The weight-loss drug Wegovy is now available in Australia.

Wegovy is administered as a once-weekly injection and is approved specifically for weight management. It’s intended to be used in combination with a reduced-energy diet and increased physical activity.

So how does Wegovy work and how much weight can you expect to lose while taking it? And what are the potential risks – and costs – for those who use it?

Let’s look at what the science says.

What is Wegovy?

Wegovy is a brand name for the medication semaglutide. Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for short, work better.

Normally when you eat, the body releases the GLP-1 hormone which helps signal to your brain that you are full. Semaglutides enhance this effect, leading to a feeling of fullness, even when you haven’t eaten.

Another role of GLP-1 is to stimulate the body to produce more insulin, a hormone which helps lower the level of glucose (sugar) in the blood. That’s why semaglutides have been used for several years to treat type 2 diabetes.

How does Wegovy differ from Ozempic?

Like Wegovy, Ozempic is a semaglutide. The way Wegovy and Ozempic work in the body are essentially the same. They’re made by the same pharmaceutical company, Novo Nordisk.

But there are two differences:

1) They are approved for two different (but related) reasons.

In Australia (and the United States), Ozempic is approved for use to improve blood glucose levels in adults with type 2 diabetes. By managing blood glucose levels effectively, the medication aims to reduce the risk of major complications, such as heart disease.

Wegovy is approved for use alongside diet and exercise for people with a body mass index (BMI) of 30 or greater, or 27 or greater but with other conditions such as high blood pressure.

Wegovy can also be used in people aged 12 years and older. Like Ozempic, Wegovy aims to reduce the risk of future health complications, including heart disease.

2) They are both injected but come in different strengths.

Ozempic is available in pre-loaded single-dose pens with varying dosages of 0.25 mg, 0.5 mg, 1 mg, or 2 mg per injection. The dose can be slowly increased, up to a maximum of 2 mg per week, if needed.

Wegovy is available in prefilled single-dose pens with doses of 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg. The treatment starts with a dose of 0.25 mg once weekly for four weeks, after which the dose is gradually increased until reaching a maintenance dose of 2.4 mg weekly.

While it’s unknown what the impact of Wegovy’s introduction will be on Ozempic’s availability, Ozempic is still anticipated to be in low supply for the remainder of 2024.

Is Wegovy effective for weight loss?

Given Wegovy is a semaglutide, there is very strong evidence it can help people lose weight and maintain this weight loss.

A recent study found that over four years, participants taking Wevovy as indicated experienced an average weight loss of 10.2% body weight and a reduction in waist circumference of 7.7cm.

For those who stop taking the medication, analyses have shown that about two-thirds of weight lost is regained.

What are the side effects of Wegovy?

The most common side effects are nausea and vomiting.

However, other serious side effects are also possible because of the whole-of-body impact of the medication. Thyroid tumours and cancer have been detected as a risk in animal studies, yet are rarely seen in human scientific literature.

In the four-year Wegovy trial, 16.6% of participants who received Wegovy (1,461 people) experienced an adverse event that led to them permanently discontinuing their use of the medication. This was higher than the 8.2% of participants (718 people) who received the placebo (with no active ingredient).

Side effects included gastrointestinal disorders (including nausea and vomiting), which affected 10% of people who used Wegovy compared to 2% of people who used the placebo.

Gallbladder-related disorders occurred in 2.8% of people who used Wegovy, and 2.3% of people who received the placebo.

Recently, concerns about suicidal thoughts and behaviours have been raised, after a global analysis reviewed more than 36 million reports of adverse events from semaglutide (Ozempic or Wegovy) since 2000.

There were 107 reports of suicidal thoughts and self-harm among people taking semaglutide, sadly including six actual deaths. When people stopped the medication, 62.5% found the thoughts went away. What we don’t know is whether dose, weight loss, or previous mental health status or use of antidepressants had a role to play.

Finally, concerns are growing about the negative effect of semaglutides on our social and emotional connection with food. Anecdotal and scientific evidence suggests people who use semaglutides significantly reduce their daily dietary intake (as anticipated) by skipping meals and avoiding social occasions – not very enjoyable for people and their loved ones.

How can people access Wegovy?

Wegovy is available for purchase at pharmacists with a prescription from a doctor.

But there is a hefty price tag. Wegovy is not currently subsidised through the Pharmaceutical Benefits Scheme, leaving patients to cover the cost. The current cost is estimated at around A$460 per month dose.

If you’re considering Wegovy, make an appointment with your doctor for individual advice.

Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

When parents are concerned about their child’s development, they often seek an assessment to address concerns and identify any conditions, such as autism, attention-deficit hyperactivity disorder (ADHD), or learning disorders.

Common worries include difficulties making friends, focusing on tasks, or meeting educational goals.

It might seem counter-intuitive but assessments are starting to focus on a child’s strengths during this process. This can create powerful opportunities to improve child and family outcomes, particularly when too much of the focus is on challenges in the family home, school and play settings.

There is, however, a lack of evidence about how to do such assessments and how certain strengths can be used in assessment.

In a new research paper, we have developed a strengths checklist for parents, carers and clinicians to more easily identify children’s skills, talents and positive qualities – and understand the type of support they need at home, school or socially.

The aim was to provide an easy way for parents and clinicians to identify strengths in children, and to provide a method for studying the role of strengths in development. This assessment can be used alongside more established assessments of challenges.

Why highlight a child’s strengths?

Focusing on a child’s strengths can have a powerful impact on children and parents. It can boost a child’s motivation, self-esteem, cognitive skills, language development, problem-solving abilities and build stronger relationships.

For parents and caregivers, it can increase their own feelings of self-worth and improve the quality of their relationship with their own children.

When parents and caregivers believe in their child’s abilities and encourage their strengths, children and families thrive.

However, there are many gaps in research about how to apply a strengths-based approach in the context of a neurodevelopmental assessment.

Currently, while the basic principle of incorporating strengths is clear, clinicians need to rely on intuition and creativity to guide their practices.

We have long needed better evidence-based methods to guide this.

This is where our research comes in

Our new study used the Sydney Child Neurodevelopment Research Registry, which aims to improve the neurodevelopmental assessment processes and the evidence for what works for families and clinicians. We asked caregivers to identify their child’s strengths on their first assessment visit.

Nearly 700 caregivers reported an average of 2.8 strengths about their children. Using these themes, we developed a child strengths checklist to use for clinical assessments.

We showed caregivers identified six categories of child strengths: cognitive and intellectual, social and interpersonal, hobbies and passions, character and personality, physical, and resilient behaviours.

Some caregivers might report that while their child had difficulty with peer interactions, they were also kind, affectionate, honest and caring.

Other caregivers described concerns about cognitive delays, but they also described how children persevered and persisted with tasks.

Analysing the data qualitatively – where we read caregiver transcripts and extracted themes – we captured the richness and detail of unique strengths. In total, we identified 61 unique strengths.

With community representatives and clinicians, we used this to develop a strengths-based checklist we’re calling the Child Autism and Neurodevelopment Strengths Checklist, or the CANS checklist.

This type of research will provide the evidence needed to be able to implement national guidelines and to develop better evidence about how strengths can be used to improve outcomes. We want to develop best practices for combining concerns and strengths into feedback, support plans and intervention strategies.

What can caregivers and clinicians do now?

Support schemes including the National Disability Insurance Scheme (NDIS) often require families to highlight what children can’t do. Still, there are some practical ways caregivers and clinicians can ensure a child’s strengths are kept front and centre.

For caregivers, along with discussing concerns, reflect on and talk with your clinicians about your child’s strengths. Make sure clinicians keep these in mind when devising supports.

For both caregivers and clinicians, it can be helpful to think about characteristics often seen as challenges – such as a strong need for routine – as also potential strengths. It may lead to new ways of supporting children. With the right environment and support, these traits can be valuable assets in a child’s development.

For clinicians, consider how a child’s strengths can inform your assessment and intervention strategies. Make sure you don’t only focus on what children can’t do or need support with.

Communicate clearly about the child’s strengths and consider how these strengths can:

• support the child’s long-term development and goals. If the child thrives on routine and pays close attention to details, showing them how to embrace these strengths can teach them how to use them to reach their own goals and to be more independent
• be the target of an intervention. Everyone needs to experience success. Designing activities around strengths can make intervention more enjoyable and engaging, and the effects are more likely to be long-lasting
• be used to support the wellbeing of families. Helping families focus on each other’s strengths and improve the way family members talk about and support one another creates a positive environment where they can all feel valued, respected and cared for.

By focusing on strengths, we want to create more effective and personalised support for children with neurodevelopmental conditions to reach their full potential.

Building a strong, evidence-based approach will help ensure children’s strengths are consistently considered in assessments and intervention planning.

Adam Guastella, Professor and Clinical Psychologist, Michael Crouch Chair in Child and Youth Mental Health, University of Sydney; Kelsie Boulton, Senior Research Fellow in Child Neurodevelopment, Brain and Mind Centre, University of Sydney, and Natalie Silove, Neurodevelopmental Paediatrician and Associate Professor, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.