Weight loss is a long-term journey that often requires the right tools and support to improve your health. GLP-1 agonist medications such as Wegovy (semaglutide) have gained popularity as effective medications for weight management. The national Wegovy shortage of the 0.25mg, 0.5mg, and 1.0mg doses is predicted through September; this has left many individuals seeking alternatives to continue their weight loss journey.
We explain what the Wegovy shortage means for individuals starting this medication and those already prescribed Wegovy and suggest alternatives for weight loss medication you can discuss with our weight management healthcare team.
About Wegovy
Wegovy (semaglutide) is an injectable prescription medication known for its high effectiveness in weight loss when combined with exercise and a reduced-calorie diet. Wegovy helps individuals with obesity and weight-related medical conditions achieve significant weight loss, averaging 12% of body weight within 18 months and, in some individuals achieving much more significant weight loss over extended periods.
How GLP-1 Medications like Wegovy Work
GLP-1 medications such as Wegovy work in three main parts of your body to help you lose weight.
In your brain, As a GLP-1 receptor agonist, suppress your food cravings.
In your stomach, GLP-1 medications slow down your gut and make you feel full for longer.
In your pancreas, GLP-1 medications help lower your blood sugar.
GLP-1 medications are not effective on their own. These combined effects help individuals consume less food, and when combined with healthy low-calorie diets and exercise, can lead to successful weight loss.
Prescription Eligibility
GLP-1 weight loss medications are typically prescribed to individuals with obesity (BMI of 30 or higher) or overweight (BMI of 27 or higher) and have weight-related health conditions, including type 2 diabetes, high blood pressure, or high cholesterol.
Dosage and Administration
Wegovy is administered once a week using a pen-like device, which delivers a single dose of the medication. The injections are given under the skin of the abdomen, thigh, or upper arm. The dosage is gradually increased under the guidance of a healthcare provider. The starting dose is 0.25 milligrams (mg) dose per week. The dosage is adjusted every four weeks as needed. The maximum dosage of Wegovy is 2.4 mg per week is reached.
Safety and Side Effects
GLP-1 medications are generally safe and well-tolerated by most individuals. However, it is essential to note that it may not suit everyone. Pregnant, nursing, or planning to become pregnant should not take GLP-1 medications; patients with type 1 diabetes, medullary thyroid cancer, or MEN2 should not take GLP-1 medications. Specific individuals, such as those with pancreatitis, or kidney or gallbladder problems, may be more prone to experiencing side effects. The most common side effects of all GLP-1 medications are nausea, constipation, headache, and heartburn.
Understanding the Wegovy Shortage
The Wegovy shortage has created a temporary challenge for individuals relying on this medication to aid their weight management journey. According to Novo Nordisk, the manufacturer of Wegovy, the shortage is expected to last at least through September 2023 and explicitly affects the following dose strengths:
0.25 mg (taken during month one)
0.5 mg (taken during month two)
1.0 mg (taken during month three)
On the other hand, it is anticipated that the 1.7-milligram and 2.4-milligram strengths, taken during months four and five, respectively, are likely to be unaffected.
Your specific circumstances will determine the impact of the Wegovy shortage on you. If you are considering starting Wegovy, obtaining the initial and subsequent medication dosages may be more challenging or impossible due to the shortage affecting the initial dosage strengths prescribed at the beginning of treatment. During the shortage, we recommend starting your weight loss journey with Saxenda (which we’ll discuss further in detail below) and transitioning to Wegovy when it becomes available for additional weight loss.
For those already taking Wegovy and have progressed to the higher dosage strengths of 1.7 mg or 2.4 mg, getting their prescription may be less problematic as these strengths are expected to be less affected by the shortage. However, to ensure uninterrupted supply, Novo Nordisk advises contacting your pharmacy for a refill at least 1-2 weeks earlier than your usual refill time as a precautionary measure.
Alternative Option 1: Saxenda (Liraglutide)
Saxenda (Liraglutide) is another GLP-1 medication in the same class as Wegovy (semaglutide). Since it is a GLP-1 medication, like Wegovy, It works in the brain, gut, and pancreas in the same way to decrease food cravings, slow digestion, reduce blood sugar and help treat insulin resistance.
Clinical trials have shown that liraglutide can lead to an average of 9% weight loss when combined with a low-calorie diet and moderate daily exercise.
Saxenda is administered once daily using a pen to deliver adjustable doses of medications. The injections are given under the skin. The doses are gradually increased each week with the guidance of your doctor. The starting dose is 0.6mg. The maximum dosage is 3.0mg.
While liraglutide has proven effective for weight management, it is essential to note that it may not suit everyone. As with any medication, it is important to consult with our weight management healthcare team to determine if liraglutide is the right choice for you.
Alternative Option 2: Contrave (naltrexone/bupropion)
Contrave is an FDA-approved prescription medication that helps change brain signaling pathways to reduce appetite and control cravings. It combines two ingredients, bupropion, and naltrexone. Bupropion is the same ingredient in the antidepressant and smoking addiction medication known as Wellbutrin. Naltrexone is traditionally used to treat opioid and alcohol dependence and can help control food cravings.
Contrave is FDA-approved for weight loss. It has an average weight reduction of about 5.4% of your body weight when combined with calorie-reduced diets and regular moderate exercise routines. It can also help with smoking cessation. It suits those struggling with emotional eating, cravings, low-energy depression, or fatigue. It is relatively inexpensive if prescribed as the two generic meds separately.
Potential side effects may include nausea, headache, constipation, and elevated blood pressure. Consult our healthcare team to determine if Contrave is right for you.
Alternative Option 3: Plenity or physician-supervised diet and exercise programs
Plenity is not a medication but a device. A capsule that, when swallowed, releases thousands of particles in the stomach that expand to help you feel full. It is FDA approved for weight loss. Average weight loss is about 4% of body weight when combined with a low-calorie diet and regular, moderate-intensity exercise programs.
It has minimal drug interactions and can be used for a BMI of 25 or higher, while every other weight loss medication requires higher BMIs. The cost is $98 per month. Insurance does not cover it. The medical device is mailed to you directly from the company in 1-2 weeks as Plenity is unavailable at any pharmacy. It can cause diarrhea, bloating, constipation, and gas.
PlushCare can connect you with weight management health coaches to improve your diet and develop exercise plans customized around your lifestyle needs to ensure you stay on track and succeed in your long-term weight loss goals. Contact us today if you’d like to discuss weight management health coaching options.
Conclusion
Weight loss is a long-term journey to achieve better health. The popularity and success of GLP-1 medications have led to waves of shortages in the past year. Short-term disruptions in medication availability do not need to alter your long-term weight loss success. Liraglutide, Contrave, Plenity, and physician-guided diet and exercise provide evidence-based tools to continue working towards your overall weight loss and health goals. These medications can assist patients in their weight loss journey when combined with lifestyle modifications.
Talking to our doctors and weight management team is important to determine the most appropriate medication option based on your goals, medical history, medication costs, and availability. We can guide, monitor progress, and evaluate for safety throughout treatment. Remember, weight management is a complex process and a comprehensive approach that includes physician-directed treatment and daily lifestyle changes to help you become healthier and happier!
Sources:
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Novo Nordisk. (2023, June). Wegovy® (semaglutide) injection for subcutaneous use [Prescribing Information]. Retrieved from https://www.novo-pi.com/wegovy.pdf
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FDA. (2020, January). Saxenda (liraglutide) injection for subcutaneous use [Prescribing Information]. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/206321s010lbl.pdf
Plenity™ (n.d.). Retrieved from https://plenity.com/
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