Understanding Approval: A Closer Look

Wegovy (semaglutide) received its initial approval for medical use in the United States in June 2021. The U.S. Food and Drug Administration (FDA) approved it as an adjunct to diet and exercise for chronic weight management in adults with obesity. Similar to other well-known medications like Ozempic, Mounjaro, and Rybelsus, Wegovy operates by mimicking GLP-1 (glucagon-like peptide-1) hormone receptors in the gut, which are responsible for inducing feelings of fullness. The primary mechanism behind weight loss with Wegovy is a reduction in appetite or caloric intake.

Research Insights: Impressive Results

The Semaglutide Treatment Effect in People with Obesity program, or STEP, comprises a series of clinical trials funded by Novo Nordisk, utilized by the FDA during the approval process of Wegovy. The STEP trial, detailed here, showcased a mean reduction in body weight from baseline to week 68 of −14.9% in the group receiving injectable semaglutide (Wegovy). This effectiveness is notably higher compared to traditional medications like phentermine, which typically result in single-digit percentages of weight loss. Ongoing studies, including the STEP 5 trial, have replicated these findings over a two-year treatment period, marking the longest clinical trial of semaglutide injections for weight loss to date.

Challenges to Accessibility

Regrettably, the cost of a month's supply of Wegovy can exceed $1000, even at lower doses. Without insurance coverage, which we discussed in this article, medications such as Wegovy remain financially out of reach for many individuals who could benefit from them. So, what alternatives are available? Fortunately, there are two: alternatives and generics.

Wegovy Substitutes

While not the primary option, several effective alternatives to semaglutide, the active ingredient in Wegovy, exist. One such alternative is tirzepatide, also known by its brands Mounjaro and Zepbound. A clinical trial in 2023 titled SURMOUNT, similar to Eli Lilly's version of the STEP trials, revealed that, on average, participants lost 26.6% of their weight over an 84-week treatment period. This is a significant difference compared to the 15% average weight loss observed with semaglutide. However, many individuals find semaglutide to be more tolerable and affordable than tirzepatide. At MD Exam, we generally recommend starting with semaglutide and considering a switch to tirzepatide if weight loss plateaus or a more aggressive approach is desired.

Generic Versions of Mounjaro

Another option is a generic form of Wegovy, though the correct term would be compounded semaglutide. Official generic versions cannot be produced until the specified patent term expires, but compounded medications serve a similar purpose. These medications are less expensive and contain the same active ingredient as branded medications but cannot be marketed or labeled with the same name. For more information on compounding, refer to this article.

Understanding Compounding

Compounding involves customizing medications to meet the unique needs of each patient, especially when standard medications are unsuitable due to allergies, intolerances, or other specific requirements. Pharmacists collaborate with healthcare providers to create personalized medications, which may involve adjusting the dose, altering the form of the medicine, or omitting ingredients that could cause issues. Compounded medications cannot be sold under brand names like Wegovy; for example, semaglutide produced in a compounding pharmacy would be referred to as compounded semaglutide, not Wegovy, to comply with patent laws.

Where to Find Alternatives or Generics

To explore the use of tirzepatide or semaglutide for weight loss, it's essential to consult with a healthcare provider such as the medical team at MD Exam. We offer semaglutide and tirzepatide at as little as $300 a month and provide a simple questionnaire for sharing medical history and setting up a personalized weight loss plan. Typically, we initiate treatment with semaglutide, as it is slightly cheaper and better tolerated than tirzepatide, reserving the latter for individuals seeking more aggressive weight loss or experiencing dissatisfaction with semaglutide. Both medications have demonstrated effectiveness and varying tolerability among individuals. Healthcare professionals, like the MD Exam team, play a significant role in understanding overall health, tailoring treatment plans, and discussing potential risks and benefits. While we'd be delighted to assist you, if you don’t choose us it is essential to exercise caution when seeking compounded medications. Many services offer only retail-priced branded medications, and those providing cheaper compounded versions may not be reputable. Look for accreditations, thorough medical inquiries, and testimonials to ensure reliability.

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