg, followed by maintenance doses of 1.7 mg and 2.4 mg. If you’re prescribed Wegovy through Found, your precise dosage amount and medication schedule will be part of your personal weight loss plan. Note: Found’s clinicians work with patients to determine the best option for each person, but the ultimate decision as to whether a patient is qualified for a medication rests with the provider.

Typically, people see changes in appetite and feelings of fullness within a few days of starting Wegovy. For weight loss, it may take some time to see results. Typically people notice a change within a couple weeks. But if it takes longer than that, it doesn't mean Wegovy isn't working. Everyone’s body is different regarding weight loss, and you may need a month or two before you see results.

In a large clinical trial studying Wegovy’s effectiveness, adults with obesity or excess weight who did not have type 2 diabetes took a weekly dose of 2.4 mg of semaglutide or a placebo. After 68 weeks, those on semaglutide lost an average of 14.9% of their initial body weight, while the placebo group lost 2.4%.

What are the side effects of Wegovy for weight loss?

Like any medication—even over-the-counter options like ibuprofen or aspirin—Wegovy and other GLP-1s may cause side effects. For Wegovy, these can range from mild and uncomfortable to serious enough for you to consider switching your weight loss medication strategy.

The most common side effects of GLP-1 medications like Wegovy are nausea, vomiting, diarrhea, and acid reflux. More serious but less common side effects include pancreatitis, gallbladder disease, and worsening of diabetic eye disease. 

Although rare, in animal studies, semaglutide increased the risk of thyroid C-cell tumors. Wegovy’s “black box” warns of the risk of these tumors. If you have trouble swallowing, develop hoarseness, or feel swelling or a lump in your neck, contact your health care provider immediately. 

The FDA also warns you shouldn’t take Wegovy if you have a personal or family history of multiple endocrine neoplasia syndrome type 2 or medullary thyroid cancer. Wegovy isn’t a treatment for those with insulin-dependent diabetes or diabetic ketoacidosis. So, if that’s you, Wegovy isn’t the right fit. 

Tell your health care provider if you experience severe stomach problems that won’t go away, including abdominal bloating or pain, acid reflux, a feeling of fullness after eating just a few bites of food, nausea, and vomiting (including vomiting undigested food eaten a few hours earlier). These may be symptoms of gastroparesis (stomach paralysis). 

Find detailed side effect and risk information for Wegovy here and for other medications by name on our dedicated medication page.

Will I gain weight if I stop using Wegovy?

Any weight management plan, whether it involves weight loss drugs or not, comes with a risk of weight regain. But if you stop using Wegovy, weight gain isn’t inevitable, especially if you have effective weight management strategies.

One study of over 20,000 patients taking semaglutide found that about 18% regained all the weight they’d lost (or more) a year after discontinuing the medication. However, 56.2% of semaglutide users were able to maintain their weight loss or continue to lose weight after stopping the drug. 

Support to help you stay on track is crucial as you navigate post-medication habits. At Found, we don't just offer clinical expertise—although that's a foundation of our program—we also connect you with trained health coaches and community members who share their challenges and victories.

Is Wegovy better than other weight loss medications?

The answer to this question is subjective because Wegovy may work best for your weight loss, but it may not work for someone else. The good news is that there’s more than one l option when it comes to weight loss medications. 

To learn about other options for weight loss medication, read about how Wegovy compares to Zepbound and the differences between Wegovy and Saxenda. If you've tried Wegovy and it doesn't seem to be a fit, talk with your Found-affiliated provider, who can suggest a different medication. There are a wide range of options, including other GLP-1s, dual agonists, and non-GLP-1 oral medications

The Found program focuses on personalization in order to support you with the right clinical treatment for your unique needs. To build these treatment plans, our clinicians use a metabolic health assessment called MetabolicPrint™, which uncovers the root causes of weight challenges and creates a foundation for a personalized treatment plan. To determine whether Wegovy or a different medication is your best fit, get started today by taking our quiz.

About Found

Found is among the largest medically-supported telehealth weight care clinics in the country, having served more than 250,000 members to date. To discover your MetabolicPrint™ and start your journey with Found, take our quiz.

About GLP-1 prescriptions

GLP-1 prescriptions filled through your local pharmacy are now available as part of Found's weight-loss toolkit. While GLP-1s can be effective for weight loss, like all medicines, they are not clinically appropriate for everyone. Eligibility for a GLP-1 is based on a thorough evaluation of your medical history and lab work. If a GLP-1 is not appropriate for you, our providers will work with you to determine an effective medication for your health profile. GLP-1 medicines are not included in the cost of the Found subscription. 

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Published date:
September 11, 2024
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Meet the author
Elizabeth Millard
Freelance health journalist
Elizabeth Millard is a freelance journalist specializing in health and wellness, with a particular focus on weight management, hormone regulation, and emotional health.
Medically reviewed by:
Rekha Kumar, MD, MS
Fact checked by:
Lisa Greissinger
Edited by:
Nichole Aksamit
Last updated on:
September 11, 2024

Sources

U.S Food & Drug Administration. (2021, June 21). FDA approves new drug treatment for chronic weight management, first since 2014. FDA. Retrieved August 15, 2024, from https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014

U.S Food & Drug Administration. (2024, March 8). FDA Approves First Treatment to Reduce Risk of Serious Heart Problems Specifically in Adults with Obesity or Overweight. FDA. Retrieved August 15, 2024, from https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-reduce-risk-serious-heart-problems-specifically-adults-obesity-or

Semaglutide injection: MedlinePlus drug information. (2024, April 20). https://medlineplus.gov/druginfo/meds/a618008.html

Blundell, J., Finlayson, G., Axelsen, M., Flint, A., Gibbons, C., Kvist, T., & Hjerpsted, J. B. (2017). Effects of once‐weekly semaglutide on appetite, energy intake, control of eating, food preference and body weight in subjects with obesity. Diabetes Obesity and Metabolism, 19(9), 1242–1251. https://doi.org/10.1111/dom.12932

International Association for Physicians in Aesthetic Medicine. (2023, October 24). The interaction between Wegovy® and alcohol - IAPAM. IAPAM. https://iapam.com/medical-weight-management-library/interaction-between-wegovy-alcohol

Mayo Clinic. (2024, April 22). How fast does semaglutide kick in? Mayo Clinic. https://diet.mayoclinic.org/us/blog/2024/how-fast-does-semaglutide-kick-in/

Adult Dose Escalation Schedule | Wegovy® (semaglutide) injection 2.4 mg. (2024, April). novoMEDLINK. https://www.novomedlink.com/obesity/products/treatments/wegovy/dosing-administration/wegovy-dosing.html

Wilding, J. P., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., McGowan, B. M., Rosenstock, J., Tran, M. T., Wadden, T. A., Wharton, S., Yokote, K., Zeuthen, N., & Kushner, R. F. (2021). Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine, 384(11), 989–1002. https://doi.org/10.1056/nejmoa2032183

Bartelt, K., RN, Mast, C., MD, Deckert, J., PhD, Gracianette, M., MD, & Joyce, B. (2024, January 23). Many patients maintain weight loss a year after stopping semaglutide and liraglutide. Epic Research. https://www.epicresearch.org/articles/many-patients-maintain-weight-loss-a-year-after-stopping-semaglutide-and-liraglutide

 

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