Wegovy, whose active ingredient is semaglutide, is a promising treatment for weight management and cardiovascular risk reduction. Used mainly in overweight or obese adults, the drug works by mimicking a natural hormone called GLP-1 (glucagon-like peptide-1), thereby regulating appetite and food intake. This article explores the benefits and risks associated with Wegovy, based in particular on the results of the SELECT trial, which demonstrated significant effects on weight loss and cardiovascular events.
[Warning: The use of Wegovy must be supervised by a healthcare professional. This treatment is reserved for obese or overweight patients with co-morbidities, under medical prescription from a specialist in endocrinology, diabetology or nutrition. As with any treatment, it may cause undesirable effects, particularly gastrointestinal, and may entail potential risks, such as discontinuation of the treatment due to tolerance. It is essential to follow medical recommendations and consult a specialist before use]
What is the SELECT study?
The SELECT trial is a clinical study involving 17,604 adults with pre-existing cardiovascular disease who are overweight or obese and do not have diabetes. Conducted over 208 weeks (approximately 4 years), it evaluated the effects of semaglutide on the reduction of major cardiovascular events and weight loss. Semaglutide reduced these events by 20% and led to an average weight loss of 10.2%, compared with only 1.5% for placebo. It also improved measures such as waist circumference and waist-to-height ratio, with fewer serious adverse events, although discontinuations were more frequent in patients with a lower BMI.
What is Wegovy and how does it work?
Wegovy is a once-weekly injection containing semaglutide. It works by stimulating GLP-1 receptors, an intestinal hormone that helps control appetite and blood sugar levels. Wegovy is indicated for chronic weight management in adult patients who are obese (body mass index [BMI] ≥30) or overweight (BMI ≥27) with at least one associated co-morbidity such as hypertension or lipid disorders.
Summary table of dosages, doses and storage conditions for Wegovy for weight loss
| Dosage | Presentation | Active substance | Dosage | Storage before opening | Shelf life After opening |
|---|---|---|---|---|---|
| 0.25 mg | Solution for injection in pre-filled pen (1.5 ml) | Semaglutide | 4 doses of 0.25 mg | Store between 2°C and 8°C, 24 months | Store below 30°C, 6 weeks |
| semaglutide 0.5 mg | Solution for injection in pre-filled pen (1.5 ml) | Semaglutide | 4 doses of 0.5 mg | Store between 2°C and 8°C, 24 months | Store below 30°C, 6 weeks |
| 1 mg | Solution for injection in pre-filled pen (3 ml) | Semaglutide | 4 doses of 1 mg | Store between 2°C and 8°C, 36 months | Store below 30°C, 6 weeks |
| semaglutide 1.7 mg | Solution for injection in pre-filled pen (3 ml) | Semaglutide | 4 doses of 1.7 mg | Store between 2°C and 8°C, 36 months | Store below 30°C, 6 weeks |
| semaglutide 2.4 mg | Solution for injection in pre-filled pen (3 ml) | Semaglutide | 4 doses of 2.4 mg | Store between 2°C and 8°C, 36 months | Store below 30°C, 6 weeks |
Is Wegovy available in France?
Wegovy is available in France, but its use is strictly regulated. This drug, used for weight management in adults suffering from obesity or overweight with co-morbidities, is subject to initial prescription by a doctor specialising in endocrinology, diabetology or nutrition. It may also be prescribed by a professional with specialist training in “Applied Nutrition”. Renewal of the prescription is not restricted, which means that the treatment can be continued after the initial assessment without the need for new specific authorisations.
However, Wegovy is not currently reimbursed by social security and is not approved for group treatment, which may limit its affordability for some patients.
The benefits of Wegovy for weight loss
According to the results of the SELECT trial, Wegovy showed impressive efficacy in weight loss, especially over a prolonged period. The study involved 17,604 adults with pre-existing cardiovascular disease who were overweight or obese, but without diabetes. Patients treated with Wegovy showed an average weight loss of 10.2% after 208 weeks, while those in the placebo group lost only 1.5% of their initial weight.
The efficacy of Wegovy was demonstrated across a range of demographic groups (gender, ethnicity, body size). Even after four years of treatment, patients maintained this weight loss, underlining the durability of the drug’s effects.
In addition to weight loss, Wegovy had a significant impact on other body measurements, notably waist circumference and waist-to-height ratio. The SELECT trial showed an average reduction in waist circumference of 7.7 cm in the Wegovy group, compared with 1.3 cm in the placebo group. The waist-to-height ratio also showed a 6.9% reduction with Wegovy.
The effects of Wegovy on cardiovascular health
In addition to weight loss, Wegovy showed significant beneficial effects on reducing cardiovascular risk. In the SELECT trial, Wegovy was shown to reduce major cardiovascular events such as heart attacks and strokes by 20% in patients with pre-existing cardiovascular disease and obesity, without diabetes.
These results are particularly promising as they show that weight management via Wegovy can have a direct impact on reducing cardiovascular risk. Reducing body weight, particularly visceral fat, is a key factor in preventing cardiovascular disease.
Risks and side effects associated with Wegovy
Like any treatment, Wegovy presents certain risks and side effects. The most frequently reported in clinical trials include gastrointestinal disorders such as nausea, vomiting and diarrhoea, especially during the first few weeks of treatment.
Another important aspect to note is the rate of discontinuation of treatment. The SELECT trial revealed that some patients stopped taking Wegovy because of adverse effects, particularly those with a lower BMI. Indeed, the lower the BMI, the higher the discontinuation rate, which could be attributed to a lower tolerance or to doses perceived as too high for this category of patients.
However, despite these discontinuations, the overall safety profile of Wegovy is considered favourable in relation to its substantial benefits in terms of weight loss and cardiovascular risk reduction.
Read more:
- Ryan, D.H., Lingvay, I., Deanfield, J. et al. Long-term weight loss effects of semaglutide in obesity without diabetes in the SELECT trial. Nat Med 30, 2049-2057 (2024). https://doi.org/10.1038/s41591-024-02996-7
- Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes Published November 11, 2023 N Engl J Med
