Canadian doctor concerned new weight-loss drug Wegovy may be used inappropriately

Ozempic or Wegovy: What's the difference? Pharmacist Jennifer Lake breaks down what to know about Wegovy and how the semaglutide injection differs from Ozempic.

As Wegovy becomes available to Canadians starting Monday, a doctor is cautioning patients wanting to use the drug to lose weight that no medication is a "magic bullet."

Denmark-based global health-care giant Novo Nordisk produces the weekly injection Wegovy and the popular diabetic and weight-loss drug Ozempic.

The new medication is meant particularly for people who meet certain criteria related to obesity and weight, CTV's medical expert Dr. Marla Shapiro said.

"The popularization of Ozempic being used by Hollywood and giving it the impression that it's a magic bullet has really been not a good thing," Shapiro said in an interview with CTV News Channel on Friday.

"The issue here is that using the medication (Wegovy) inappropriately, you may lose the weight, but if you stop the medication, you're likely to increase back. Remember, the medication only works with exercise and a calorie-reduced diet."

Shapiro said Wegovy is an on-label weight-loss medication, which means it's prescribed for a specific purpose. In this case, Wegovy is prescribed to adults who are obese, with a body mass index (BMI) greater than or equal to 30. The drug also targets those who are significantly overweight, with a BMI of 27, and have at least one weight-related medical condition such as high blood pressure, Type 2 diabetes, cholesterol problems, dyslipidemia (an imbalance of lipids such as cholesterol or triglycerides), or obstructive sleep apnea.

"We really want people to understand that obesity is a chronic medical condition and that is what we're treating," Shapiro said. "We're not looking to treat someone who walks in and wants to lose five pounds, 10 pounds, who really doesn't meet those two strict criteria."

Since Wegovy is an on-label medication for a chronic disease, it implies it's meant for chronic use, she added.

"It needs to be monitored by your health-care provider," she explained. "And you really have to have the indications to go on it, having failed all the other alternatives that may have been given to you prior to thinking about going on a long-term medication."

The medication makes people feel fuller and reduces gastric emptying, or the process of the stomach expelling its contents, Shapiro said.

Who should not use Wegovy

Individuals who should not use Wegovy, according to Shapiro, include those with serious allergic reactions to the medication, those with pancreatic or renal kidney problems, those using drugs for diabetes, those who are or are planning on becoming pregnant or breastfeeding and those with a history of thyroid cancer, particularly medullary thyroid cancer.

Like other medications, she said Wegovy has side effects like constipation and nausea, which is why the drug is suggested to be used at night.

Users may also experience inflammation of the pancreas, also known as pancreatitis, gallbladder problems, lower blood sugar, kidney issues, increased heart rates, depression, suicidal thoughts and serious allergic reactions such as hives.

"No medication is benign," she said. "It's naive to say that any medication is without any side effects."

Many people are overweight not necessarily because of their lifestyle choices in failing to eat less and exercise more, it's because they have obesity as a chronic disease, Shapiro explained. "This is an illness like other illnesses and this is a tool to treat it."

Experts estimated Wegovy would probably cost about $400 a month, though it is unclear whether medical insurance plans would cover it.

Novo Nordisk Canada declined to share the price for Wegovy to The Canadian Press. In a statement, it said that "medication pricing in Canada is influenced by multiple factors including federal, provincial and territorial governments and insurance providers, and prices may vary person to person."

Health Canada only approved Ozempic to treat Type 2 diabetes but it has been prescribed off-label for weight loss.

The health agency later approved Wegovy in November 2021 amid supply shortages of Ozempic. Wegovy carries a higher weekly dose of semaglutide at 2.4 milligrams, compared to one milligram in a single Ozempic dose. Semaglutide, which mimics an insulin-promoting hormone, suppresses appetite and helps people feel fuller.

Clinical trials showed that Wegovy was safe and effective for weight loss, and had a positive impact on other weight-related conditions such as cardiovascular health, Vancouver-based endocrinologist Dr. Ehud Ur told The Canadian Press. Ur is not affiliated with Novo Nordisk.

With files from The Canadian Press