Can I finally use the "magic drug" to lose weight? All your concerns are here

Written by: David Duan

In the "weight loss circle",

The "magic drug" for weight loss that has become popular in the past two years: semaglutide

I believe everyone must be familiar with it.

As a hypoglycemic drug,

It has a significant effect in reducing body weight.

It has become a "magic tool" for many people to lose weight.

Previously, although semaglutide injection was included in the national medical insurance catalogue, its payment scope was limited to two situations related to type 2 diabetes in adults. Weight loss was not within the payment scope, medical insurance could not reimburse, and it was suspected of being illegal to prescribe and purchase on behalf of others.

Screenshot from the National Drug Administration

However, the situation has changed recently. According to the WeChat official account of "Novo Nordisk China R&D Center" on June 25, the National Medical Products Administration (NMPA) recently approved the marketing application of NovoWin (semaglutide injection for long-term weight management) developed and produced by Novo Nordisk in China.

This means that semaglutide has finally been legitimately used for weight loss in China.

Who is suitable for it? How effective is it for weight loss? Can it be reimbursed by medical insurance? Let's take a look at these questions that everyone is concerned about.

Who is suitable for it?

It is suitable for long-term weight management of adult patients based on controlling diet and increasing physical activity. The initial body mass index (BMI) meets the following conditions: ≥30kg/m2 (obesity), or ≥27kg/m2 to <30kg/m2 (overweight) and the presence of at least one weight-related comorbidity, such as hyperglycemia, hypertension, dyslipidemia, obstructive sleep apnea or cardiovascular disease.

Oral or injection?

Currently in China, semaglutide is approved for the treatment of weight loss only in the form of an injection, not an oral form, which means that patients need to use the drug by injection.

How effective is it for weight loss?

NovoIn can achieve an average weight loss of 17% (16.8kg) and can last for 16 months. It can bring patients multiple health benefits beyond weight loss, and its safety has been widely verified.

What is the price?

In the United States, the price of Novo Nordisk's weight loss version of semaglutide (trade name: Wegovy) is US$1,350 per month. As for the domestic pricing, it has not yet been announced. Novowin said that the company has officially started the relevant process of drug supply as planned, and the price of Novowin will be announced when it is commercially launched.

Can medical insurance cover it?

After semaglutide injection was approved for use in type 2 diabetes in my country in April 2021, it was included in the national medical insurance catalogue through negotiations that year, and its price was less than one-tenth of that in the United States. However, semaglutide used for weight loss purposes cannot be covered by medical insurance. The "Interim Measures for the Management of Basic Medical Insurance Drugs" clearly stipulates that 8 types of drugs cannot be reimbursed by medical insurance, and one of them is mainly for "improving living conditions" such as enhancing sexual function, treating hair loss, losing weight, beautifying, quitting smoking, and quitting drinking. In this regard, semaglutide can be reimbursed for use as a hypoglycemic drug, but it cannot be reimbursed by medical insurance when used as a weight loss drug.

Can I use it if I want to lose weight?

"Obesity treatment is not 'weight loss' in the general sense, and this approval does not mean that anyone can use the drug for weight loss. Ji Linong, director of the Department of Endocrinology at Peking University People's Hospital, said in an interview with reporters that outpatients often want to be prescribed semaglutide for weight loss, and many of them have a BMI within the normal range. The hospital has a strict process for prescribing semaglutide. Clinical off-label use requires a series of evaluations, hospital approval, doctor guidance and regular follow-up. It is not recommended for patients with digestive system diseases, a history or family history of thyroid cancer, severe retinopathy, etc. Therefore, before use, it must be evaluated by a professional doctor. Currently, the drug is only approved for use in adult patients, and has not yet been approved for use in children under 18 years old in China.

Are there any side effects?

Any drug may have side effects, and semaglutide is no exception.

Related studies suggest that non-diabetic obese male patients who use semaglutide for weight loss have an increased risk of ED (erectile dysfunction) and testosterone deficiency.

In addition to this controversial question, the U.S. Food and Drug Administration (FDA) clearly stated in the announcement approving Wegovy (Novoying's overseas trade name) for marketing that its most common side effects include nausea, diarrhea, abdominal pain, bloating, vomiting, constipation, headache, fatigue, indigestion, dizziness, hiccups, hypoglycemia in diabetic patients, flatulence and gastroesophageal reflux.

The prescribing information for Wegovy also contains a black box warning to inform healthcare professionals and patients of the risk of thyroid C-cell tumors. Therefore, Wegovy should not be used in patients with a personal or family history of medullary thyroid cancer or in patients with the rare disease multiple endocrine neoplasia syndrome type 2.

Will weight loss rebound?

Previous studies have shown that after stopping semaglutide, users are prone to weight rebound. Within a year after stopping GLP-1 weight loss drugs, users usually regain more than two-thirds of the weight they lost before, but people who exercise during treatment with GLP-1 weight loss drugs do not have the same tendency to rebound after stopping the drug.

These studies show that although semaglutide has a significant effect on weight loss, weight management still requires comprehensive consideration of factors other than drug treatment.

There has never been a "magic weight loss drug" in the world.

If not combined with proper diet and exercise,

No weight loss program will produce long-term results.

I hope everyone will keep this in mind!

Reference sources: CCTV Finance, People's Daily Online, Xinwen Morning Post, National Business Daily, The Paper, etc.