With powerful weight loss drugs like Wegovy soaring in popularity, you’d be forgiven for thinking they offer a quick fix to lose a few pounds.
But is that what these drugs are offering?
Wegovy, or semaglutide, is approved for weight loss in adults with obesity, as well as some people who are overweight and have weight-related health conditions. At a lower dose, it’s sold under the brand name Ozempic to help people with diabetes control their blood sugar levels — although it is sometimes prescribed off-label for weight loss. Both come from drugmaker Novo Nordisk.
In clinical trials, Wegovy was shown to reduce body weight in people with body mass indexes, or BMIs, of 27 or greater by around 15% over 68 weeks. People on average lost about an eighth of that weight in the first month.
But how effective is the drug in people without obesity? And can it help with short-term weight loss?
Dr. Shauna Levy, a specialist in obesity medicine and the medical director of the Tulane Bariatric Center in New Orleans, said that while it wouldn’t be harmful for people without obesity to use the drugs, they’d most likely be sorely disappointed with the results.
That’s because, Levy said, the effects take time.
Doctors will typically start patients on lower doses of Wegovy — usually 0.25 milligrams — and gradually increase them over several weeks as people adjust to the effects of the medication, which slows how quickly the stomach empties and can cause nausea and stomach pain.
“It’s been my experience that it can take three months to really start seeing weight loss,” she said.
The effects may also not be the same for someone who isn’t overweight, she said, adding that Wegovy hasn’t been studied in patients with BMIs below 27.
“In normal-BMI patients, if people are trying to reach a one-month goal and maybe they don’t have obesity and they’re not supervised by a physician, it may not be exactly the same,” she said.
“Obesity is a chronic progressive disease,” Levy said. “To me, that’s a different circumstance than just trying to lose weight to go to a pool party or something like that.”
Nicole Araujo, a spokesperson for Novo Nordisk, said in a statement that Wegovy is intended for long-term use in people with obesity or people who are overweight and have a weight-related health problem.
“Novo Nordisk does not promote or condone the misuse of its medicines in any form,” she said.
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Dr. Holly Lofton, the director of the weight management program at NYU Langone Health in New York City, said that because the medication is meant to be used long-term, people who start the drug — and then stop it after they reach their weight loss goals — may regain the weight.
“Your body’s hunger hormones are the highest when you’re at that max weight loss,” she said. “It’s really not intended for short-term weight loss.”
People should also know the medication can come with unpleasant side effects, like vomiting. Eating too much or drinking too much alcohol can make it worse.
“An analogy I use is opening up your faucet full-stream and as you slowly turn it off to a drip, that is what Wegovy is doing to your stomach,” Lofton said. “So if I just turn on the faucet and shut it off all of sudden, it would make you throw up, because all the water would back up.”
Levy said people may also be at risk of losing their skeletal muscle mass, which can “ultimately make themselves less healthy.”
Dr. Susan Spratt, an endocrinologist and the senior medical director of the Population Health Management Office at Duke Health in North Carolina, said people with “normal” BMIs — 25 and under — don’t need to use Wegovy.
“I think all of us would like to lose five or 10 pounds, but you have to do it in a healthy way,” she said.
She recommended that people get at least 150 minutes of exercise every week. People should eat mostly fruits and vegetables, with a little bit of protein, starch and fats, she said.
“Weight loss is a long-term change in your habits. That is the best thing you can do,” she said.
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