15 February 2023

What you need to know about the weight loss drug set to be sold in pharmacies

15 February 2023

An appetite-suppressant drug will soon be available from high street pharmacies.

Wegovy was recently approved by the National Institute for Health and Care Excellence (Nice), meaning thousands of obese people will be able to get it on the NHS.

Now, Superdrug say Wegovy is ‘coming soon’ on its website, and ASDA Online Doctor says it will be “available soon” as well.

The controversial appetite-suppressing drug is said to be used by celebrities to manage their weight. When asked about how he stayed slim and healthy, Twitter owner Elon Musk said his secret was fasting and Wegovy.

How does Wegovy work?

“There is a hormone that we all secrete, we release, called GLP-1. This is when you eat – it’s released by the guts, and it works on the pancreas to release insulin, but it also works in the brain to tell you that you’ve had some food and you shouldn’t carry on forever,” explains Dr Babak Ashrafi, clinical lead for service expansion at Asda Online Doctor (onlinedoctor.asda.com/uk).

“So it suppresses your appetite, [and] drugs like Wegovy and Saxenda and the others, they are GLP-1 analogues. They chemically look like and act like GLP-1, so it’s adding more of that hormone into your body, and it tells the brain that you’re not hungry anymore, you’ve had enough to eat.”

Wegovy is administered via a single-dose pen injector once a week by the patient themselves. It’s understood that pharmacies can sell four doses at a time and prices haven’t yet been confirmed.

“It has a very long half-life, so that’s why it’s administered once a week – it stays in your system for a long time,” adds Ashrafi. “The half-life is about seven days, and you increase the dose once a month – so for four weeks, you’re on the same dose. It’s a gradual increase, partly so that your body gets used to it, and you reduce the risk of side effects you might get with it.”

Who might benefit from Wegovy?

Nice has issued a draft guidance for semaglutide – also known as Wegovy – recommending it for adults with at least one weight-related condition and a body mass index (BMI) of at least 35. In some cases, those with a BMI of 30 may be able to access the drug.

“Those are the ones we really want to target and help on their weight loss journey, to improve their overall lifestyle goals and their health,” says Ashrafi.

How long you take Wegovy for varies from person to person, but the Nice guidelines say semaglutide should be used for a maximum of two years.

“What we advise is that you should be seeing significant weight loss by the time you’re on it for six months. So if you’ve not had five to 10% weight loss by then – which most patients from the studies have done – then it’s probably not the right drug for you, and you should probably come off it and we’ll think about other options you might have.”

According to Nice, people on the weekly injections saw their weight drop by 12% on average after 68 weeks.

What are the side effects?

Ashrafi suggests the side effects are “better” than many other weight loss drugs available.

“There are some gut-related side effects, because the hormone does act on the gut as well,” he says. “Those include nausea, heartburn, constipiation, [but] they tend to get better with time and hydration.

“A lot of people who start these drugs find because their appetite’s reduced, they tend to reduce their fluid intake as well – so some [of the side effects] are related to that.”

He also mentions some other brain-related side effects, “Mainly things like headache and fatigue and so on.

“There’s a potential of low sugar symptoms, because these drugs have been used to reduce sugar – they’re primarily diabetic drugs… So if you’re eating a very small amount of food, then potentially you could feel a bit like your sugar is on the low side, but you can combat that quite easily.”

How might it be abused?

Ashrafi stresses that a drug like Wegovy is “not a quick fix” for weight loss.

While it will soon be available in pharmacies, patients will have to go through “rigorous checks” before being prescribed the drug in the UK. There may be fears that it could be abused by people who don’t meet the BMI criteria if it becomes more readily available though.

Ashrafi says: “We make sure the BMI of the person is at the right level, and we do that by asking for photos and making sure their identity is checked,” he says.

Questions about medical history will be asked and a patient’s GP will be informed.

“I think whoever wants to prescribe something like this to a patient needs to make sure they are in contact with the NHS health records, because they have the most data, they have the most information,” he says. “And if there’s some reason the patient shouldn’t be on it – a medical condition or whatever else – then we as providers need to be informed.

“But apart from that, there needs to be support ongoing – because it’s not a quick fix.”

He stresses that it only worked for people in the studies “who were also dieting, reducing calorie intake, who were exercising, who were making other lifestyle choices and changes”.

And it’s not without side effects and other potential risks, so you only want to be taking it when you have to, Ashrafi says.“If you’re taking it as a short-term fix when you don’t have a high BMI, then you run the risk of putting on weight afterwards, you run the risk of other harms that come from it – potential things like gallstones developing and so on.

“There’s the risk of abuse as well – it’s a psychological and mental change, which can be harmful and have a negative impact on your psyche by taking it that way.”

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