Comprehensive Guide to Wegovy Side Effects

Obesity is a chronic disease rising in prevalence. Over 40% of adults age 20 or older are obese, according to the Centers for Disease Control.[1] With the high prevalence of obesity and the many diseases associated with obesity, it’s not a surprise that the treatment of this illness is being closely investigated.

Wegovy is one of several medications currently being used to treat obesity. It was approved in June 2021. [6] The active compound in this medication is semaglutide, which is also used for diabetes under the name Ozempic. 

Wegovy belongs to a class of medication known as glucagon-like peptide-1 (GLP-1) receptor agonists. GLP-1 receptor agonists activate GLP-1 receptors in the pancreas and other organs.[11] The activation of these receptors causes several effects:

• Decreased appetite
• Slowed emptying of the stomach
• Changes to fat metabolism and energy expenditure
• Improvements in blood sugar metabolism

Like any medication, Wegovy has potential side effects. Knowing the potential side effects of any medication you take and when to seek medical attention is important. This article reviews the potential side effects of Wegovy. 

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Overview of Wegovy Side Effects

There are many potential side effects to Wegovy that range from common, less serious side effects to life-threatening ones.  

Common Side Effects

Common side effects (reported in 5% or more of people) of Wegovy are [14,15]: 

• Nausea
• Dizziness
• Vomiting
• Constipation
• Abdominal pain
• Headache
• Fatigue
• Dyspepsia
• Dizziness
• Abdominal distension
• Belching
• Low blood sugars
• Flatulence
• Heartburn/reflux
• Gastroenteritis 

Less Common but Notable Side Effects

Wegovy also has several side effects that are less common but still important to understand. Some of these include [9]:

• Vision changes
• Dehydration
• Heart palpitations
• Injection site reactions
• Fatigue
• Dizziness 

Serious Side Effects

The serious side effects of Wegovy include [14,9,7]:

• Inflammation of the pancreas – symptoms include severe abdominal pain, nausea, and vomiting
• Allergic reactions – characterized by rash, itching, hives, facial swelling
• Gallbladder disease
• Thoughts of self-harm or suicide
• Thyroid cancer
• Gastroparesis
• Bowel obstruction

Anesthesia Risks

Wegovy slows the emptying of stomach contents, which increases the risk of complications during surgical anesthesia. In sedated patients, the delayed gastric emptying associated with Wegovy significantly heightens the risk of pulmonary aspiration if food is regurgitated during surgery.[7] 

Who Is at Higher Risk for Side Effects

Many factors may increase the risk of developing Wegovy. People with:

• A pre-existing stomach condition or who has had pancreatitis in the past may be more likely to develop gastrointestinal side effects or pancreatitis.
• A family history of multiple endocrine neoplasia is at a theoretically increased risk of developing medullary thyroid cancer.[14]
• Diabetes are at an increased risk of developing hypoglycemia (low blood sugars), especially if they are on other medications for the condition. 

Another potential side effect of Wegovy and other GLP-1 medications is sarcopenia (muscle loss). This is common with many medications with the potential to cause significant weight loss. People at greater risk include those who:

• Are inactive, have insulin resistance, certain autoimmune conditions such as rheumatoid arthritis, or other conditions like chronic obstructive pulmonary disease (COPD), kidney disease, diabetes, or cancer are at an increased risk of developing sarcopenia.[8]  

Special Considerations for Healthcare Providers

It is important to screen patients for conditions that significantly increase the risk of serious side effects before starting them on Wegovy. For example:

• Patients with a history of medullary thyroid cancer or multiple endocrine neoplasia syndrome type 2 should not take Wegovy.[8,13] 
• Patients with kidney impairment, diabetic retinopathy, pancreatitis, or are on other medications to lower their blood sugars should be carefully monitored. 

It’s also important to be aware that slowed gastric emptying may affect the absorption of other medications taken orally. 

Women who are planning to get pregnant should stop taking Wegovy and other GLP-1 medications at least 2 months before getting pregnant, as these medications are contraindicated in pregnancy.[5] 

Managing Wegovy Side Effects

Nausea and vomiting are the most common side effects patients experience. Eating smaller, more frequent meals, regular sips of cold fluids, and ginger-containing foods or beverages may help alleviate nausea and vomiting.[4] Heartburn may also be managed with small meals. 

Small, frequent sips of fluids can also help manage dehydration associated with Wegovy use.

When to Seek Medical Attention

Some of the potential side effects of Wegovy, such as pancreatitis and gallstones, can be serious and potentially life-threatening. These conditions require immediate medication attention [15]:

• Severe abdominal pain
• Yellowing of the skin or eyes
• Swelling of the face or neck
• Severe rash or dizziness
• Severe dizziness
• Very rapid heartbeat

Comparison to Other Weight Loss Medications

Wegovy is one of three medications approved for weight loss in the GLP-1 class. Saxenda (liraglutide) and Zepbound (tirzeptide) are the other two. Zepbound is a dual-acting medication that affects gastric inhibitory polypeptide in addition to GLP-1. Ozempic is another medication that is frequently mentioned for weight loss. Ozempic is the same compound as Wegovy (semaglutide) but is FDA-approved for diabetes.

How Wegovy Compares

The primary difference between Wegovy and Ozempic is what they are approved to treat and the doses used. Wegovy pens contain a single dose of medication, while Ozempic pens have multiple doses. 

The side effects of Saxenda and Zepbound are similar to those of Wegovy. There are no head-to-head studies to compare side effect profiles. Still, in individual studies, many of the common side effects associated with the medications were slightly more common in Wegovy than in Zepbound.[3]

Clinical Studies on Wegovy Side Effects

A 2021 study in the New England Journal of Medicine showed significantly more gastrointestinal side effects in patients taking semaglutide than those taking a placebo (74.2% vs 47.9%). Most of these side effects resolved over time without having to stop the medication. About 9.8% of people on semaglutide reported serious side effects vs. 6.4% in the placebo group.[16]

Patient Education and Support

Patient education and support are important components when starting any new medication. 

Effective Communication with Patients

Before initiating any therapy, it’s important to ensure patients know the potential side effects of medications. Patients should be made aware of signs and symptoms that would lead them to seek urgent medical care and the importance of regular monitoring. 

Patients may want to seek online support groups or consider looking at resources that the manufacturer offers for patients on the medication. Novo Nordisk, the manufacturer of Wegovy, also offers health coaching and other resources.[2]

Using Wegovy Safely

When using any medication, it’s important to take it as prescribed and have regular follow-up appointments with a healthcare provider. Routine monitoring can help minimize risks associated with Wegovy. 

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Key Takeaways

• Wegovy is a new, effective medication for weight loss
• GI side effects are among the most common
• People with a family history of medullary thyroid cancer or multiple endocrine neoplasia syndrome 2 should not take Wegovy.
• Wegovy should be stopped at least 2 months before getting pregnant
• Patients on Wegovy should have routine follow-up and monitoring
• Wegovy is most effective when combined with lifestyle modifications.
• Patients and healthcare providers should know the common and potentially serious side effects of Wegovy and other GLP-1 medications.