Considering taking Wegovy to lose weight? Here are the risks and benefits – and how it differs from Ozempic
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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.
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Lychees vs Kumquats – Which is Healthier?
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Our Verdict
When comparing lychees to kumquats, we picked the kumquats.
Why?
In terms of macros, everything is comparable except for fiber, of which kumquats have 5–6x as much fiber, which means a very significant win for kumquats in this category.
When it comes to vitamins, lychees have slightly more of vitamins B3, B6, C, and K, while kumquats have a lot more of vitamins A and B1, and moderately more vitamins B2, B9, E, and choline. A fair win for kumquats here.
In the category of minerals, lychees have a little more copper, phosphorus, and selenium, while kumquats have 11x as much calcium, as well as a 2–3x more iron, magnesium, manganese and zinc. An easy win for kumquats.
Both fruits have great phenolic profiles, being both rich in antioxidants.
All in all, enjoy both, but if you’re going to pick one, kumquats easily win the day!
Want to learn more?
You might like to read:
- Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
- When Bitter Is Better: Enjoy Bitter Foods For Your Heart & Brain ← kumquats have a bitter citrus taste, while lychees are quite sweet and mellow
Take care!
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Are You Taking PIMs?
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Getting Off The Overmedication Train
The older we get, the more likely we are to be on more medications. It’s easy to assume that this is because, much like the ailments they treat, we accumulate them over time. And superficially at least, that’s what happens.
And yet, almost half of people over 65 in Canada are taking “potentially inappropriate medications”, or PIMs—in other words, medications that are not needed and perhaps harmful. This categorization includes medications where the iatrogenic harms (side effects, risks) outweigh the benefits, and/or there’s a safer more effective medication available to do the job.
You may be wondering: what does this mean for the US?
Well, we don’t have the figures for the US because we’re working from Canadian research today, but given the differences between the two country’s healthcare systems (mostly socialized in Canada and mostly private in the US), it seems a fair hypothesis that if it’s almost half in Canada, it’s probably more than half in the US. Socialized healthcare systems are generally quite thrifty and seek to spend less on healthcare, while private healthcare systems are generally keen to upsell to new products/services.
The three top categories of PIMs according to the above study:
- Gabapentinoids (anticonvulsants also used to treat neuropathic pain)
- Proton pump inhibitors (PPIs)
- Antipsychotics (especially, to people without psychosis)
…but those are just the top of the list; there are many many more.
The list continues: opioids, anticholinergics, sulfonlyurea, NSAIDs, benzodiazepines and related rugs, and cholinesterase inhibitors. That’s where the Canadian study cuts off (although it also includes “others” just before NSAIDs), but still, you guessed it, there are more (we’re willing to bet statins weigh heavily in the “others” section, for a start).
There are two likely main causes of overmedication:
The side effect train
This is where a patient has a condition and is prescribed drug A, which has some undesired side effects, so the patient is prescribed drug B to treat those. However, that drug also has some unwanted side effects of its own, so the patient is prescribed drug C to treat those. And so on.
For a real-life rundown of how this can play out, check out the case study in:
The Hidden Complexities of Statins and Cardiovascular Disease (CVD)
The convenience factor
No, not convenient for you. Convenient for others. Convenient for the doctor if it gets you out of their office (socialized healthcare) or because it was easy to sell (private healthcare). Convenient for the staff in a hospital or other care facility.
This latter is what happens when, for example, a patient is being too much trouble, so the staff give them promazine “to help them settle down”, notwithstanding that promazine is, besides being a sedative, also an antipsychotic whose common side effects include amenorrhea, arrhythmias, constipation, drowsiness and dizziness, dry mouth, impotence, tiredness, galactorrhoea, gynecomastia, hyperglycemia, insomnia, hypotension, seizures, tremor, vomiting and weight gain.
This kind of thing (and worse) happens more often towards the end of a patient’s life; indeed, sometimes precipitating that end, whether you want it or not:
Mortality, Palliative Care, & Euthanasia
How to avoid it
Good practice is to be “open-mindedly skeptical” about any medication. By this we mean, don’t reject it out of hand, but do ask questions about it.
Ask your prescriber not only what it’s for and what it’ll do, but also what the side effects and risks are, and an important question that many people don’t think to ask, and for which doctors thus don’t often have a well-prepared smooth-selling reply, “what will happen if I don’t take this?”
And look up unbiased neutral information about it, from reliable sources (Drugs.com and The BNF are good reference guides for this—and if it’s important to you, check both, in case of any disagreement, as they function under completely different regulatory bodies, the former being American and the latter being British. So if they both agree, it’s surely accurate, according to best current science).
Also: when you are on a medication, keep a journal of your symptoms, as well as a log of your vitals (heart rate, blood pressure, weight, sleep etc) so you know what the medication seems to be helping or harming, and be sure to have a regular meds review with your doctor to check everything’s still right for you. And don’t be afraid to seek a second opinion if you still have doubts.
Want to know more?
For a more in-depth exploration than we have room for here, check out this book that we reviewed not long back:
To Medicate or Not? That is the Question! – by Dr. Asha Bohannon
Take care!
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The Sugary Food That Lowers Blood Sugars
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Loved the article on goji berries! I read they are good for blood sugars, is that true despite the sugar content?❞
Most berries are! Fruits that are high in polyphenols (even if they’re high in sugar), like berries, have a considerable net positive impact on glycemic health:
- Polyphenols and Glycemic Control
- Polyphenols and their effects on diabetes management: A review
- Dietary polyphenols as antidiabetic agents: Advances and opportunities
And more specifically:
Dietary berries, insulin resistance and type 2 diabetes: an overview of human feeding trials
Read more: Which Sugars Are Healthier, And Which Are Just The Same?
As for goji berries specifically, they’re very high indeed in polyphenols, and also have a hypoglycemic effect, i.e., they lower blood sugar levels (and as a bonus, increases HDL (“good” cholesterol) levels too, but that’s not the topic here):
❝The results of our study indicated a remarkable protective effect of LBP in patients with type 2 diabetes. Serum glucose was found to be significantly decreased and insulinogenic index increased during OMTT after 3 months administration of LBP. LBP also increased HDL levels in patients with type 2 diabetes. It showed more obvious hypoglycemic efficacy for those people who did not take any hypoglycemic medicine compared to patients taking hypoglycemic medicines. This study showed LBP to be a good potential treatment aided-agent for type 2 diabetes.❞
- LBP = Lycium barbarum polysaccharide, i.e. polysaccharide in/from goji berries
- OMTT = Oral metabolic tolerance test, a test of how well the blood sugars avoid spiking after a meal
For more about goji berries (and also where to get them), for reference our previous article is at:
Goji Berries: Which Benefits Do They Really Have?
Take care!
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Basil vs Oregano – Which is Healthier?
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Our Verdict
When comparing basil to oregano, we picked the basil.
Why?
You may be thinking: these are just herbs; we don’t eat enough of these for the nutritional values to be relevant!
And to this we say: there’s nothing stopping you :p Herbs are full of flavor and goodness and there is really no reason to deny yourself. On this note, check out the sabzi khordan (traditional Levantine herb platter), linked below. You’ll start thinking about herbs in new ways, and you can thank us later!
Now, in terms of macros, nominally basil has more protein and oregano has more carbs and fiber, but the numbers are so close in each case that we’re going to call this category a tie.
When it comes to vitamins, things get more interesting: basil has more of vitamins B2, B3, B6, B9, K, and choline, while oregano has more of vitamins A, B1, B5, C, and E. This means a 6:5 win for basil, but note how the two herbs together give an impressive vitamin coverage. In other words, they complement each other nutritionally, not just culinarily!
In the category of minerals, basil has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium and zinc, while oregano has more selenium. Now, this is obviously a clear win for basil, but we’d like to highlight that both of these herbs are incredibly rich in minerals (i.e. oregano is a very good source of all those minerals we listed for basil, too!); it’s just that basil has even more of most of them.
When looking at any nutrient-dense food (which most herbs are), it’s worth looking at polyphenols. In this case, both are very abundant in polyphenols, and/but their respective numbers are close enough to be within each other’s margin of variation (i.e. exact numbers will depend on the individual plant’s life history), so this category is a tie.
Adding up the sections makes for an overall clear win for basil, but absolutely please do enjoy both unless you have a good reason not to—they complement each other so well, in nutrients as well as in flavor!
Want to learn more?
You might like to read:
- Cilantro vs Parsley – Which is Healthier?
- Holy Basil: What Does (And Doesn’t) It Do?
- Invigorating Sabzi Khordan (A Traditional Levantine Platter Of Herbs & Accompaniments)
Enjoy!
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Bulgarian Split Squats: How To Get The Best Glute Strength & Size
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Even without considering aesthetics, the glutes are very important muscles (you absolutely cannot have a healthy back and hips without strong glutes).
Bulgarian split squats have a name that makes them sound complicated; they’re actually very simple, but there are mistakes that people make that sabotage their progress.
Professional coach Elisi Wolf explains in this video:
Mistakes most people make
There are quite a few, but bear with us, as they really do come together—and once you understand them, you’ll have it for life;
- Lack of neural pathway establishment: most people skip the step of building a mind-muscle connection before adding weight. Focus on bodyweight movements first until you can feel your glutes working.
- Not focusing on glute contraction: avoid counting reps; it distracts the brain. Don’t use weights too soon, as they can prevent neural pathway development. Focus on time under tension and feeling the glutes before adding resistance.
- Not lowering slowly enough: slow, controlled movements give the brain time to activate the glutes. This increases time under tension and improves neural pathway formation.
- Not wearing knee sleeves: knee sleeves stabilize the joint, allowing the brain to recruit the glutes more efficiently.
- Not leaning over to the working side: staying upright distributes weight to the back leg instead of the glute, whereas leaning over the working side maximizes glute activation.
- Holding two dumbbells instead of one: two dumbbells force your body to stay level, reducing glute activation. Instead, hold a single dumbbell on the opposite side to improve balance and allow for a greater lean. You can even rest it on your thigh if you like; you’re not here for an arm workout, after all, and allowing the body to focus on one task is better.
- Not pushing out the working knee: pushing the knee outward mimics a sprinting motion, engaging the glutes more effectively.
- Allowing the pelvis to tilt down: if the pelvis tilts as you lower, the glutes disengage. Keeping the pelvis level ensures the glute medius stays activated.
For more on all of these plus visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like:
Strong Curves: A Woman’s Guide to Building a Better Butt and Body – by Bret Contreras & Kellie Davis
Take care!
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Coffee & Your Gut
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Coffee, in moderation, is generally considered a healthful drink—speaking for the drink itself, at least! Because the same cannot be said for added sugar, various sorts of creamers, or iced caramelatte mocha frappucino dessert-style drinks:
The Bitter Truth About Coffee (or is it?)
Caffeine, too, broadly has more pros than cons (again, in moderation):
Caffeine: Cognitive Enhancer Or Brain-Wrecker?
Some people will be concerned about coffee and the heart. Assuming you don’t have a caffeine sensitivity (or you do but you drink decaf), it is heart-neutral in moderation, though there are some ways of preparing it that are better than others:
Make Your Coffee Heart-Healthier!
So, what about coffee and the gut?
The bacteria who enjoy a good coffee
Amongst our trillions of tiny friends, allies, associates, and enemies-on-the-inside, which ones like coffee, and what kind of coffee do they prefer?
A big (n=35,214) international multicohort analysis examined the associations between coffee consumption and very many different gut microbial species, and found:
115 species were positively associated with coffee consumption, mostly of the kind considered “friendly”, including ones often included in probiotic supplements, such as various Bifidobacterium and Lactobacillus species.
The kind that was most strongly associated with coffee consumption, however, was Lawsonibacter asaccharolyticus, a helpful little beast who converts chlorogenic acid (one of the main polyphenols in coffee) into caffeic acid, quinic acid, and various other metabolites that we can use.
More specifically: moderate coffee-drinkers, defined as drinking 1–3 cups per day, enjoyed a 300–400% increase in L. asaccharolyticus, while high coffee-drinkers (no, not that kind of high), defined as drinking 4 or more cups of coffee per day, enjoyed a 400–800% increase, compared to “never/rarely” coffee-drinkers (defined as drinking 2 or fewer cups per month).
Click here to see more data from the study, in a helpful infographic
Things that did not affect the outcome:
- The coffee-making method—it seems the bacteria are not fussy in this regard, as espresso or brewed, and even instant, yielded the same gut microbiome benefits
- The caffeine content—as both caffeinated and decaffeinated yielded the same gut microbiome benefits
You can read the paper itself in full for here:
Want to enjoy coffee, but not keen on the effects of caffeine or the taste of decaffeinated?
Taking l-theanine alongside coffee flattens the curve of caffeine metabolism, and means one can get the benefits without unwanted jitteriness:
Enjoy!
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