Jump to: What are GLP-1 receptor agonists? | Semaglutide for weight loss and type 2 diabetes | Wegovy VS Ozempic: Any difference in the dose? | Take home message
Wegovy® and Ozempic® are the same drugs under different brand names from the pharmaceutical company Novo Nordisk. They’re both medications that require a weekly injection with semaglutide as the active ingredient.
Semaglutide is a GLP-1 receptor agonist that helps reduce hunger and appetite, allowing you to eat fewer calories, lose weight, and manage your blood sugar levels.
Ozempic® is for individuals living with type 2 diabetes to support blood glucose control, but you’ll likely experience weight loss while on the medications due to the appetite-suppressing effects.
Wegovy® is for individuals living with obesity to help them eat fewer calories and lose weight. Still, you’ll also experience improved glycemic control due to the effect of GLP-1s on insulin function.
They were initially approved as prescription drugs but are now widely available online for private purchase in the U.S., with them being released in the UK in 2023.
Both medications are taken once a week via a self-administered injection. The only difference between the two drugs is the recommended dosage and what they’ve been approved for. Wegovy® is available in higher doses than Ozempic®.
Second Nature is launching a new GLP-1 assisted weight loss programme this spring. But we have limited space available; register your interest here.
Dosing schedules
Ozempic® is available to purchase in the UK and U.S. and via prescription from your GP in the UK.
Wegovy® is available to purchase in the U.S. and via prescription from your GP in the UK if you have a high BMI and are at risk of type 2 diabetes. It’s not currently available without a prescription in the UK but is expected to be available by spring 2023.
Not a magic pill
These medications are designed as additional tools for weight management interventions and shouldn’t be considered lifelong medications.
Instead, they should be used to help you kickstart your weight loss and health journey while you commit to living a healthier lifestyle.
At Second Nature, we’ve been trusted by the NHS since 2017 to support people with type 2 diabetes and obesity to lose weight and manage their blood sugar levels and lead healthier lifestyles for the long term.
If you’re considering purchasing Wegovy® (when it’s available) or Ozempic® but need support in making positive changes to your lifestyle, Second Nature could be an option for you.
In 2022, the NHS published data in the BMJ that compared the weight loss outcomes of five providers in the National Diabetes Prevention Programme.
Second Nature was more than twice as effective at supporting weight loss than the other four providers.
Second Nature is launching a new GLP-1 assisted weight loss programme this spring. But we have limited space available; register your interest here.
You can also learn more about our new GLP-1 programme from our CEO, Chris.
Otherwise, keep reading as we dig into the science of Wegovy® and Ozempic® and how GLP-1s work.
1) What are GLP-1 receptor agonists?
When we eat food, our stomach releases a hormone that helps the body regulate hunger and blood sugar levels. This hormone is called GLP-1 (glucagon-like peptide-1). The actions of GLP-1 are the target of Wegovy® and Ozempic®.
This class of medications are known as GLP-1 receptor agonists (GLP-1s). They mimic the actions of the hormone GLP-1.
GLP-1s help your pancreas release more insulin to lower blood sugar levels, delay emptying food from the stomach (also called gastric emptying), and reduce appetite via a mechanism in the brain.
There are two well-known GLP-1 medications available in the UK and U.S.:
- Liraglutide (Saxenda®): Taken once a day.
- Semaglutide (Wegovy® and Ozempic®): Taken once a week.
Do GLP-1 receptor agonists work?
Clinical trials have demonstrated that GLP-1s are more effective at weight loss than other weight loss medication drugs like orlistat, which has a different mode of action for weight loss and lowering BMI (body mass index).
A systematic review and meta-analysis (a study analysing lots of different studies) analysed 28 trials in over 29,000 people investigating the effectiveness of five weight loss medications on weight loss.
The study found that all five medications were more effective than the placebo at supporting weight loss.
This trial included orlistat and the GLP-1 liraglutide and found that liraglutide was more effective at weight loss than orlistat and showed that participants taking liraglutide were twice as likely to achieve more than 5% weight loss than orlistat.
Due to the relationship between obesity, blood sugar levels, and cardiovascular disease, research shows a positive relationship between GLP-1s and heart disease risk factors such as high blood pressure (hypertension) and triglyceride levels.
Interestingly, more recent studies have shown that semaglutide (Wegovy® and Ozempic®) is more effective at supporting weight loss and type 2 diabetes than liraglutide (Saxenda®).
It’s not recommended for pregnant women or individuals with a family history of thyroid cancer to take GLP-1s.
Key points:
- GLP-1 receptor agonists (GLP-1s) are a class of medications that mimic the actions of the hormone GLP-1, which helps regulate hunger and blood sugar levels.
- GLP-1s help the pancreas release more insulin, delay stomach emptying, and reduce appetite.
- Two well-known GLP-1 medications in the UK and U.S. are liraglutide (Saxenda) and semaglutide (Wegovy® and Ozempic®).
- Research has suggested that GLP-1s are more effective at supporting weight loss than other weight loss medication drugs like orlistat.
- A systematic review and meta-analysis found that all five weight loss medications investigated were more effective than placebo at supporting weight loss.
- Liraglutide was more effective at weight loss than orlistat.
- Semaglutide is more effective at supporting weight loss and type 2 diabetes than liraglutide.
2) Semaglutide for weight loss and type 2 diabetes
A meta-analysis investigated the impact of semaglutide (Ozempic®) and liraglutide (Saxenda®) and suggested that semaglutide was more effective at lowering blood sugar levels (as measured by HbA1c).
The study showed that a 0.5mg dose of semaglutide led to a more significant reduction (0.17%) in HbA1c than liraglutide.
The 1mg dose of semaglutide showed a further benefit compared to 1.2mg and 1.7mg of Saxenda at 0.47% and 0.3%, respectively.
However, the studies used to compare the two drugs were from individual trials, comparing one of the medications with a placebo (a sugar pill). They hadn’t yet been compared directly with one another.
Fortunately, a randomised controlled trial was conducted in 2022 investigating the impact of semaglutide and liraglutide on weight loss in individuals living with obesity.
The results showed that the participants in the semaglutide group lost 15.8% of their body weight compared to 6.4% in the liraglutide group.
Semaglutide was also shown to be more tolerated than liraglutide. 13.5% of participants in the semaglutide group discontinued their treatment due to side effects, compared to 27.6% with liraglutide.
Over 80% of participants in both groups reported common side effects and GI-related issues such as constipation, cramping, bloating, and diarrhoea.
Due to the positive results from these studies, Semaglutide was made available in 2022 in the UK after the U.S. approved the drug in 2021.
Key points:
- A meta-analysis compared the impact of semaglutide (Ozempic®) and liraglutide (Saxenda®) on lowering blood sugar levels (measured by HbA1c) and suggested that semaglutide was more effective than liraglutide
- A randomised controlled trial conducted in 2022 investigated the impact of semaglutide and liraglutide on weight loss in individuals living with obesity
- The results showed that semaglutide was more effective at weight loss (15.8% body weight loss) than liraglutide (6.4% body weight loss)
- Semaglutide was also better tolerated than liraglutide, with fewer participants discontinuing treatment due to side effects, but GI-related issues were common in both groups
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3) Wegovy VS Ozempic: Any difference in the dose?
The only difference between Wegovy® VS Ozempic® is the available dose, with Wegovy® available up to 2.4mg, compared to 1mg with Ozempic®.
Initial research on semaglutide focused on Ozempic® and doses between 0.5mg and 1mg.
However, the studies found that 20-30% of individuals on the medication didn’t reach the treatment targets for reducing their blood sugar levels.
A randomised controlled trial with 961 participants compared the impact of a once-weekly dose of 1mg or 2mg of semaglutide on blood glucose levels and weight loss for people living with type 2 diabetes.
You might expect that a doubling of the dose would lead to a doubling of the effect.
However, the human body is a bit more complex than that. Medications (and hormones in the body) often have a ‘ceiling effect’ where the relationship between the exposure and the effect is no longer linear.
The results showed that 1mg of semaglutide reduced HbA1c (average blood glucose) by 1.9% compared to 2.2% in the 2mg group.
A similar trend was shown with weight loss. 1mg of semaglutide led to an average weight loss of 6 kg compared to 6.9 kg in the 2mg group. Interestingly, both groups reported similar levels of adverse events and side effects.
So, the higher dose of semaglutide that you’ll receive with Wegovy® will likely lead to slightly more significant reductions in weight loss and blood sugar levels without experiencing more adverse events or side effects.
However, you must monitor your medication responses and determine your tolerance level. You might tolerate a higher dose, but you might not.
The research on these medications has shown that the most severe side effects are reported when the dose of the medication is increased while your body adjusts.
You might determine that any side effects are worthwhile to help you improve your health conditions and lose weight.
But you must contact your healthcare team and discuss any side effects to ensure this is monitored and the dose adjusted to suit your needs.
Key points:
- Most research with semaglutide is with the doses of 0.5mg and 1mg that you have with Ozempic®
- Only one trial has compared the impact of 1mg to 2mg of semaglutide and found it did lead to more significant reductions in weight and blood sugar levels
- However, the differences weren’t as significant as you might expect and the dose that’s best for you will depend on your tolerance level and weight loss goals
- You must report any side effects to your healthcare team and adjust your dose accordingly
Take home message
The recent innovations in GLP-1 medications are remarkable and have caused quite a stir in the world of healthcare.
We’re in new territory where obesity and type 2 diabetes medications treat an underlying cause instead of merely treating the symptoms to support better management.
However, these drugs shouldn’t be seen as miracle cures; they’re not designed to be used for life.
They’ve been designed to be taken alongside lifestyle changes that will enable you to eventually come off the medications and maintain your lower weight for the long term.
The harsh reality is that we still don’t know the long-term effects of these medications on our health. There are examples of drugs being withdrawn from the market as more long-term data comes to light.
Lorcaserin was a weight loss drug approved by the Food and Drug Administration (FDA) in the U.S. but was recently withdrawn as data indicated that it increased cancer risk.
The example of lorcaserin is why you must weigh the pros and cons when your doctor prescribes medication or before you purchase it yourself and start treatment. Report any side effects to your healthcare team.
GLP-1s are safe and effective for most people in the short to medium term, but we don’t have long-term data to be sure they’re not causing severe adverse effects down the line.
At Second Nature, we’re not against using medications to support people in making healthy changes and reducing their risk of chronic disease.
However, we don’t recommend using medications as a reason not to make healthy lifestyle changes. The causes of obesity and type 2 diabetes aren’t merely rooted in biology but also in psychology and sociology.
With these medications, you may lose weight and reduce blood sugar levels. But will you be happier? Will you be more fulfilled? Will you be content with your life and social relationships?
For that, you may need to consider a lifestyle change, and if that’s something you want to commit to alongside taking GLP-1 medications, Second Nature is launching a new GLP-1 assisted weight loss programme this spring.
But we have limited space available; register your interest here.
