Hype about weight loss injections – one year of “Wegovy” in Germany
Published: Thursday, Jul 11th 2024, 09:40
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The slimming injection "Wegovy" has been on the German market for a year now. Despite various side effects, demand is high. This creates problems. What has happened since its launch a year ago? An overview:
WHAT IS "WEGOVY"?
"Wegovy" is a prescription medication that is intended to help with weight loss and weight maintenance by suppressing appetite and increasing the feeling of satiety. Doctors have been able to prescribe the drug from Danish company Novo Nordisk for this use in Germany since mid-July 2023. Patients inject it under the skin once a week using a pre-filled pen that resembles a pen.
The "Wegovy" active ingredient semaglutide has been used for some time to treat type 2 diabetes - under the trade name "Ozempic". "Wegovy contains the active ingredient in a higher dosage and has been approved for people with obesity, i.e. a body mass index (BMI) of 30 or more. The therapy should be combined with diet and exercise.
WHAT CONCLUSIONS CAN BE DRAWN AFTER ONE YEAR?
The launch of "Wegovy" in Germany a year ago was accompanied by the hope that "Ozempic" would no longer be used as an obesity drug and would be increasingly available to diabetes patients. The Swiss Medicines Agency Swissmedic has already approved "Wegovy" in 2022. Since March of this year, health insurance companies in Switzerland have been covering the costs of the drug.
Although the availability of "Ozempic" has improved since its launch, there are still supply bottlenecks, according to reports from Germany. However, demand for "Wegovy" is also greater than production, said Matthias Laudes, Vice President of the German Obesity Society (DAG) and Director of the Institute for Diabetology and Clinical Metabolic Research at the University Medical Center Schleswig-Holstein.
This situation increases the risk of counterfeit products - and the European Medicines Agency (EMA) explicitly warns against buying such preparations on the black market. In addition, the preparations should only be used for the respective approvals - type 2 diabetes and obesity. If non-obese people only used such drugs to optimize their figure, this would exacerbate the already existing shortages.
HOW DOES "WEGOVY" WORK?
The "Wegovy" active ingredient semaglutide imitates the effect of the intestinal hormone GLP-1 (glucagon-like peptide-1). This is released from the small intestine after eating, explains Matthias Laudes, Vice President of the German Obesity Society (DAG) and Director of the Institute for Diabetology and Clinical Metabolic Research at the University Medical Center Schleswig-Holstein.
The hormone signals the pancreas to produce insulin. "This is the anti-diabetic effect," says Laudes. The second effect is that the brain is informed that something has been eaten and it can develop a feeling of satiety. "That is the weight-regulating effect."
The third effect is that the stomach is signaled that there is still enough food in the small intestine, thus delaying gastric emptying. Patients noticed this effect in particular as a side effect - namely nausea. However, this usually subsides once people get used to eating smaller portions, says Laudes.
WHAT OTHER SIDE EFFECTS ARE THERE?
In addition to nausea, other gastrointestinal complaints such as vomiting, diarrhea and constipation often occur at the start of treatment, says Karsten Müssig from the German Society for Endocrinology (DGE), head physician at the Clinic for Internal Medicine, Gastroenterology and Diabetology at Franziskus-Hospital Harderberg. Therefore, a low dose is started, which is gradually increased. Rare side effects include inflammation of the pancreas and intestinal obstruction. "Treatment should therefore only be carried out under medical supervision," warns Müssig.
A study recently published in the journal "Jama Ophthalmology" suggests that semaglutide could be associated with a serious eye disease in very rare cases - so-called non-arteritic anterior ischemic optic neuropathy (NAION). Although this has not been proven, it should be taken seriously, says Horst Helbig from the German Ophthalmological Society (DOG) and the University Hospital Regensburg. Clarification of this question requires further investigations and careful observation of patients.
Reports point to another phenomenon known as the "Ozempic Face": in general, rapid weight loss can cause the face to appear sunken and severely aged.
DOES "WEGOVY" HAVE TO BE TAKEN FOR LIFE?
Obesity, like diabetes, is a chronic disease, says Laudes, so the medication must be taken for life. "With diabetes medication, nobody would say that you can stop taking it after six months," says Laudes. "Every obese person has the lifelong problem that they can gain weight again and again." This can also be seen after stomach reductions, for example.
HOW MUCH DOES "WEGOVY" COST?
According to Müssig, the price of obesity therapy is around 300 euros per month. Patients have to bear the costs themselves, as the medication is not covered by statutory health insurance.
DOES "WEGOVY" AFFECT THE FERTILITY OF WOMEN?
According to Ulrich Knuth, Chairman of the German Association of Reproductive Medicine Centers (BRZ), there have been pregnancies in women who have had an unfulfilled desire to have children for a long time during treatment with semaglutide - i.e. "Wegovy" or "Ozempic". However, there are no valid figures on this. According to the expert, it is possible that the reduction in body weight plays a role here. It is known that obesity reduces the likelihood of pregnancy.
The preparation should not be used during pregnancy and breastfeeding. According to the European Medicines Agency (EMA), anyone wishing to have a child should discontinue semaglutide at least two months in advance.
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