Understanding Wegovy: The Science Behind Its Weight Loss Mechanism

Introduction to Wegovy

Wegovy contains the active ingredient, Semaglutide which is the same ingredient found in Ozempic. Both Ozempic and Wegovy are injectable treatments that influence how the body metabolizes molecules into energy. The similar Rybelsus is an oral form of semaglutide. All three are made by the same company, Novo Nordisk.

There is an inordinately huge amount of publicity surrounding this family of semaglutide drugs. We regularly hear of the “next” celebrity who is taking it. If you search or ask for information about this once, you will find a lot more information popping up in your paid social media advertising feeds about this and that miracle, and this and that truly amazing event that has happened linked to these drugs.

Mechanism of Action of Semaglutide

Understanding GLP-1 Agonists

Semaglutide is a Glucogon Like Protein 1 (GLP-1) agonist. Let’s unpack that. Our body sends signals from one place to another with hormones – these are signal compounds that will leave one place, bind to a receptor protein somewhere else, and cause an effect. An agonist is a synthetic chemical (or sometimes a natural one isolated from a different organism such as a plant) that will bind to the receptor, triggering the effect the receptor is supposed to trigger.

The Role of Insulin in Metabolism

Insulin is a well-known hormone – if blood sugar rises, your pancreas should produce insulin, which will then tell cells to remove glucose from the blood and do something with it. This can be to store the glucose in the liver, or, to turn it into fat. If you beat your body into submission by eating a lot of carbohydrates all the time, the constant influx of sugar into the body can cause the cells to almost give up, and then you can develop an increase in blood sugar. It can also precipitate weight gain and obesity.

When we eat food, GLP-1 is released in parts of the intestines, and this travels to other parts of the body where it causes us to feel full and less likely to want to eat. It also increases blood insulin. The GLP-1 peptide has a very short life in the body – under two minutes – meaning that it leaves the intestines where it is produced, reaches the parts of the body it needs to get to, sends a tickle of a message, and then gets destroyed by natural enzymes in the body. Semaglutide will bind to the same receptors, and, due to its structure will not be degraded by enzymes as quickly, with the result that it will influence your body's metabolism. This can result in weight loss.

Why Wegovy's Half-life Matters

Semaglutide is a synthetic version of GLP-1, and as a result, it shares 94% similarity (homology is the scientific word) with the original molecule. It however has a much lower rate of degradation. GLP-1 produced by your body has a half-life of two minutes!! This means that after two minutes enzymes have destroyed half of the GLP-1 peptide signals. Semaglutide on the other hand has a half-life of 155-184 hours! That is 6 and a half to 7 and a half days! This means that it can be administered as a once-weekly subcutaneous injection. The manufacturers provide the medication in a convenient-to-use subcutaneous home injection format.

So, Ozempic and Wegovy are basically very similar versions of the same drug, in slightly different formats for slightly different treatments. They are made by the same manufacturer. They have an amazing PR campaign running right now, and this is really driving sales and profits. Should you jump on the bandwagon and run out there and get a prescription to assist with weight loss?

Risks and Side Effects of Wegovy

Evaluating Wegovy's Efficacy

I personally have been around long enough now to have seen a few generations of miracle cures arise. Each miracle drug that does come out often skulks away into obscurity a decade or two later. Normally the reason for this is that the drug causes some horrible health side effects. We need to tip-toe a line when making choices about new treatments – do we trust the company making the drug? If it’s a pharmaceutical product you would do well being a skeptical person as the industry track record does have a few precedents of recklessness it has set over the past century.

If we look at a new drug, it has a patent profit cycle. It takes about 10-15 years from discovery to market for a pharmaceutical product. Humans live about 60-90 years on average depending on where you are in the world. The Semaglutide Patent was supposed to lapse in 2026 but some legal footwork means the patent holds until the end of 2031. The drug was first given public exposure in 2012. After this, there are all the legal obstacles a drug must clear to make it to the market, with the FDA granting the first formulation a license in 2017. There is usually a lag phase when a drug enters a market, then a phase where the market expands rapidly, and then a tapering phase as the drug saturates the market, or people start to realize the drug is dangerous. The Semaglutide family of drugs is in the honeymoon phase of profitability where the public and medical fraternity are in love with these drugs.

Concerns About Safety and Long-term Use

Human thinking can be flawed at times. When things become a fad or a craze, we often stop thinking critically about what we are doing. If everybody else is doing it, it must be safe. Asbestos floor tiles were once all the rage too. Not anymore. My logic goes something like this – if a product has a big health warning that it may cause cancer on its home page, you should think carefully before taking it. This is a product that has 12 years of real data available for the effects of taking it, and probably only really 3-4 years for large-scale use!! If we need a health warning on the landing page of the product website right now, we know that bigger scarier side effects are probably going to be discovered. As I mentioned earlier, the lifecycle of a human is 60-90 years. Humans have kids after 15-30 years of birth. Any drug that has been on the market for less than a decade, and which can influence human metabolism on a fundamental level will most likely show several unexpected side effects over a longer period.

Long-term Considerations and Skepticism

This is a fascinating medication, and its mode of action is effective. When you read the papers published about Semaglutide however, you cannot avoid noting that there is a lot of speculation as to how it actually works. There are hypotheses, but many of the researchers use words such as “may” and “putatively”. When it comes to choosing whether to use such a drug to assist with weight loss, it is well worth considering all available options, and, if those are exhausted, to consider Wegovy. It is definitely a poor first choice, but, if available options have been exhausted, it is an effective choice for certain difficult cases. With time, we hope that more data will appear that will really back up the miracle claims and that this will prove to be a safe, effective medication.