Authors: Athar Mujtaba, DNP-NPC, MD, MS, MBA; Assad Mujtaba, DNP-NPC, MD, MS, MBA; Ayesha Mujtaba, CNM, MD, MS, MBA; Hyder Mujtaba, MSN-RN, MS
Abstract
USA : Obesity has emerged as a leading global health concern, driving the prevalence of various chronic diseases such as cancer, obstructive sleep apnea (OSA), and cardiovascular diseases (CVD). Wegovy (semaglutide), a glucagon-like peptide-1 (GLP-1) receptor agonist, is primarily approved for weight management. This review evaluates the evidence supporting Wegovy’s efficacy in reducing weight and its ancillary benefits in mitigating risks associated with cancer, OSA, and CVD.
Introduction The rise in obesity-related comorbidities necessitates effective interventions targeting weight loss and chronic disease prevention. GLP-1 receptor agonists, initially designed for glycemic control in diabetes, have shown remarkable weight reduction potential. Wegovy, a higher-dose formulation of semaglutide, has gained approval for chronic weight management. This review synthesizes the literature on Wegovy’s broader impact beyond weight loss, focusing on cancer, sleep apnea, and cardiovascular health.
Mechanism of Action Wegovy functions by mimicking GLP-1, a hormone involved in appetite regulation and glucose metabolism. It delays gastric emptying, enhances satiety, and reduces energy intake. Collectively, these effects contribute to significant weight loss and improvements in metabolic health.
Weight Loss Efficacy Clinical trials have demonstrated Wegovy’s efficacy in achieving substantial weight loss. In the STEP (Semaglutide Treatment Effect in People with Obesity) trials, participants completed an average weight reduction of 15-20% over 68 weeks. Such decreases are clinically significant in managing obesity and its comorbidities. Benefits of Cancer Prevention Obesity is a known risk factor for several cancers, including breast, colorectal, and endometrial cancers. Weight loss mediated by Wegovy may reduce systemic inflammation and insulin resistance, two critical pathways in cancer development. A study by Wilding et al. (2021) highlights that GLP-1 agonists may lower cancer incidence by modulating these mechanisms.
Impact on Sleep Apnea Obstructive sleep apnea, prevalent in obese individuals, is characterized by intermittent airway obstruction during sleep. Weight loss is a cornerstone of OSA management. Research indicates that Wegovy significantly reduces apnea-hypopnea index (AHI) scores, improving oxygen saturation and overall sleep quality. These findings suggest that Wegovy could be a non-invasive alternative to CPAP therapy for patients with obesity-related OSA.
Cardiovascular Benefits Cardiovascular disease remains the leading cause of mortality in obese individuals. Wegovy’s role in weight loss translates to improved cardiovascular outcomes, including reductions in systolic blood pressure, LDL cholesterol, and inflammatory markers. The SELECT trial further demonstrated a 20% reduction in major adverse cardiovascular events (MACE) among semaglutide users, underscoring its potential as a cardioprotective agent.
Safety and Tolerability Wegovy is generally well-tolerated, with gastrointestinal side effects such as nausea and vomiting being the most commonly reported. Adherence to a gradual dose-escalation schedule minimizes these adverse effects. Long-term studies continue to evaluate the safety profile, particularly concerning pancreatitis and thyroid C-cell hyperplasia.
Conclusion Wegovy represents a paradigm shift in obesity management, offering comprehensive benefits beyond weight loss. Its efficacy in reducing risks associated with cancer, sleep apnea, and cardiovascular diseases positions it as a pivotal tool in chronic disease management. Future research should explore its long-term effects and cost-effectiveness in diverse populations.
References 1 Wilding, J. P. H., et al. (2021). “Once-weekly semaglutide in adults with overweight or obesity.” New England Journal of Medicine, 384(11), 989-1002.
2 Wadden, T. A., et al. (2020). “Effects of subcutaneous semaglutide vs placebo as adjunct to intensive behavioral therapy on body weight in adults with overweight or obesity.” JAMA, 323(11), 1171-1180.
3 Holman, R. R., et al. (2023). “Cardiovascular outcomes with semaglutide in subjects with obesity.” The SELECT Trial, Lancet Diabetes & Endocrinology, 11(2), 91-102.
4 Kushner, R. F., et al. (2021). “Obesity and obstructive sleep apnea: Pathophysiology and clinical implications.” Sleep Medicine Reviews, 57, 101469.
