This family of molecules has been used for many years in the treatment of type 2 diabetes. They imitate the action of incretins, gastrointestinal hormones which stimulate the secretion of insulin when the blood sugar level (blood sugar level ) is high. They thus help to regulate blood sugar, delay gastric emptying and increase the feeling of satiety. In addition to diabetes management, these effects therefore lead to weight loss, mainly through a reduction in the mass of fat cells. This mechanism works both in people with diabetes and in those suffering from excess weight or obesity but without diabetes.
How effective is Wegovy?
Clinical trial data on Wegovy includes 18 phase 3 trials (STEP program), in obese non-diabetic people. Weight losses range from 15 to 17%, with follow-up up to 68 weeks.
But Wegovy also improves the cardiometabolic profile of patients. In the SELECT study, involving overweight or obese non-diabetic adults with a history of cardiovascular disease, a 20% relative reduction in the risk of major cardiovascular events was observed (cardiovascular death, myocardial infarction, stroke brain).
I am overweight or obese. Can I take it?
Since October 8, Wegovy (2.4 mg) is available only to patients with a body mass index (BMI) greater than or equal to 35 kg/m² (obesity), aged under 65, and after failure of nutritional support including a low-calorie diet and regular physical activity. Other restrictions apply. Its delivery is only possible on medical prescription written by a doctor specializing in endocrinology-diabetology-nutrition or by a doctor who has completed specialized transversal training in “applied nutrition”. This during the first prescription because afterwards, the general practitioner will be able to renew this prescription.
Probably scalded by the scandals linked to weight loss treatments such as Mediator, the National Medicines Safety Agency (ANSM) thus wants to limit the risk of drifting towards use for purely aesthetic purposes in non-obese or overweight people, without associated health problems.
Finally, Wegovy is not reimbursed by Health Insurance, although we expect a reimbursement decision in the coming months, at least for people suffering from severe or massive obesity. For now, patients will have to pay between €9 and €12 per day out of pocket, or around €270 to €360 per month*.
What are the side effects of Wegovy?
The side effects of Wegovy (injectable solution in pre-filled pens) are known, mainly gastrointestinal: nausea, vomiting, diarrhea and constipation. However, these disorders only lead to treatment discontinuation in less than 5% of patients. Treatment begins with a minimum dose of 0.25 mg for 4 weeks. The doses are then increased gradually, over several months.
Epi-Phare – a scientific interest group dedicated to the epidemiology of health products – examines rare but serious gastrointestinal events in France (pancreatitis, intestinal obstruction, gastroparesis which is the paralysis of the stomach with a delay in its draining). No alert has been issued at this stage.
Is it the only anti-obesity drug?
Wegovy, from the Novo Nordisk laboratory, is just one of the representatives of a new generation of super drugs aimed at weight loss. Saxenda (liraglutide) was until now the only GLP-1 analogue indicated for obesity in France.
New, even more powerful drugs are in the pipeline. They combine the effect of GLP-1 analogues with other mechanisms of action, targeting hormones such as glucagon or GIP. Some of these drugs, which include double (and soon triple) combinations, are already available in the United States.
A tidal wave is predicted. According to the Bank of Montreal, in 2035, 19 million Americans will be treated for obesity, compared to 3 million today.
Some specialists are concerned about the widespread prescription of anti-obesity drugs. Especially since they must be continued for life, their cessation leading to the return of the lost kilos. Nutritional education and an active lifestyle are essential, but we must be pragmatic: these measures have proven their insufficiency in the face of the constant increase in obesity and overweight rates, both in our country and internationally. . As proof, the latest French Obépi 2020 figures published in 2023 where the obesity curve seems uncontrollable.
*Patients who benefited from early access will benefit from support until the end of January 2025.
My child is having academic difficulties: how should I react?
