Wegovy now in Canada: Who should (and shouldn’t) use the weight-loss drug
Still life of Wegovy an injectable prescription weight loss medicine that has helped people with obesity. It should be used with a weight loss plan and physical activity. (Photo by: Michael Siluk/UCG/Universal Images Group via Getty Images)
After years of persistent shortages, Canadians can now access Wegovy, an on-label weight loss medication, made by the same manufacturers of Ozempic.
Novo Nordisk’s drug officially hit the shelves on Monday, marking its availability despite being greenlit in Canada since 2021. Wegovy’s arrival holds promise for those battling obesity and diabetes.
Yet, as excitement brews, questions about its differences from medications like Ozempic, its ideal candidates and potential side effects may arise.
“This is a medical treatment approved for and studied in people living with a medical condition, obesity,” Dr. Sanjeev Sockalingam of Obesity Canada told Global News.
“In addition to losing weight to improve health, we also have evidence that [Wegovy] improves and reduces cardiovascular events in people who have had a previous history as well.”
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In Canada, the prevalence of obesity increased three-fold over the last three decades and now affects one in four adults, according to Obesity Canada.
Obesity not only diminishes a person’s quality of life and life expectancy but also escalates the risk of serious chronic illnesses such as heart disease, cancer, stroke, diabetes and non-alcoholic fatty liver disease, Sockalingam said.
“We want to think about how we can intervene early and prevent this,” Sockalingam said, adding that he believes medications like Wegovy will have a tremendous health impact for Canadians, as it is “another tool in our toolbox for treating obesity. “
Wegovy is the brand name for a medicine called semaglutide, the same as Novo Nordisks’s blockbuster diabetes drug Ozempic.
The drugs belong to a family of medicines known as GLP-1 analogues originally designed to control blood sugar but that also led to weight loss by making people feel full.
The weekly injections start at 0.25 milligrams of active ingredient semaglutide and gradually increase to the maintenance dose of 2.4 mg, according to the company’s website.
Wegovy contains the same drug, semaglutide, as Ozempic but at a higher dose, said Dr. Tom Elliott, an endocrinologist and medical director of BCDiabetes.
“It’s the same formulation,” he told Global News. “Ozempic comes at a maximum dose of one milligram a week, whereas Wegovy comes in a maximum dose of 2.4 mg per week.”
Wegovy is also specifically approved for chronic weight management and is administered as a higher-dose injection once a week. In contrast, Ozempic is primarily approved for the treatment of Type 2 diabetes and is typically administered as a lower-dose injection once a week.
Elliott said he has been prescribing Ozempic off-label for weight management with his patients for years. And with Wegovy now accessible, he intends to transition his patients to this new option for weight management.
“I think it’s a great thing,” he said. “The stigma for people with obesity taking Ozempic will now be gone. It’s a drug that has Health Canada approval for obesity. It’s safe and it’s on-label. And physicians across the country can prescribe this drug in good conscience for people with obesity.”
Wegovy is typically prescribed for people who are looking for an effective obesity treatment and is recommended for individuals with a body mass index (BMI) of 27 kg or higher and who have at least one weight-related condition, such as high blood pressure, Type 2 diabetes, or high cholesterol, according to the drug’s Health Canada approval statement.
“You need to have one other comorbidity such as sleep apnea or hypertension,” Elliott said. “But most people with significant obesity will have one of those two things.”
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The drug is intended to be used with a reduced-calorie diet and increased physical activity to improve weight loss.
Obesity is a significant medical concern, and while Wegovy represents a crucial treatment option, Sockalingam emphasized that the medication shouldn’t be viewed as a cosmetic solution for shedding a quick 15 pounds.
He highlighted a crucial distinction between individuals grappling with obesity as a chronic condition and those who have gained weight temporarily and carry excess pounds.
“This is not for people to simply lose a few pounds. This is not a cosmetic type of agent. This is a medication that is a treatment for a medical condition that’s obesity and how we’re defining it,” he said.
“There are side effects that we need to think about and one thing is gastrointestinal side effects. These are things that should be monitored by a physician and aren’t aren’t a quick fix for a few pounds.”
The most common side effects of Wegovy include nausea, diarrhea, vomiting, constipation, abdominal (stomach) pain, headache, tiredness (fatigue), upset stomach, dizziness, feeling bloated, belching, gas, stomach flu and heartburn, according to the company’s website.
Elliott said side effects are rare but do happen.
“Only rarely are these drugs not tolerant,” he said. “I’d say only one in 20 people can’t take them because of side effects. The main side effect is nausea and occasionally vomiting.”
Elliott believes the biggest drawback to Wegovy is the price.
“It’s going to be expensive. It’s probably not going to be covered by public insurance, by the various provincial plans and it’ll take a while for private plans to kick in,” he said.
According to the Canadian Journal of Health Technologies, treatment with Wegovy is expected to cost approximately C$4,726 per patient per year.
And because the drug only works as long as you take it, that means people may have to be on Wegovy indefinitely, Elliott said.
“Most people who start these drugs will stay on them as long as they can afford them,” he added.