Wegovy side effects: Why do they happen? What can you do?

Obesity is a complex, chronic disease that affects over 40% of adults in the United States. Wegovy® is an FDA-approved medication for the treatment of obesity that can help patients lose, on average, around 15% of total body weight when combined with healthy dietary and physical activity patterns. A weight loss of just 5-10% can improve comorbid conditions such as type 2 diabetes, high blood pressure and high cholesterol, with a weight loss of over 10% leading to even greater improvement in weight-related conditions. While taking Wegovy for weight loss is very safe and effective for most people, there are potential side effects that people should consider before introducing Wegovy to your system. Side effects of Wegovy range from mild to potentially serious in nature.  In this article, we will review when Wegovy side effects start, whether the side effects of Wegovy go away, what the common and rare side effects that can occur while taking Wegovy, and strategies to reduce the risk of side effects while taking Wegovy.

Understanding Wegovy side effects

Wegovy is a glucagon-like peptide-1 (GLP-1) receptor agonist that mimics gut hormones that our body naturally produces to reduce appetite and cravings in the brain and to increase feelings of fullness through slowed stomach emptying. It also has an effect on the pancreas and other cells in the body to improve blood sugar regulation. It is injected once a week subcutaneously, or under the skin, and is available in doses of 0.25 mg, 0.5 mg, 1 mg, 1.7 mg and 2.4 mg weekly doses.

To reduce the risk of side effects, Wegovy is usually started at the lowest 0.25 mg dose and increased every 4 weeks until the maximum (2.4 mg) dose is achieved. If a dose increase is not well tolerated, the dose can be reduced by the prescribing clinician until the medication is better tolerated. 

While GLP-1 is a naturally occurring hormone in the body, it is usually only produced right after eating to promote feelings of fullness and reduce feelings of hunger. Wegovy, however, increases levels of GLP-1 activity in the body throughout the day. The body has to adjust to the constant feelings of fullness which can lead to side effects. The good news is that these side effects are usually most bothersome when starting Wegovy and with each new dose increase. The side effects will start to improve over time as the body gets used to each dose. 

Common side effects of Wegovy

Common side effects of Wegovy include, but are not limited to:

• Nausea
• Vomiting
• Heartburn 
• Feeling bloated
• Belching
• Constipation
• Diarrhea
• Stomach discomfort
• Headaches
• Tiredness
• Dizziness
• Pain, redness or rash at the injection site

When do Wegovy side effects start?

Potential side effects are usually most noticeable when starting Wegovy and with dose increases and typically do improve over time. Additionally, many of these side effects can be reduced or avoided with simple lifestyle adjustments.

Do the side effects of Wegovy go away?

By now you may be wondering, do the side effects of Wegovy go away? There are several lifestyle changes your healthcare provider may discuss with you that can help to alleviate common side effects while taking Wegovy. 

• Eating more slowly and stopping when satisfied, but not overly full, can reduce many of the gastrointestinal side effects caused by Wegovy. Because Wegovy slows stomach emptying, most people report feeling more full on smaller portions and feeling discomfort if they overeat while taking Wegovy.
• Eating more bland foods and foods containing more water such as soups can also help with reducing nausea.
• Avoiding high fat or greasy foods is helpful to reduce gastrointestinal side effects because high fat foods also slow stomach emptying and can therefore make side effects such as nausea, bloating, heartburn and belching worse if eaten while taking Wegovy.
• Focusing on hydration throughout the day can help reduce the risk of headaches, dizziness and constipation while on Wegovy. Wegovy can reduce feelings of thirst in addition to reducing hunger so many people report needing to remind themselves to hydrate appropriately. 
• Getting outside for a walk or other activity can help reduce feelings of nausea. Physical activity can also improve constipation that may occur on Wegovy.
• Eating foods high in fiber such as fruits and vegetables can also help to alleviate constipation that some may experience on Wegovy.

It is important to contact your healthcare provider if bothersome side effects occur and before making any changes a medication or treatment plan.

Rare side effects of Wegovy

While most of the side effects that occur when taking Wegovy are benign and transient in nature, there are some rare but potentially serious side effects that should be considered when taking Wegovy.

Wegovy has a boxed warning aimed to alert healthcare providers and patients of a potentially serious adverse reaction, for potential risk of thyroid tumors and medullary thyroid cancer. It is recommended that patients tell their healthcare provider if they notice a lump or swelling in their neck, hoarseness, trouble swallowing, or shortness of breath. In studies with rodents, Wegovy and other GLP-1 medications caused thyroid tumors, including medullary cancer. The relationship between GLP-1 medications and medullary thyroid cancer is not clear in humans. For this reason, Wegovy should be avoided in patients with a personal or family history of a rare type of thyroid cancer called medullary thyroid carcinoma (MTC) or a rare syndrome called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

Other potential rare but serious side effects of Wegovy:

• Pancreatitis: inflammation of the pancreas that may present as severe upper abdominal pain, often radiating to the back, with nausea and/or vomiting. This requires urgent evaluation by a healthcare provider.
• Gallbladder Diseases: including gallstones which may obstruct the outflow duct from the gallbladder may require urgent surgery. Patients should seek medical care urgently if they experience severe pain in the upper, right side of the abdomen, nausea, fever, yellowing of the skin or eyes or clay-colored stools.  
• Hypoglycemia (low blood sugar): can occur if Wegovy is taken with another glucose-lowering medication such as insulin or a sulfonylurea medication. Patients should monitor home blood sugars if on these medications together and follow up closely with their healthcare providers to make any necessary medication adjustments. Symptoms of low blood sugar may include dizziness, shakiness, sweating, weakness, tiredness, irritability, confusion, fast heartbeat, and hunger.
• Vision changes in people with Type 2 Diabetes: treatment with Wegovy may cause worsening of an eye condition called Diabetic Retinopathy. Patients with diabetes should undergo regular eye exams and tell their healthcare provider if any vision changes occur.
• Kidney Injury: can occur in patients with underlying kidney disease who become dehydrated due to significant vomiting or diarrhea while on Wegovy. Preventing dehydration with adequate fluid intake is important while taking Wegovy.
• Increase in Heart Rate: can occur while taking Wegovy. In most cases, this is a mild increase in heart rate that is not of concern but patients should seek medical care if they notice their heart racing or pounding for several minutes while at rest on Wegovy. 
• Depressive symptoms or thoughts of suicide: patients should watch for any worrisome changes in mood, behaviors, thoughts or feelings and contact their medical provider right away if any worrisome changes occur.
• Serious Allergic Reaction: patients should stop using Wegovy right away and seek urgent medical care if symptoms of serious allergic reaction occur including swelling of the throat, tongue or face, difficulty breathing or swallowing, severe rash or itching, fainting or feeling lightheaded or rapid heart rate.

What you can do

While most side effects on Wegovy do not require urgent medical attention, there is a risk of potential serious side effects on Wegovy that require urgent medical attention. Patients should be aware of the potential side effects and risks associated with taking Wegovy and seek immediate medical attention if they notice any of the severe signs or symptoms discussed above or any other concerning, serious symptoms while taking Wegovy.

There are some simple ways to reduce the risk of serious complications on Wegovy. 

• Avoiding excessive alcohol reduces baseline risk for pancreatitis (drinking alcohol while taking Wegovy is generally not recommended)
• Staying well hydrated reduces risk of dehydration and kidney injury.
• For people with diabetes, staying up to date on regular eye exams reduces the risk of vision-related complications.
• For people with diabetes, checking blood sugars regularly and keeping the medical team informed can help to reduce the risk of low blood sugars.
• For all patients, having regular appointments with the healthcare team and communicating with the medical team about any changes noted while on Wegovy helps the medical team to catch any concerning symptoms more quickly and appropriately address potential risks. 

Implementing lifestyle changes when taking Wegovy

From before Wegovy side effects start until after side effects of Wegovy go away, there are many simple lifestyle changes that can be beneficial for reducing side effects and improving well-being while on Wegovy. These include:

• Eating more slowly and stopping when satisfied, but not overly full.
• Eating lighter foods including plenty of lean proteins, fruits and vegetables, and avoiding foods while taking Wegovy that are high in fat or greasy.
• Drinking plenty of water throughout the day.
• Getting outside regularly for physical activity.

These habits are not only helpful for reducing side effects and avoiding weight loss plateaus on Wegovy but also great habits for achieving a healthy weight!

Seeking professional medical support and guidance on Wegovy

Wegovy side effects can be different for everyone and recommendations for managing these side effects should be individualized to each person’s unique needs. We recommend working closely with a healthcare provider who is experienced in prescribing Wegovy and with the various side effects that can occur while taking this medication. At Form Health, all of our doctors are board certified in Obesity Medicine. They are experienced at prescribing Wegovy and can help patients navigate any side effects that may occur.

Empowered and prepared: Taking Wegovy with confidence

While Wegovy can produce side effects in some people, most side effects of Wegovy go away over time throughout your Wegovy experience. Healthy lifestyle changes can help to reduce any side effects that may occur while taking Wegovy. Wegovy should be taken under medical supervision from a clinician experienced in prescribing and managing the side effects of Wegovy. 

At Form Health, patients work with Registered Dietitians and doctors who are board certified in Obesity Medicine to find the treatment plan that works best for them based on their unique history, other medical conditions, and health goals. At Form Health , medications such as Wegovy may be prescribed, if appropriate, along with healthy lifestyle modifications to help patients achieve sustainable weight loss and manage any side effects along the way. If you are interested in learning more about how the Form Health program may help you achieve your weight loss and health goals, take our quiz to find out if you are eligible for the Form Health medical weight loss program. 

Wegovy® is a registered trademark of Novo Nordisk A/S.