Microdosing GLP-1s: Does It Work for Weight Loss?
Can tiny doses of powerful GLP-1 drugs help people lose weight or maintain weight loss? Here’s what an obesity doctor has to say about microdosing GLP-1s.
Wegovy has gotten tons of buzz about its ability to aid in sustainable weight loss. Learn if it’s right for you here.
The chatter about weight-loss medications is all around us these days—it pops up in your Instagram reels, in celebrity gossip magazines, and in your social circles. Even news outlets like National Public Radio are covering it. New weight-loss drugs have indeed reached a new level of popularity. And one, in particular, has been at the forefront of most talk: Wegovy®.
Wegovy (semaglutide) has been all over the news not only because its results have been remarkable but also because of the nationwide shortages. In May, Novo Nordisk announced on its website that demand continues to exceed the company’s current supply capacity, and patients may have difficulty filling their Wegovy prescription through September.
Research suggests it can help patients lose up to 15 percent of their body weight over 68 weeks when combined with diet and exercise. Wegovy is one of two GLP-1s approved by the U.S. Food and Drug Administration (FDA) for weight loss. The other is Saxenda® (liraglutide), which works similarly for chronic weight management in people who have obesity or who have a BMI of 27 or greater with related health issues.
In addition to Wegovy and Saxenda, Ozempic® (also semaglutide), which is FDA-approved for the treatment of type 2 diabetes, has also shown promise and is often prescribed off-label for weight loss. And to say demand for this drug is high among those looking to drop pounds—whether 10 or 100—would be a major understatement.
With all the information circulating around, you may have questions about how Wegovy weight loss works and whether it’s right for you. We’re here to help sort through some of the claims and give you up-to-date information on what we know now.
Wegovy, the brand name for semaglutide, is a once-weekly, injectable glucagon-like peptide 1 receptor agonist (GLP-1 RA).* Wegovy is manufactured by Novo Nordisk, which also produces popular diabetes drugs Rybelsus® and Ozempic. Interestingly enough, Novo Nordisk saw the weight loss success Ozempic had in patients with type 2 diabetes. So it began testing higher doses of semaglutide in clinical trials and received FDA approval for Wegovy in June of 2021.
Unlike Ozempic, Wegovy is FDA-approved for weight management in patients with a body mass index (BMI) of 27 or greater who have at least one weight-related condition—like high blood pressure, type 2 diabetes, or high cholesterol—or in patients with a BMI of 30 or greater.
The medication imitates the GLP-1 hormone your body already makes and helps regulate appetite and slow gastric emptying. It also signals your pancreas to release insulin after eating or when blood sugar is high—ultimately reducing blood sugar levels. Essentially, what Wegovy does is help your gut and brain better communicate to make you feel fuller and help reduce appetite.
The Wegovy weight loss results are promising. In a double-blind 68-week clinical trial by Novo Nordisk, the manufacturer of Wegovy, 1,961 adults with obesity or overweight took either Wegovy or a placebo in addition to following a reduced-calorie diet plan and increased physical activity. Those on Wegovy lost an average of about 35 pounds, or about 15% of their body weight. Those taking the placebo lost an average of 6 pounds, or roughly 2.5% of their body weight.
How much weight you lose when taking Wegovy for weight loss completely depends on you. You’re wonderfully unique. And although the trial results are encouraging, they depend on factors like biology and behavioral healthy lifestyle changes. Your health care provider should cover all the information you need to make the best choice regarding weight-loss meds to see if Wegovy weight loss is a fit for you.
In the 68-week trial, patients taking Wegovy began to lose weight at around four weeks, when doses increased from 0.25mg to 0.50 mg. And they continued to lose weight throughout the trial.
Keep in mind, Wegovy may be touted as a “quick-fix” drug, but that’s not how Wegovy weight loss works—with or without medication. So don't stress if it’s not working right away. It takes dedicated and continual use for results that last. Remember to keep your health care provider in the know about your weight loss and how you’re feeling during the journey. If Wegovy isn’t working for you, they’ll try other medications that may work better.
The typical Wegovy weight loss dosing begins at 0.25 mg, injected under your skin once a week for four weeks (one month). You’ll use a higher dose every four weeks until you reach a weekly maintenance dose of 2.4 mg. The standard dosing schedule might look like this:
Great question. Obesity is a chronic disease, which means that for many people, medication will need to be taken long-term for sustainable weight loss. Just like other medical conditions like asthma or arthritis, obesity needs to be treated continually.
One review in the Journal of Investigative Medicine found that those who were given a placebo after 20 weeks of losing weight on semaglutide regained around 13 pounds. Meaning when they stopped using the drug, they didn’t sustain their weight loss. This shows that continual use is needed for ongoing weight management. Not only that, the most common side effects were pretty minor and included things like nausea and constipation—which subsided. And Wegovy has been proven to be well-tolerated by most patients for long-term use.
Wegovy works similarly to other GLP-1 prescription drugs in one of three ways. First, semaglutide mimics the GLP-1 incretin hormone your body already makes that helps control your appetite. Second, it communicates with the pancreas letting the organ know how much insulin to produce after you eat, helping to manage blood sugar levels. And third, it delays gastric emptying, which means it slows digestion, supporting weight loss by promoting the feeling of fullness so you eat less.
Wegovy works most effectively when used as prescribed in combination with a reduced-calorie diet (which means something different to everyone so chat with your health care professional about healthy meal changes) and increased physical activity.
If you qualify for anti-obesity medications, chances are you’re concerned about improving specific health metrics as one of your weight loss goals. Obesity can have profound effects on body systems like your heart and your kidney, and even small reductions in weight can improve your heart health.
A new study in December 2023 demonstrated that Wegovy has significant benefits for cardiovascular health that go beyond just the effects of weight loss. In this study, people who took Wegovy were less likely to experience serious cardiac events like heart attacks. This benefit was greater than the benefit you’d expect from weight loss alone, indicating that Wegovy provides additional health benefits in addition to weight loss.
We mentioned a few of the common side effects, but there are a few others you may potentially experience. Here’s what to be aware of:
And, although rare, you may experience more severe side effects. They include:
Wegovy also comes with a black box warning. You shouldn’t take it if you or your family have a history of a thyroid cancer called medullary thyroid carcinoma (MTC) or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
Before taking Wegovy for weight loss, you’ll receive all the prescribing information from your healthcare provider. And you’ll be advised about any possible interactions with other medications, over-the-counter or prescription drugs, or supplements you may be taking or how the drug may impact other health issues.
Here’s a helpful step-by-step on what to expect after you’ve been prescribed Wegovy. When you fill your prescription for Wegovy, you’ll get your four-week supply of four single-use pens prefilled with your prescribed dose. There’s a tiny, hidden needle at the tip of each pen, which is how you’ll inject yourself.
The weekly injection is inserted in your upper arm, upper thigh, or abdomen (stomach), and the manufacturer recommends rotating where you inject yourself to avoid irritation at the injection site. You’ll use one pen per week, and do your best to make sure you inject yourself on the same day each week.
Novo Nordisk also recommends keeping your Wegovy injection pens in the fridge at 36–46º, but they’ll still be okay to use if you keep them between 46–86º for up to 28 days.
Once you've decided on an injection site, it’s time to give yourself the Wegovy shot.
As a note, you can watch a video about how to administer your Wegovy dose here if you’d like a play-by-play on how to do it. After you’ve given yourself the dose, throw the used pen away in a sharps container or a heavy-duty plastic container with a screw-on lid. (Novo Nordisk will provide a free sharps container to patients using Wegovy through NovoCare.) Because the Wegovy pen contains a needle, it’s important not to throw it into your regular trash.
As of May 2023, the list price for Wegovy is $1,349.02/package for a 28-day supply. But, depending on your insurance coverage, you may end up paying way less.
Novo Nordisk has a Savings Offer where you can pay as little as $0 per 28-day supply but there are terms and conditions for eligibility and you must have commercial insurance to qualify. Before you’re prescribed Wegovy, check with your health insurance to see if it’s covered and what your out-of-pocket expense may be. You can also refer to Novo Nordisk’s patient support network, NovoCare, to get a cost estimate for Wegovy.
*GLP-1 Note: "GLP-1s are now available as part of Found's weight-loss medication offering. While GLP-1s are effective for weight loss, they are not clinically appropriate for everyone. Eligibility for a GLP-1 is based on a thorough evaluation of your medical history, eating behavior, lab work, and insurance coverage. If a GLP-1 is not appropriate for you, our providers will work with you to determine an effective medication for your health profile."
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GLP-1*
GLP-1 prescriptions, filled through your local pharmacy, are now available as part of Found's weight-loss toolkit. While GLP-1s are effective for weight loss, they are not clinically appropriate for everyone. Eligibility for a GLP-1 is based on a thorough evaluation of your medical history, eating behavior, lab work, and insurance coverage. If a GLP-1 is not appropriate for you, our providers will work with you to determine an effective medication for your health profile.
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Davies M, Færch L, Jeppesen OK, Pakseresht A, Pedersen SD, Perreault L, Rosenstock J, Shimomura I, Viljoen A, Wadden TA, Lingvay I; STEP 2 Study Group. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet. 2021 Mar 13;397(10278):971-984.https://pubmed.ncbi.nlm.nih.gov/33667417/
New York Department of Health. Nov 2021. Chronic Diseases and Conditions.https://www.health.ny.gov/diseases/chronic/
Novo Nordisk. WEGOVY (semaglutide) injection, for subcutaneous use Initial U.S. Approval: 2017.https://www.novo-pi.com/wegovy.pdf
Singh G, Krauthamer M, Bjalme-Evans M. Wegovy (semaglutide): a new weight loss drug for chronic weight management. Journal of Investigative Medicine. 2022;70:5-13.https://jim.bmj.com/content/70/1/5
U.S. Food and Drug Administration. (4 June 2021). FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014. https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014
Wilding J P.H., D.M., et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021; 384:989-1002.https://www.nejm.org/doi/full/10.1056/NEJMoa2032183
Zhong P, Zeng H, Huang M, Fu W, Chen Z. Efficacy and safety of once-weekly semaglutide in adults with overweight or obesity: a meta-analysis. Endocrine. 2022 Mar;75(3):718-724.https://pubmed.ncbi.nlm.nih.gov/34981419/
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