High doses of "Wegovy" are more effective for weight loss but cause more side effects - study
Kyiv • UNN
A study found that patients taking higher doses of Wegovy lost more weight but experienced more nausea, diarrhea, and other side effects. This finding may influence dosing recommendations for people with obesity.
According to research, people who took higher doses of Wegovy lost weight faster and more dramatically. At the same time, this group more often experienced nausea, diarrhea, and other unpleasant side effects. This is reported by UNN with reference to NewScientist.
Details
As the publication indicates, previous studies have shown that "people receiving a standard weekly injection of the drug "Wegovy", which contains the active ingredient semaglutide, typically lose about 15% of their body weight within a year in combination with exercise and a healthy diet."
The drug works by mimicking the action of the hormone glucagon-like peptide-1, or GLP1, which causes delayed gastric emptying and affects the brain, reducing appetite.
Increased dose
"There are patients who don't respond to treatment as well as they could, or who respond well but want to lose more weight than the typical 10-15%," says Laura Heisler from the University of Aberdeen, UK, who was not involved in the study.
To investigate whether increasing the dose could help, Sean Wharton from the University of Toronto in Canada and his colleagues recruited over 1,000 obese adults in 11 countries, including the US, Canada, and parts of Europe.
They randomly assigned participants, none of whom had diabetes, to groups receiving either a standard weekly injection of semaglutide at a dose of 2.4 milligrams, or a higher dose of 7.2 milligrams, or a placebo injection.
All participants were also advised to consume 500 fewer calories per day and perform 150 minutes of physical exercise per week.
After one year, those receiving the standard dose lost 16% of their body mass on average, while the higher-dose group lost about 1%. In contrast, the placebo group lost about 4% of their body mass.
One-third of participants in the standard-dose group lost up to 20% of their weight, while half of the participants in the higher-dose group showed this result.
Only 3% of participants in the placebo group achieved this level of weight loss.
"This suggests that a higher dose leads to a significant improvement in weight loss," says Heisler.
At the beginning of the study, more than a third of participants in each group had prediabetes – a condition in which blood sugar levels are higher than average, but not high enough to indicate type 2 diabetes.
But at the end of the study, the high-dose group had 83% fewer cases, and those receiving the standard dose had 74% fewer cases of prediabetes.
"This is really positive because, of course, the goal of weight loss is to improve health," says Heisler.
Side effects
But there are also drawbacks. 61% of those receiving the standard dose experienced gut-related side effects such as nausea, vomiting, and diarrhea. Among those receiving the increased dose, the number of those who experienced these side effects was 71%.
Meanwhile, 40 percent of those receiving placebo experienced the same symptoms.
"This is because people can have such symptoms for reasons unrelated to treatment," says Heisler.
In addition, more than a fifth of participants in the higher-dose group experienced unpleasant and painful sensations on the skin, known as dysesthesia. As a result, four participants stopped treatment. In contrast, only 6% of those receiving the standard dose, and only one person from the placebo group experienced this side effect, and none of them stopped treatment.
Together, these findings, according to Heisler, suggest that for some people, the benefits of taking a higher dose may outweigh the risks.
"For a patient who needs to achieve more weight loss and who doesn't experience many side effects, perhaps this higher dose will help them achieve it," she says.
But it may not be appropriate for those who lose enough weight on the standard dose or experience worse side effects, she says. Heisler adds that she would like to see further trials confirm the results before the drug is used in the clinic.
In a separate study, Wharton and his colleagues found preliminary evidence that a higher dose may also lead to greater weight loss and improved blood sugar levels among people with obesity and type 2 diabetes. But the results were not statistically significant, meaning that further research is needed to confirm this, says Simon Cork from Anglia Ruskin University, UK.
Addition
"Wegovy" from Novo Nordisk is approved for the treatment of people with obesity, as well as those who are overweight and have at least one weight-related condition, such as type 2 diabetes.