From TikTok influencers talking it up to celebrities worrying about "ozempic face," drugs like Wegovy and Ozempic are being touted as weight loss miracles in a country obsessed with slimness.
But, the drugs aren't intended for cosmetic weight loss. Ozempic is approved for diabetes, and Wegovy is for people with obesity who also have weight-related conditions such as high blood pressure or high cholesterol that put them at risk of heart disease. That's millions of Americans.
And evidence shows the new class of drugs are far more effective than prior obesity medications. A landmark clinical trial published in The New England Journal of Medicine in 2021 found that the drug led to a 15% reduction in body weight, on average.
There's been such an increase in demand that an FDA database lists the medication's active ingredient, semaglutide, as "currently in shortage." Its manufacturer, Novo Nordisk, says keeping supplies stable is a priority. The company also markets Ozempic to treat diabetes, which is a lower dose of semaglutide.
But at a cost of about $1,400 a month — out of pocket when insurance doesn't cover it — many people can't afford to stay on the medication for the long term. And when people stop taking it, there's often rebound weight gain that's hard to control. In fact, a study found that most people gain back most of the weight within a year of stopping the medicine.
That's what is happening to Yolanda Hamilton from South Holland, Ill. Hamilton's doctor prescribed Wegovy because she had an elevated BMI, high blood pressure and elevated blood sugar. She lost 60 pounds and started feeling much better.
"It gave me more energy," she says, allowing her to exercise and do house chores. Her cravings for sugar subsided, and she felt satisfied from smaller meals. "I was very surprised by how good I felt," Hamilton says. The drug is administered by a once a week injection at home, which Hamilton says is easy to do.
Her Aetna insurance plan covered the cost of the medication, but when she changed jobs last fall, her new insurance plan through Blue Cross and Blue Shield of Illinois denied coverage. She now works in a hospital ER registering patients, which requires her to sit most of the day. And, after a few months of not taking the drug, she has gained back 20 pounds.
"I'm very frustrated about the weight coming back on in so little time," Hamilton says.
Blue Cross and Blue Shield of Illinois told NPR that benefits offered by employer plans can vary. "Weight-loss drugs like Wegovy may be covered, depending on the member's benefit plan," a spokesperson for the company said. Many other insurance carriers also determine coverage based on what employers are willing to cover.
Barriers to a life-changing drug
The rebound weight gain is not a surprise given how the medication works. Wegovy's active ingredient — semaglutide — is a GLP-1, or glucagon-like peptide-1, which mimics the GLP-1 satiety hormone in our bodies. When we eat, GLP-1 is released from our intestines and sends signals to our brain centers that control appetite.
"This hormone is telling your brain, I'm full, I don't need to eat anymore," explains Dr. Robert Kushner of Northwestern University, who treats Yolanda Hamilton. Kushner also serves on a Novo Nordisk medical advisory board, for which he receives an honorarium.
"What the pharmaceutical companies have done is taken this hormone that is naturally occurring and restructured it into a drug," he explains. So, it's not a surprise that when people stop taking the medicine, they start to feel hungrier, he says.
"I crave sweets," Hamilton says. And her appetite has increased. She no longer feels satisfied with small meals. "I'm losing my energy" as the weight comes back, she says.
Kushner's office is helping Hamilton appeal the insurance denial, but as she waits, she's worried that stopping the medication will also influence her blood pressure and blood sugar. "She is at risk of having these conditions worsen with regain of weight," Kushner says.
"If I gain more weight, I will be on more medications," says Hamilton. Given her long struggle with weight loss, she'd finally found something that was working.
"We're seeing a lot of patients have this rebound weight gain, and it can really be devastating," says Dr. Karla Robinson, a family physician based in Charlotte, N.C., and a medical editor at GoodRx, a company that helps people find the lowest prices for generic and brand drugs. There's no generic version of semaglutide.
"Unfortunately, being a new medication, it's one of those that is subject to the pricing of the manufacturer," Robinson says.
A representative from Novo Nordisk notes that the company offers a $500 coupon for Wegovy to reduce the cost for patients paying cash.
But, this chart from GoodRX shows the lowest price among all retailers is $1,304 per month for people paying out of pocket, which is out of reach for most people — even with a coupon.
"I do feel like Wegovy is revolutionary," Hamilton says. But she says she definitely can't afford to pay for it.
"Some of the people who need it the most are unable to access it," Robinson says, pointing out that people with low incomes experience obesity at disproportionately higher rates.
"We're talking about a huge health equity issue," she says. Black and Hispanic adults have higher rates of obesity, according to the CDC.
Since Wegovy was approved by the FDA in 2021, some insurance plans have begun to cover the medication for people who meet the clinical prescribing guidelines. According to the FDA, people are eligible if they have a BMI of 27 or higher and also have at least one "weight-related ailment" such as hypertension, diabetes, or high cholesterol. Or they have a BMI of 30 or higher, regardless of weight-related ailments.
But insurance coverage is very spotty. Medicare does not cover Wegovy or other weight loss drugs, and many insurers follow Medicare's lead. Increasingly, there's pressure to change this. As STAT reported last week, the Moffitt Cancer Center in Florida is lobbying for legislation that would allow Medicare to pay for obesity drugs, citing the link between obesity and cancer risk. The NAACP is also registered to lobby on this issue.
In addition, the American Academy of Pediatrics has new guidance recommending that pediatricians offer weight loss drugs to adolescents 12 and older with obesity as an adjunct to behavior change and lifestyle interventions.
Long-term unknowns
But the fact that people may need to stay on Wegovy indefinitely in order to maintain the weight loss has raised concerns about long-term use. The most common side effects of the drug are GI symptoms. "Nausea, diarrhea, constipation, vomiting in some people, or heartburn," Kushner says.
He says starting with a low dose and increasing it over time can help people tolerate the drug better. There's ongoing research to evaluate the drug's effect on the cardiovascular system, which is positive so far.
But the drug does carry a black box warning because in rodent studies it caused thyroid tumors. So, Kushner says doctors need to screen patients to find out if they have a family history of a specific kind of thyroid carcinoma, or another rare condition called multiple endocrine neoplasia syndrome type 2 (MEN 2). "This would be an individual patient conversation," Kushner says. Generally, if you don't have a history of these conditions, "this medication is thought to be safe," he says.
If this sounds unsettling, it's a reminder of how high the stakes are to combat obesity. The theoretical risk of thyroid tumors may be unnerving. But doctors point to the risks of leaving obesity untreated: Heart disease is the leading cause of death in the U.S., and obesity and weight-related conditions are top risk factors.
Of course, exercise and diet modification are still the first strategies to try. But given that about 70% of Americans are overweight or obese, nearly half of adults in the U.S. have hypertension and more than 1 in 3 have pre-diabetes, doctors' groups cite an urgent need to layer on more interventions that can be helpful.
"We, as a society, are spending $173 billion in obesity-related health care costs," says Dr. Marcus Schabacker, CEO of ECRI, an independent, nonprofit group that has reviewed the evidence of new weight loss drugs.
He argues that the drugs can be part of destigmatizing obesity by treating it like any other disease that you treat with medicine. "We would not ask someone who has hypertension to just do exercises and change your diet and then you will be fine. No, we give them beta blockers. It's not different here. Exercise and diet are key components of tackling obesity, but so are medications which have proven to be effective," he says.
Copyright 2023 NPR. To see more, visit https://www.npr.org.
FAQs
What can replace Wegovy? ›
Saxenda. Saxenda is the version of liraglutide approved for weight loss. Like Wegovy, it can be used in adults with a BMI of 30 mg/kg² or greater, or at least 27 mg/kg², with one or more weight-related medical conditions. Adolescents who meet certain weight-related measures also qualify for Saxenda.
How do I reduce the cost of Wegovy? ›Using a mail-order pharmacy
Using this type of service may help lower the drug's cost and allow you to receive your medication without leaving home. Some Medicare plans may help cover the cost of mail-order medications. You may also be able to get a 90-day supply of the drug via mail order.
If you miss your Wegovy doses for more than 2 weeks, take your next dose on the regularly scheduled day or call your healthcare provider to talk about how to restart your treatment.
When should you stop Wegovy? ›It's recommended that you stop taking Wegovy (semaglutide) at least 2 months before you plan to become pregnant. If you get pregnant while taking Wegovy (semaglutide), stop the medication right away and let your healthcare provider know.
What medication is equal to Wegovy? ›Both Ozempic® and Wegovy® are the same medication: semaglutide. Wegovy®, however, is available in slightly higher doses: 0.25 mg, 0.5 mg, 1.0 mg, 1.7 mg, and 2.4 mg pens. Ozempic® is available in 0.25 mg, 0.5 mg, and 1.0 mg pens.
Can I get Ozempic instead of Wegovy? ›Ozempic is approved to treat Type 2 diabetes. Wegovy is a higher-dose version that's approved for weight loss. They aren't interchangeable.
Can you skip doses of Wegovy? ›If you miss a dose of Wegovy™, and the next scheduled dose is more than 2 days away, use it as soon as possible. If you miss a dose, and the next scheduled dose is less than 2 days away, skip the missed dose and go back to your regular dosing schedule.
How do you get Wegovy for 25 dollars? ›After the patient's sixth (6th) fill or July 1, 2022, whichever comes first, patients with commercial drug coverage for Wegovy™ will then pay as little as (“PALA”) $25 per 28-day supply, $50 per 56-day supply, or $75 per 84-day supply of Wegovy™.
Is there a generic for Wegovy? ›There is currently no generic alternative to Wegovy. Wegovy is not covered by most Medicare and insurance plans, but manufacturer and pharmacy coupons can help offset the cost.
Can you take Wegovy forever? ›How long can you take Wegovy? Wegovy is one of six medications currently approved by the FDA for the long-term treatment of obesity. As such, it can be used for as long as it remains beneficial for weight loss and/or weight maintenance and is not causing intolerable side effects.
What happens if you miss two weeks of Wegovy? ›
Take your next dose on the regularly scheduled day. If you miss doses of Wegovy® for more than 2 weeks, take your next dose on the regularly scheduled day or call your health care provider to talk about how to restart your treatment.
What happens when you stop mounjaro? ›In a study that allowed patients to stop taking Mounjaro after one year, most patients regained the weight they lost, indicating a need to take a maintenance dose. To maintain results, research is needed to determine maintenance dose vs. treatment dose.
What happens if you just stop Wegovy? ›Recent research published in the journal Diabetes, Obesity and Metabolism indicates that once patients stop using semaglutide drugs like Wegovy and Ozempic any weight they've lost is likely to return.
Can Wegovy damage your kidneys? ›Wegovy can rarely cause kidney problems, including sudden kidney failure. Your risk of this side effect may be higher if you already have kidney problems, such as chronic kidney disease. Your doctor can help determine whether Wegovy is safe for you to use if you have kidney problems. Pancreas problems.
Is Wegovy a lifetime drug? ›Wegovy is considered a long-term, possibly lifelong medication to treat chronic obesity.
Does Wegovy cause hair loss? ›...
| Placebo N = 1261 % | WEGOVY N = 2116 % | |
|---|---|---|
| Gastroesophageal Reflux Disease | 3 | 5 |
| Gastritisd | 1 | 4 |
| Gastroenteritis Viral | 3 | 4 |
| Hair Loss | 1 | 3 |
Ozempic for weight loss: which is better? In a clinical trial that compared weekly use of semaglutide 1 mg and 2.4 mg, semaglutide 2.4 mg (the maximum dose of Wegovy) caused more significant weight loss than semaglutide 1 mg (the typical maintenance dose of Ozempic) (Davies, 2021; Singh, 2022).
What medication is similar to Mounjaro? ›PhenQ and Zotrim are easily two of the best OTC diet pills to use as alternatives to Mounjaro.
Can I pay for Wegovy out of pocket? ›The cost of Wegovy can vary depending on several factors, including your insurance coverage and the rates at your local pharmacy. If you have insurance coverage, you may pay as little as $25 for a monthly supply of the medication. Without insurance, you could pay $1,350 or more.
Can you switch from Wegovy to Saxenda? ›Wegovy contains semaglutide while Saxenda contains liraglutide. Can I switch from Saxenda to Wegovy? If your provider deems a switch in medication safe, you can switch from Saxenda to Wegovy while under their supervision.
How can I get Ozempic for free? ›
Novo Nordisk, the manufacturer of Ozempic, also has a patient assistance program that may help cut costs. The Novo Nordisk Patient Assistance Program (PAP) offers free medication to people who meet certain income and insurance requirements.
Do you have to stay on Wegovy? ›HOW LONG DO I STAY ON THE MEDICATION? Wegovy is considered a long-term medication. If you are tolerating it well, and it is helping you to lose weight, it is recommended to continue the medication.
How overweight do you have to be to be prescribed Wegovy? ›Wegovy® is an injectable prescription medication for adults with obesity (BMI ≥30) or overweight (excess weight) (BMI ≥27) who also have weight-related medical problems, to help them lose weight and keep it off. Wegovy® should be used with a reduced-calorie meal plan and increased physical activity.
Can you do Wegovy every other week? ›...
Recommended Dosage.
...
Wegovy savings card.
| Program website | www.wegovy.com/saving-and-support/save-and-support.html |
|---|---|
| How do I get the discount? | Download and print a card. |
Currently, Wegovy is not typically fully covered by commercial health insurance companies.
When will Wegovy .25 mg be available? ›Novo Nordisk expects all strengths of Wegovy to be available in the United States by the end of 2022. They're also making plans for additional production going into 2023.
When will Wegovy become generic? ›DrugPatentWatch® Generic Entry Outlook for Wegovy
By analyzing the patents and regulatory protections it appears that the earliest date for generic entry will be December 5, 2031.
In a recent study, most patients reported preferring taking oral tablets to subcutaneous injections, supported by the ease of administration and the lack of pain. 40 From these results, most patients would possibly prefer to take an oral tablet of semaglutide than a once-weekly subcutaneous injection.
Why did they stop making Wegovy? ›The contract development and manufacturing organization (CDMO) Catalent has emerged as responsible for the Wegovy supply issue, as the company had a penalty from the FDA following the inspection of its Belgian filling plant, in October 2021.
What are the long term effects of Wegovy? ›
increased risk of low blood sugar (hypoglycemia) in patients with type 2 diabetes, especially those who also take medicines for type 2 diabetes such as sulfonylureas or insulin. kidney problems (kidney failure). serious allergic reactions. change in vision in patients with type 2 diabetes.
How long can you go between Wegovy shots? ›For weight management: For injection dosage form (Wegovy™ solution): Adults—At first, 0.25 milligrams (mg) injected under the skin once a week for 4 weeks. Your doctor may increase your dose every 4 weeks.
How long does a box of Wegovy last? ›1 PACK = 4 WEEKS OF TREATMENT Each dose of Wegovy™ comes in 1 pack of 4 pens, like you see here.
Can I take Wegovy on an empty stomach? ›wegovy™ is the first and only prescription weight-management medicine taken once weekly. It's taken on the same day each week, any time of day, with or without food.
How long does semaglutide stay in your system? ›As a dose of 0.5 or 1 mg, semaglutide has a half-life of 7 days; therefore, it would reach steady state in 4-5 weeks. There are few drug interactions and dose adjustments are not necessary. However, similar to other GLP-1 RAs, semaglutide can delay gastric emptying and may impact the absorption of oral medications.
Does Wegovy cause thyroid tumors? ›Wegovy™ may cause serious side effects, including: Possible thyroid tumors, including cancer. Tell your healthcare provider if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath. These may be symptoms of thyroid cancer.
Can you just stop taking Mounjaro? ›Mounjaro controls type 2 diabetes but does not cure it. It may take 4 weeks or longer before you feel the full benefit of this medicine. Continue to take this medicine even if you feel well. Do not stop taking this medicine without talking to your doctor.
Are there any drug interactions with Mounjaro? ›There are 247 drugs known to interact with Mounjaro (tirzepatide), along with 5 disease interactions, and 2 alcohol/food interactions. Of the total drug interactions, 2 are major, 224 are moderate, and 21 are minor.
What are the tips and tricks of Mounjaro? ›Avoid fried, greasy, or fatty foods and foods high in sugar: These tend to be the toughest for your body to digest and the most likely to cause nausea while taking a GLP-1 medication. Eat slowly, and eat smaller meals. Eat foods that are light and bland. Drink clear or ice-cold drinks (like water or unsweetened tea).
Do you take semaglutide for life? ›The hitch is that these drugs must be used throughout life, much like diabetes medications, or else the benefits are lost. In fact, a 2021 study led by Rubino found that people on semaglutide regain weight when the drug is stopped.
When do you start to lose weight on Mounjaro? ›
by Drugs.com
When compared to some other diabetes treatments, studies have shown that it can take 8 weeks to reach an A1C target of ≤7% and 12 weeks to reach an A1C ≤6.5% with Mounjaro. Significant weight loss can occur as early as 28-weeks.
Although some people choose to stay on Semaglutide for a while after they reach their goal weight to help them with maintenance, others finish their treatment right away, and others may benefit from gradually reducing their dose over time.
Can Wegovy cause heart issues? ›In clinical trials, Wegovy was shown to be associated with an increased heart rate at rest. 2This may be of concern, especially for those at risk of developing certain arrhythmias.
Does Wegovy affect your metabolism? ›It helps regulate your metabolism which has a lot to do with insulin, etc. The thing about these peptides and what makes them different, is that they regulate the output of these hormones in your body: Insulin. Glucagon.
Does Wegovy affect vision? ›Some of the serious side effects of Wegovy can only affect you if you have diabetes: diabetic retinopathy and hypoglycemia. Diabetic retinopathy is a condition that damages the blood vessels in your eyes. Symptoms of diabetic retinopathy include blurry vision, seeing eye floaters, and sudden vision loss.
Can Ozempic replace Wegovy? ›Ozempic and Wegovy are not interchangeable. So you typically won't switch from one to the other. This is especially true if you're taking Ozempic for Type 2 diabetes, since Wegovy isn't approved for that use. That said, some healthcare providers prescribe Ozempic off-label for weight loss.
Is Wegovy the same as metformin? ›Wegovy is intended to be prescribed for obese patients who have a BMI of over 30 or a BMI of over 27 with additional obesity-related health problems like heart disease. As with metformin, Wegovy is designed to supplement healthy lifestyle changes like a healthy diet and increased physical activity or regular exercise.
Is there an OTC version of Wegovy? ›PhenQ ~ Top-rated OTC Wegovy Alternative
PhenQ is a professionally proven appetite suppressant and fat burner for weight reduction. There are six components. The primary component is a patented, trademarked blend known as -Lacys Reset®, which stimulates the body to burn fat and expend calories.
About Wegovy
There is currently no generic alternative to Wegovy. Wegovy is not covered by most Medicare and insurance plans, but manufacturer and pharmacy coupons can help offset the cost.
Ozempic for weight loss: which is better? In a clinical trial that compared weekly use of semaglutide 1 mg and 2.4 mg, semaglutide 2.4 mg (the maximum dose of Wegovy) caused more significant weight loss than semaglutide 1 mg (the typical maintenance dose of Ozempic) (Davies, 2021; Singh, 2022).
Can I purchase Wegovy online? ›
Buying Wegovy online can help reduce the cost. An online doctor can prescribe the drug, and you can fill it at an online pharmacy. The pharmacy can then deliver Wegovy to your home.
Why is Wegovy not covered? ›The short answer to whether or not Wegovy® is covered by insurance depends on your coverage. Unfortunately, the Affordable Care Act doesn't require health plans to cover obesity-related medications or surgeries.
Can you take diet pills with Wegovy? ›Your doctor will likely recommend stopping any other weight loss products you use before you start Wegovy. Wegovy shouldn't be used with other glucagon-like peptide-1 (GLP-1) receptor agonists. It also shouldn't be used with drugs that contain the same active drug,* semaglutide.
What happens when I stop taking Mounjaro? ›In a study that allowed patients to stop taking Mounjaro after one year, most patients regained the weight they lost, indicating a need to take a maintenance dose.
Will Wegovy be covered by medicaid? ›...
Will Wegovy be covered by insurance?
| Type of insurance | Expected coverage for weight loss medications |
|---|---|
| Medicare | No coverage |
Mounjaro is not yet approved as a weight loss medication, and insurance companies will not typically cover any cost for this use, even if your doctor writes you a prescription for weight loss (known as an “off-label” indication).
Which has better results Wegovy or Saxenda? ›A recent 68-week study compared both medications head-to-head in over 300 adults. The results showed that, when combined with diet and exercise, people taking Wegovy had lost significantly more weight compared to those taking Saxenda. The Wegovy group lost an average of roughly 16% of their initial body weight.