Medical Review by Jennie Stanford, MD, FAAFP, DABOM
Summary:
- Before starting Wegovy®, have an open conversation with your healthcare provider about your weight loss goals, medical history, and any medications you’re taking to ensure a safe and effective start.
- Wegovy® is a once-weekly injection that begins at a low dose of 0.25 mg, gradually increasing over five months. Your provider will guide you through dose adjustments based on how your body responds.
- As your body adjusts, you may experience appetite changes, shifts in energy levels, and digestive side effects, like nausea or constipation. These effects are usually temporary and manageable with small dietary and lifestyle adjustments.
- Serious side effects of Wegovy® require immediate attention, including severe stomach pain, allergic reactions (swelling, trouble breathing), and mood changes like depression or suicidal thoughts. Stop taking Wegovy® and contact your provider if you experience any of these symptoms.
- Regular check-ins with your provider are key to monitoring your response to Wegovy®. If you struggle with side effects or dose increases, adjustments can be made to ensure a smoother experience.
When beginning your weight-loss journey with Wegovy®, you may be unsure of how to navigate the road ahead. Wegovy®, a GLP-1 receptor agonist, is a branded form of semaglutide. It is an FDA-approved injection designed to help with long-term weight management in people with obesity. It is also prescribed to those who are overweight and have a weight-related health condition like high-blood pressure, type 2 diabetes or high cholesterol.
The team at Lemonaid Health is here to help you learn what to expect when starting Wegovy®. In this guide, you’ll find helpful tips on preparing for the initial consultation with your healthcare provider, a breakdown of how to manage the most common side effects that appear during your first few weeks, and notes on what to expect with long-term use of this medication.
Learn more: The ultimate guide to Wegovy®: uses, benefits, side effects & more
Your initial consultation & your prescription
When preparing to speak to your healthcare provider about Wegovy®, it is important to be honest with what you want in terms of weight loss. It may be helpful to bring in notes on how you feel and a list of any questions you want to ask.
Be sure to tell your healthcare provider if you:
- Have or have had problems with your pancreas or kidneys
- Have type 2 diabetes and a history of diabetic retinopathy
- Have or have had depression, suicidal thoughts, or mental health issues
- Are scheduled to have surgery or any other procedures that use anesthesia or deep sedation
- Are pregnant or plan to become pregnant
- Are breastfeeding or plan to breastfeed, as it is not known if Wegovy® passes into your breast milk
You should also tell your healthcare provider about all medications you are taking, including prescriptions, over-the-counter drugs, vitamins, and supplements. Wegovy® can interact with other medications, including diabetes treatments such as insulin. Since Wegovy® slows stomach emptying, it can affect how some medicines are absorbed into your bloodstream.
Your healthcare provider will review your medical history and individual health factors to determine whether a prescription for Wegovy® is clinically indicated for your case. If they do prescribe Wegovy® to you, the next step will be to determine your dosage and teach you about administering your medication.
Dosage & administration
Wegovy® is available in five different dose strengths and is given as a weekly injection under the skin.
At the beginning of your Wegovy® treatment, you’ll start with a low dose of 0.25 mg once a week, gradually increasing the dose every four weeks. At month five, your healthcare provider will decide if your maintenance dose should be 1.7 mg or 2.4 mg, depending on what will work best for your specific needs.
It may be helpful to check-in with your healthcare provider each time you step up a dose. Remember, your healthcare provider is your partner in treatment, and you have the power to strengthen that partnership by keeping them informed of your progress.
Learn more: Microdosing semaglutide medications
What to expect during your first few weeks with Wegovy®
Understanding what to expect when you first start Wegovy® can make the transition smoother and set you up for long-term success.
Starting Wegovy® comes with gradual adjustments as your body adapts to the medication. In the first few weeks, along with side effects, you may notice changes in appetite, digestion, and energy levels as semaglutide begins to take effect.
Monitoring your weight & health
Wegovy® is often prescribed for weight loss in patients who also have conditions like high-blood pressure, type 2 diabetes or high cholesterol. Because of this, your healthcare provider may request lab work to check your hemoglobin A1C. This is a blood test that shows your average blood sugar level over the past 2-3 months.
Generally used for measuring the effectiveness of type 2 diabetes treatment, monitoring your A1C levels helps your healthcare provider assess whether your blood sugar levels are moving in the right direction.
Managing potential side effects
When starting Wegovy®, you may experience side effects, though they tend to vary from person to person. The good news is that many of these side effects can be managed with the right approach.
The most common side effects associated with Wegovy® are:
- Diarrhea and vomiting
- Constipation and feeling bloated
- Stomach pain and upset stomach
- Nausea
- Fatigue
- Headache
- Dizziness
- Low blood sugar in people with type 2 diabetes
- Gas and belching
- Stomach flu
- Heartburn
- Runny nose or sore throat
General tips for managing common Wegovy® side effects
Some of the more common side effects–including vomiting, diarrhea, abdominal pain and constipation–can be managed with a few small changes to your eating habits.
To help manage side effects associated with GLP-1 receptor agonists, try the following:
- Eat slowly and only when hungry
- Eat smaller portions more frequently
- Stop eating at first sign of fullness
- Avoid drinking through a straw
- Don’t lie down after meals
- Try to avoid physical activity after meals
- Don’t eat too close to bedtime
Nausea
If you’re still feeling nauseous 30 minutes after your dose, try limiting your diet to bland, low-fat foods such as toast. You can also try snacking on apples, or ginger-based drinks to help settle your stomach. Fresh mint or ginger root may also be soothing. Additionally, it’s best to steer clear of strong smells—that’s because they might make your nausea even worse.
Vomiting and diarrhea
For diarrhea, foods like chicken broth, rice, carrots, and very ripe fruit without the skin can provide relief, but you should also take steps to avoid the following:
- Isotonic drinks (ie. sports drinks)
- Dairy products
- Coffee
- Alcohol and soft drinks
- Products with sweeteners ending in “ol” (sorbitol, mannitol etc.), including gum and candy
- Foods with high fiber content
To reduce your risk of vomiting, try eating smaller meals with more frequency throughout the day. If you are experiencing persistent vomiting, avoid drinking liquids during meals. Instead, plan to have liquids between 30 to 60 minutes before or after meals.
Constipation
If you’re having feelings of constipation, get moving and stay hydrated—adequate water can help with stool movement.
Make sure your meals include enough fibre, along with a well-balanced diet, to keep things running smoothly.
Know when to call your healthcare provider
Some serious side effects can occur with Wegovy® and should not be ignored.
- Inflammation of pancreas: Severe pain in your stomach or abdomen that won’t go away.
- Hypoglycemia:Hypoglycemia is a condition when your blood sugar levels drop too low (below 70 mg/dL). It’s most commonly seen in people with diabetes but can also happen due to excessive exercise, alcohol consumption, or certain medications. Signs and symptoms can include:
- Dizziness or lightheadedness
- Blurred vision
- Sweating
- Slurred speech
- Confusion or drowsiness
- Shakiness and weakness
- Headache
- Racing heartbeat
- Serious allergic reactions: Signs and symptoms can include:
- Swelling of face lips tongue or throat
- Severe rash or itching
- Problems breathing or swallowing
- Rapid heartbeat
- Fainting or feeling dizzy
- Gallbladder problems: These may include:
- Pain in your abdomen
- Clay-colored stools
- Yellowing of skin or eyes
- Fever
Other potentially serious problems when taking Wegovy® include kidney problems and kidney failure, severe stomach problems, increased heart rate, changes in vision in people with type 2 diabetes, and depression or thoughts of suicide.
Stop taking Wegovy® and contact your healthcare provider immediately if you are experiencing any of the serious side effects listed above.
Lifestyle & dietary considerations
Using Wegovy® is only one part of your weight-loss journey. In clinical trials, Wegovy® was prescribed as part of a treatment which also included diet and lifestyle counselling.
When used in combination with a reduced-calorie diet and increased physical activity, Wegovy® can be an effective piece of the puzzle to achieve your long-term weight-loss goals. The steps below can help support your Wegovy® use—be sure to follow any specific advice you get from your healthcare provider as well.
Avoiding triggers
Certain dietary choices may have an impact on how Wegovy® works for you. It is recommended to avoid spicy foods, sweet dressings and canned foods, as these can contribute to your risk of experiencing side effects.
Try keeping a food journal, and make note of what is working—and not working—for you and your specific needs.
Keeping up with regular exercise
When combined with lifestyle modifications, especially exercise, studies have shown that weight-loss medications are more effective than using them without exercise.
In weight-loss medication maintenance trials, it was reported that moderate-to-vigorous exercise helped limit side effects of increases in heart rate. Though more studies are needed, pairing exercise with semaglutide is thought to have the same effect, while boosting cardiorespiratory fitness.
Long-term expectations with Wegovy®
A key advantage to treatment with Wegovy® is it is suitable for long-term weight management.
According to one study, patients taking 2.4 mg of Wegovy®, lost between 9.6 and 17.4% of their initial body weight in a 68-week program.
Wegovy® (semaglutide) not only stands out for its effectiveness in weight reduction, but also has heart-protective benefits.
Dosage adjustments & check-ups
As you begin taking Wegovy®, your dosage amount will be steadily increased over time. At week 17, and after consulting with your healthcare provider, your maintenance dose should remain at 2.4 mg.
However, if you’re experiencing difficulty with the dosage increase, your healthcare provider may recommend delaying the increase for another four weeks.
If your final maintenance dose of 2.4 mg is not well-tolerated, you may have your dose decreased to 1.7 mg weekly, for up to four weeks.
It is important to keep your healthcare provider informed about how you feel with each dose increase, and let them know if you are noticing any adverse side effects.
Learn more about starting Wegovy® with Lemonaid Health
Starting Wegovy® can be a significant step towards long-term weight management, and understanding what to expect during the first few weeks can help you stay on track. By working closely with your healthcare provider, monitoring your progress, and making necessary diet and lifestyle adjustments, you can set yourself up for success.
Remember, weight loss is a journey, and with the right support and approach, Wegovy® can be a valuable tool in achieving your health goals. This is where Lemonaid Health can help. Book an online consultation with one of our US-based healthcare providers to get your questions about Wegovy® answered and see if it’s the right fit for your health journey.
Wegovy® is a registered trademark of Novo Nordisk A/S.
