Is weight-loss drug Wegovy REALLY a game-changer? trends now

For millions of failed dieters, the arrival of Wegovy — a ‘miracle’ treatment offering a guaranteed slimming effect — seems like the discovery of the Holy Grail.

Almost two in three Britons are living with obesity or unhealthy extra weight, with one in four children, teenagers or young adults affected.

As well as immediate problems such as arthritis as a result of carrying excess weight, there are serious long-term complications of obesity — heart disease, cancer and a risk of type 2 diabetes (women with a body mass index, or BMI, of 35 are up to 90 times more likely to have type 2 than someone of a healthy weight, according to a study last year by Aberdeen University).

Clinical trials of weekly injections of semaglutide (Wegovy is the brand name) found that people could lose up to 20 per cent of their body weight in 17 months. The Step 1 studies involved 1,961 severely obese patients from around the world, including the UK.

Two-thirds of the group received weekly injections of semaglutide, while the remainder had dummy injections. All went on a slightly lower-calorie diet and followed a suggested exercise programme of two hours of weekly walks, as well as undergoing monthly counselling sessions. None of those involved knew whether they were receiving the active drug.

At the end of the trial, the semaglutide group had lost an average of almost 34 lb (15 kg), with considerable improvements in heart disease risk factors such as blood pressure (the control group lost just 5.7 lb, or 2.6 kg).

Other studies, called Step 2 to Step 8 trials, have shown significant weight loss in 20 weeks and dramatic reductions in the risk of type 2 diabetes.

Last week, the National Institute for Health and Care Excellence (NICE) recommended that semaglutide should be made available on the NHS for two years through specialist weight-loss management centres, to people with a BMI of 35 and at least one weight-related condition such as high blood pressure (or, exceptionally, to those with a BMI of 30-34.9).

The NICE guidance also said semaglutide should be prescribed alongside a reduced-calorie diet and increased activity.

According to the latest health survey of England in 2021, about 26 per cent of us fit into this obese category (BMI 30 and above) but, overall, almost 70 per cent of us are too heavy and the population is getting steadily larger.

With such dramatic trial results, it is unsurprising that semaglutide and a stream of similar weight-loss drugs in the pipeline are being seen as offering real hope for many living with obesity.

Last week, it was reported that government officials are drawing up plans for drug companies to bid for multibillion-pound contracts to provide the treatment much more widely.

Semaglutide was first developed more than ten years ago by the Danish pharma company Novo Nordisk to treat type 2 diabetes. Marketed as Ozempic, it is already available on NHS prescription (although at slightly different, usually lower, doses to Wegovy).

Studies in patients with diabetes showed it also led to weight loss, raising the question of whether it would benefit people living with obesity who had not yet developed type 2 diabetes.

Semaglutide works by mimicking the effect of a hormone in our bodies called glucagon-like peptide-1 (GLP-1), which is released from the intestine after eating to signal fullness. The drug therefore reduces excess appetite and stops people feeling hungry.

It also slows down stomach emptying and digestion; stimulates the production of insulin, a hormone that removes excess sugar in the blood after eating; and reduces production of another natural hormone called glucagon, which is also involved in blood sugar regulation. These effects curb the symptoms and damage caused by type 2 diabetes.

Wegovy is administered by a weekly injection into the stomach with a pre-loaded pen (which users do themselves), with doses increasing progressively until you reach the full dose — and is already available privately, with prices starting at £73 a month for those who can afford it.

These reportedly include Kim Kardashian, who is said to have used it to squeeze herself into a dress worn by Marilyn Monroe for last year’s Met Gala in New York.

The space billionaire Elon Musk said he’d shed weight using it (alongside fasting); while Jeremy Clarkson has also admitted he is taking semaglutide, which he had ordered online.

For everyone else, despite the recent NICE recommendation, the chance of an NHS prescription remains slim. That’s because there has been a surge in people seeking it for weight loss, leading to a worldwide semaglutide shortage.

NICE had actually drafted its semaglutide approval guidance in June last year, but delayed publication because Novo Nordisk could not meet the demand until it had expanded its production.

Tam Fry, a spokesman for the National Obesity Forum, said he has no doubt semaglutide is a game-changer, but that ‘word has got round that it’s a fantastic drug which will take pounds off you’.

Yet ‘Novo Nordisk hasn’t really taken notice of that and only manufactured a relatively small batch’, he adds. ‘It will mean morbidly obese people who really need it — and for whom it’s a real lifesaver — won’t be able to get it.’ The drug’s popularity following celebrity use is not the only factor limiting access to it.

Ahmed Ahmed, a bariatric surgeon and clinical senior lecturer in bariatric surgery at Imperial College London, says only half the UK patient population has access to the specialist weight-management centres that can prescribe the drug on the NHS, and waiting lists can be longer than a year.

That means that although four million people fit the criteria to receive weight-loss treatment, realistically only about 35,000 people will get it. ‘At the moment there’s very high demand from people and no supply,’ he says. ‘NICE has been very clever; it has made semaglutide hard to get.

‘If it made it possible for GPs to prescribe then demand would be through the roof, but it can only be given after referral and consultation at a “tier 3” specialist weight-loss clinic. They are few and far between and only half the population has access to them.’

He adds: ‘Some [doctors] will be sceptical anyway. There has always been inherent prejudice and stigmatisation of obesity. Half the medical profession don’t agree it’s a disease.’

And while he says semaglutide offers genuine benefits, he believes drugs will not provide the answer to our obesity crisis.

‘They only really produce a weight loss of 5 or 10 per cent in practice, even if the trials showed much better results,’ he says.

‘If you have someone with a BMI of 35 to 40, then a weight loss of 5 or 10 per cent will be quite good for their diabetes but not enough to ease their arthritic knee pain.

‘You can get 30 per cent weight loss with bariatric [i.e. weight-loss] surgery — that’s still the most effective treatment and we need to focus on offering it more widely.’

However, others disagree.

‘We are entering a new era in which effective and safe drugs for treating obesity are available,’ said Nick Finer, an honorary clinical professor at the National Centre for Cardiovascular Prevention and Outcomes at University College London (who has previously worked for Novo Nordisk).

‘Overwhelming evidence over decades shows that with current approaches few people can lose weight and maintain weight loss.

‘Results from another semaglutide trial involving 17,000 people and looking at its impact on reducing heart disease, stroke and death are due out later this year.’

He adds: ‘Real proof of the value of the drug will be when it is shown that this weight loss reduces obesity complications. We know that the same drug in lower doses for people with [type 2] diabetes reduces mortality, stroke and heart attack risk, so hopefully this will also translate to people with obesity.’

With obesity expected to affect half of the global population aged over five by 2035, drug market analysts predict that the world market for GLP-1-type drugs (such as

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