Wegovy: Can we all inject slim now?

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Expert interview on Wegovy weight loss injections: Can we all have slimming injections now?

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There is no genetic engineering in the plant

But don’t worry: they’re genetically modified

The Wegovy weight loss injection has also been available in Germany since last Monday. The drug promises to shed pounds and has triggered a real hype in the USA. Legitimately? We spoke to a chief doctor for obesity surgery.

Goodbye yo-yo effect and hello dream figure? In the USA, Elon Musk and Kim Kardashian, among others, have triggered quite a hype about the Wegovy weight loss injection. At times there were delivery bottlenecks. Since last Monday, doctors have also been able to prescribe the syringes for self-use in Germany.

What can the “miracle injection” do and where are the limits and perhaps even possible risks? We asked Sylvia Weiner, Head of the Clinic for Obesity Surgery and Metabolic Surgery at the Sana Clinic in Offenbach.

FOCUS online: Ms. Weiner, what do you say about the Wegovy weight-loss injection – a promising drug or unjustified hype?

Sylvia Weiner: In fact, the active ingredient semaglutide in it has been approved for seven years. Wegovy is practically the latest stage of development. The proof of effectiveness is provided, it intervenes substantially in the metabolic dysregulation. Therefore, this drug has its justification. It can help many people who are affected, so I think it’s great that it’s now also on the German market.

But very important: It is a drug. So you should only take it if you have a medical condition. In this case if really one obesity present (BMI ab 30) or Overweight (BMI from 27) with at least one weight-related comorbidity such as type 2 diabetes. If you have a few excess fat pads, the injection makes no sense.

So aren’t we all going to just squirt ourselves slim now?

Weiner: No. Something in the metabolism is disturbed in overweight people, but not in healthy people. I would even say that you might even inject yourself with a risk of becoming overweight later on. We know that from short-term diets. If I control the metabolism incorrectly, I provoke false adaptation mechanisms.

In addition, there is currently no data on how the drug works in people of normal weight. So I can only strongly advise against seeing the syringe as a lifestyle product.

About the expert

Miss Dr. medical Sylvia Weiner has been the head of the Clinic for Obesity Surgery and Metabolic Surgery at the Sana Klinikum Offenbach since October 2022.

To whom would you specifically recommend the slimming injection?

Weiner: It is ideal for people with a BMI between 30 and 40. Here we actually have the opportunity to induce changes in the metabolism and thus also to avoid surgery and secondary diseases such as diabetes or fatty liver.

If you are very obese, i.e. have a BMI over 40, I would no longer prescribe the drug. The dysregulation is more pronounced, several mechanisms are at work. Semaglutid, the active ingredient in Wegovy, is then no longer sufficient as a therapy. Here we are with the surgical forms of treatment.

How exactly does the active ingredient semaglutide work?

Weiner: Semaglutide mimics the action of the body’s own small intestine hormone GLP-1. This slows down gastric emptying and optimizes insulin release. It also acts on the brain, in terms of satiety and appetite suppressant.

But our metabolism is highly complex, with numerous different influences. GLP-1 is just one building block. But a very important one, it must be said.

What are the potential side effects?

Weiner: Side effects can occur that affect the gastrointestinal tract, such as feeling full, nausea, vomiting, diarrhea or constipation. But it can also trigger headaches and depress mood.

People react to it very differently. Some lose a lot and have no side effects, for them it’s tip-top. But there are also others who hardly lose weight and suffer from headaches, nausea and bad moods. Therefore, the recommendation is to test it for four to six weeks first, check the results and then decide whether to do the long-term therapy. Because this is also an important point: it makes no sense to inject for a few weeks and then stop. You have to stick with it for the rest of your life.

It is also important that treatment is always discussed with a specialist. For example, the drug is not suitable for people with thyroid, kidney or pancreas disease. Because these organs are also heavily involved in the metabolism.

How do people become morbidly obese?

Weiner: Many factors come into play here. This can be genetic. But it also plays a role, for example, whether you were born through the birth canal, because then so-called bifidobacteria are transmitted, which are important for a healthy intestinal flora. Other factors include breastfeeding, an appendectomy, tonsillectomy, whether the mother had diabetes or obesity, and of course diet.

Basically, however, obesity is to be regarded as a chronic inflammatory disease, similar to an autoimmune disease. Above a certain level, those affected can no longer take countermeasures themselves and it does not mean, for example, that they then eat too much. Unfortunately, obesity is still insanely stigmatized. She meets so many people. I would roughly estimate that around 30 million people in Germany require treatment because they are overweight. That’s a third and the numbers are increasing. So we see the need is great, so it’s even better that there is now a remedy that can help those affected.

Are the costs for the injection covered by health insurance?

Weiner: Unfortunately, no. Obesity has long been recognized as a disease by the WHO. In the German Social Code, however, weight loss aids fall under lifestyle products and are excluded from reimbursement. That’s a pity, because it would be more worthwhile to fight obesity now than later on from complications such as fatty liver or diabetes.

You would have to finance the injections yourself. How expensive is it?

Weiner: It depends on the dosage in which the drug is used. The highest dose (2.4 mg) for a four-week ration costs around 250 euros. That’s a lot of money, but also an opportunity for many people who don’t want an operation or don’t need one yet. Unfortunately, our experience shows that people continue to gain weight on average. So it helps to take countermeasures early on.

There was a big rush in the USA, and there were supply bottlenecks. Do you also see this coming to Germany?

Weiner: We’ve already seen it with Ozempic, Wegovy’s predecessor drug. This is actually approved for diabetes, but many bought it to lose weight. There were delivery bottlenecks and there was no more Ozempic for the diabetics. I’m afraid that will also happen with Wegovy. The potential for abuse is there, we have also seen that in the USA.

Would you take the medicine?

Weiner: I would have loved to have lost five kilos before my vacation. I just can’t get them down. And I would have access to it. But no, I would not inject myself. I am not obese and would not take the risk of possibly misregulating my metabolism.

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