Canadian doctor fears new weight-loss drug Wegovy could be used inappropriately

As Wegovy becomes available to Canadians starting Monday, one doctor is warning patients who want to use the drug to lose weight that no medication is a “magic bullet.”

Novo Nordisk, the Denmark-based global health giant, produces the weekly injection Wegovy and the popular diabetes and weight loss drug Ozempic.

The new drug is especially intended for people who meet certain criteria related to obesity and weight, said CTV medical expert Dr. Marla Shapiro.

“The popularization of Ozempic being used by Hollywood and giving it the impression that it’s a magic bullet hasn’t really been a good thing,” Shapiro said in an interview with CTV News Channel on Friday.

“The problem here is that if you use the drug (Wegovy) inappropriately, you may lose weight, but if you stop the drug, it is likely to gain back. Remember, the drug only works with exercise and a low-calorie diet.”

Shapiro said Wegovy is an on-label weight loss medication, meaning it is prescribed for a specific purpose. In this case, Wegovy is prescribed to obese adults, with a body mass index (BMI) greater than or equal to 30. The medication is also targeted at those who are significantly overweight, with a BMI of 27, and have at least a weight -Related medical condition such as high blood pressure, type 2 diabetes, cholesterol problems, dyslipidemia (an imbalance of lipids such as cholesterol or triglycerides), or obstructive sleep apnea.

“We really want people to understand that obesity is a chronic medical condition and that’s what we’re treating,” Shapiro said. “We’re not looking to treat someone who comes in and wants to lose five or 10 pounds, who doesn’t really meet those two strict criteria.”

Because Wegovy is an on-label medication for a chronic disease, it implies that it is intended for chronic use, he added.

“You need to be monitored by your healthcare provider,” he explained. “And you really have to have the indications to move forward, having failed all the other alternatives that you may have been given before thinking about taking a long-term medication.”

The medication makes people feel fuller and reduces gastric emptying, or the process by which the stomach expels its contents, Shapiro said.

Who should not use Wegovy?

People who should not use Wegovy, according to Shapiro, include those with severe allergic reactions to the drug, those with pancreatic or renal kidney problems, those using diabetes medications, those who are or plan to become pregnant or breastfeeding, and those with a History of thyroid cancer, particularly medullary thyroid cancer.

Like other medications, he said, Wegovy has side effects such as constipation and nausea, so it is suggested to use the medication at night.

Users may also experience inflammation of the pancreas, also known as pancreatitis, gallbladder problems, low blood sugar, kidney problems, increased heart rate, depression, suicidal thoughts, and serious allergic reactions such as hives.

“No medication is benign,” he said. “It is naive to say that any medication has no side effects.”

Many people are overweight not necessarily because of their lifestyle choices of eating less and exercising more, but because they have obesity as a chronic disease, Shapiro explained. “This is a disease like other diseases and this is a tool to treat it.”

Experts estimated that Wegovy would likely cost about $400 a month, although it’s unclear whether health insurance plans will cover it.

Novo Nordisk Canada declined to share Wegovy’s pricing with The Canadian Press. In a statement, it said that “drug prices in Canada are influenced by multiple factors, including federal, provincial and territorial governments and insurance providers, and prices can vary from person to person.”

Health Canada only approved Ozempic to treat type 2 diabetes, but it has been prescribed off-label for weight loss.

The health agency subsequently approved Wegovy in November 2021 amid Ozempic supply shortages. Wegovy carries a higher weekly dose of semaglutide, 2.4 milligrams, compared to one milligram in a single dose of Ozempic. Semaglutide, which mimics an insulin-promoting hormone, suppresses appetite and helps people feel fuller.

Clinical trials showed Wegovy was safe and effective for weight loss, and had a positive impact on other weight-related conditions, such as cardiovascular health, Vancouver-based endocrinologist Dr. Ehud Ur told The Canadian Press. Ur is not affiliated with Novo Nordisk.

With files from The Canadian Press

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