The new oral formulation of Wegovy, containing the same active ingredient semaglutide as the injection, has begun shipping to UK pharmacies, offering a less invasive option for individuals seeking to break through weight-loss plateaus. However, early user experiences indicate a challenging adjustment period marked by notable side effects.
Louise Atkinson, an early recipient of the Wegovy pills, detailed her first month of use, highlighting the shift from weekly Mounjaro injections to a daily tablet. While anticipating greater simplicity, she was initially met with a collection of medications to manage potential side effects, including those for diarrhea, bloating, constipation, and heartburn. Atkinson had previously lost 2 stone (approximately 28 pounds) on Mounjaro over 18 months and was seeking to shed a final half stone to reach a BMI within the healthy range.
The Wegovy pills, available privately in the UK since early July, utilize a special coating to protect the semaglutide as it passes through the stomach lining. Manufacturers, Novo Nordisk, have released only the two lowest doses initially, with higher doses expected later. The pills are priced similarly to the injection form, around £100 for a month's supply of the lowest dose, while Mounjaro remains more expensive at £150.
Initial Side Effects and Adjustment
Atkinson's first week was characterized by a bitter-tasting pill that required an empty stomach and strict adherence to not eating or drinking for at least 30 minutes afterward. Stress dreams and intense sugar cravings emerged, leading to concerns that the 4mg dose might not be potent enough. By day four, nausea set in, described as a mild, persistent discomfort. Rachael Joy, chief clinical officer at SheMed, explained that semaglutide has a long half-life, meaning it accumulates in the body over several weeks to reach a steady state. While serious complications like pancreatitis are rare, Joy noted that oral semaglutide might lead to more gradual weight loss, potentially reducing the risk of such issues compared to injections, though more real-world data is needed.
By the second week, despite efforts to maintain healthy eating habits, Atkinson experienced evening nibbling and wine cravings, accompanied by waves of nausea and a subsequent itchy rash on her neck and upper shoulders. Diarrhea and gastrointestinal discomfort also contributed to fatigue. She observed similar struggles reported by other users in online support groups. Despite the adverse effects, Atkinson decided to persevere, citing the cost-effectiveness of the pill for weight maintenance compared to Mounjaro and the consistent daily suppression of appetite it provided.
Breakthrough and Sustained Progress
The third week brought a slight weight loss of one pound, and a reduction in side effects. The evening cravings and nausea lessened, and the rash cleared with antihistamines. The routine of taking the pill became more manageable, with occasional nausea now seen as reassurance that the medication was working. However, constipation emerged as a new challenge, managed with a fiber drink and prunes. Fatigue persisted, leading to afternoon sleepiness.
By the fourth week, Atkinson's weight dropped to 11st 4lb (approximately 158 pounds), indicating a breakthrough after a year-long plateau. She expressed optimism about reaching her weight-loss goal and achieving a healthy BMI for the first time in three decades. The side effects had completely subsided, and she found an easy rhythm with the daily pill, noting its convenience for travel and its effectiveness in resisting temptations like cocktails and pastries. She plans to continue with the 4mg dose, considering a switch to the lower 1.5mg dose once her goal weight is achieved to maintain long-term GLP-1 levels.
Atkinson also noted that the side-effects care package, initially provided, was not included with her second supply of pills, with SheMed clarifying it was a one-time support gesture for first-time users. She expressed hope for future price reductions to increase accessibility, mentioning the upcoming approval of another GLP-1 pill, Foundayo, which might instigate a price war. Despite the initial cost, she concluded that savings on food and other expenses effectively made the daily pill virtually free.