1. Will I lose all enjoyment of food if I take Wegovy?
Absolutely not!
Wegovy doesn’t alter the taste of food, it works by suppressing your appetite. You will also start to feel full much sooner than normal. This dual action makes it much easier for you to avoid snacking and to control the size of your main meals.
You can still enjoy the pleasure of lovely food, but Wegovy puts you in control so you are able to moderate your calorie intake.
2. Does Wegovy have side-effects?
Like all medications, Wegovy may cause side effects.
The most common include nausea, bloating and constipation (occasionally accompanied by abdominal cramps).
This is because one of the ways Wegovy helps is by slowing down how fast the stomach and intestine empty, which contributes to a sense of early and prolonged fullness after meals.
Persistent vomiting can lead to dehydration. It’s usually the result of not using the Wegovy properly, either by rushing up to a higher dose pen too quickly, or by over-eating despite the sensation of fullness the drug induces. It’s really important to avoid this.
Side effects are typically worse when starting treatment and for the first few days after moving up to a higher dose pen.
Provided that the strength of each pen is gradually increased, most people (>95%) find side effects fairly easy to tolerate, particularly as they tend to improve over time.
However if they persist it’s important to seek medical advice.
3. What other side effects that have been reported?
The following information will give you some idea of how much more frequently certain side effects were reported during Wegovy treatment (compared with patients taking a dummy injection) [1]:
Serious Adverse Events 3%
Adverse Events leading to discontinuation of Wegovy 4%
Fatal Events 0%
Nausea 27%
Vomiting 18%
Diarrhoea 16%
Constipation 14%
Indigestion 7%
Abdominal pain 4%
Headache 3%
In patients with type 2 diabetes (only) new or worsening diabetic retinopathy (vision problem) 1.3%
Gallstones 1%
Acute Pancreatitis 0.2%
Cancer 0%
Allergic/Injection Site Reactions 0% (more common with dummy injection)
Low blood sugar 0% (more common with dummy injection)
Kidney, heart and liver disorders 0% (all more common with dummy injection)
Gastroparesis; this is unusually slow emptying of the stomach that can be associated with excess vomiting has been noted in a very small number of patients taking Semaglutide, but it has not been possible to estimate how much of a risk this is or establish a causal risk between the condition and medication.
4. What are the risks of Wegovy in pregnancy or if I’m breastfeeding?
Semaglutide should not be used in pregnancy.
Rapid weight loss could be linked to poor foetal development and possibly an increased risk of miscarriage.
The safest advice is that all women of childbearing potential should use contraception when treated with Wegovy.
If pregnancy does occur you must stop Wegovy immediately.
If you wish to become pregnant, discontinue Wegovy at least 2 months before planned conception.
In animal studies semaglutide was excreted in milk and so to reduce any possible risk to your infant do not take Wegovy if you are breast-feeding.
5. Does Wegovy cause cancer?
This is a bit of an urban myth.
Since semaglutide was approved in the USA in 2017 there has never been a single case of cancer reported in humans that was thought to be related to taking the treatment.
The hype comes from studies in rats that showed a risk of a rare kind of non-lethal thyroid tumour (C-cell tumour), something to which rats are particularly susceptible when taking semaglutide.
No other types of tumour were noted.
The relevance to humans is thought to be low, but to err on the side of safety we don’t allow people with a history of thyroid cancer (particularly some rare hereditary forms of thyroid cancer) to join the SemaPen programme.
6. Can I take Wegovy if I have diabetes?
Yes.
In fact many patients with type 2 diabetes are already treated with semaglutide under its other name, Ozempic (see FAQ above “What’s the difference between Ozempic and Wegovy”).
However, there are some special considerations we need to take into account before prescribing Wegovy for weight loss in patients with diabetes.
a. Certain drugs:
If you are on insulin or a sulphonylurea (eg gliclazide) there is an increased of severe hypoglycaemia (low blood sugar) when used in combination with Wegovy (about 4% compared with placebo),
At the present time we do not accept patients on these medications into the SemaPen programme but we will be reviewing this in the coming months.
b. Vision problems:
In patients with type 2 diabetes new or worsening diabetic retinopathy (vision problems) was more likely to occur in patients taking Wegovy (up +1.3% compared with placebo). It is not certain that this is a direct side effect of Wegovy, nevertheless we recommend a diabetic eye check before starting Wegovy and every 6 months afterwards.
c. Using two GLP1 agonists at the same time:
Obviously, you should not use Wegovy for weight loss in conjunction with any other drug of a similar class that is being used to treat your diabetes.
These include Victoza, Trulicity, Ozempic, Saxenda, Rybelsus, Byetta and Bydurion.
7. I’ve heard Wegovy might affect mental health. Is this true?
A small number of case reports in Iceland and the USA, have raised the question whether there is a potential link between use of GLP1 agonists like semaglutide and thoughts of self-harm. At the time of writing the number of reports are tiny compared with the number of people treated with Wegovy, and no causal association has been demonstrated.
We will monitor your mental health during your time on the SemaPen programme using special self-assessment questionnaires. In the unlikely event that you experience any suicidal thoughts whilst on the treatment, our advice is to stop Wegovy and seek urgent help from your family doctor or mental health practitioner.
8. Can I take other medications alongside Wegovy?
Yes, although see FAQ above about diabetes medications.
Clinical studies have shown no relevant drug interactions with Wegovy, and in particular it was not found to affect the absorption of oral contraceptives, statins, metformin, warfarin or digoxin.
9. How dangerous would it be for someone with an eating disorder to take Wegovy?
Extremely.
A past or current history of eating disorders such as anorexia or bulimia is an absolute contraindication to using Wegovy.
It could lead to significant malnutrition and even death.
For this reason we ask all potential SemaPen patients to formally confirm:
a. That they do not have a history of an eating disorder
b. That the information they have provided regarding height and weight is accurate
c. Their age and identity using a biometric ID check cross-referenced to photo ID
d. Their GP contact details so that we can check whether the GP has any concerns about the patient starting Wegovy.
We also have a policy whereby failure to
a. Provide GP details
b. Register the smart scales provided and repeated failure (after prompting) to record regular weight readings
will result in suspension of your account within 3 months with no further medication issued.
Finally, our algorithms can detect excessive weight loss which will trigger one of our team reaching out to assess and provide support.
Whilst it is impossible to completely prevent an individual from circumventing these measures, we hope these processes will minimise that risk and alert people to the dangers.
10. If I experience any unusual side effects how do I report this?
As with any new medication, it’s important that regulatory authorities are made aware of any unexpected or unusual side effects as soon as possible.Although Wegovy appears to be extremely safe and has been in widespread use in many countries now, should you notice any unusual side effects please message our team via the SemaPen app or through live chat. You can also self-report side effects using the government’s yellow card scheme here.
11. Do I need to stop weight loss injections before surgical treatment under an anaesthetic?
This is an area where we don’t yet have clear guidance available as relatively little evidence exists in the literature beyond case studies.
Before surgery under anaesthetic, patients are usually told not to eat or drink for a 12 hours or so. The main concern is aspiration, where a patient actively vomits while under anaesthesia or their stomach contents passively come back up and enter the lungs, causing severe breathing difficulties.
We know that GLP-1 injections like Wegovy and Mounjaro can slow gastric emptying, so the question is whether this increases the risk of aspiration under anaesthesia. The short answer is that we don’t know.
In patients taking GLP1 injections for weight loss or diabetes, whilst there is no clear answer at this point, advice from the American College of Anaesthesiologists states that patients should consider stopping the medication 1 week before surgery.
If surgery is planned under local anaesthetic then there is no need to stop semaglutide beforehand