Andrea Pereira, MD, PhD
On 01/02/2022, ANVISA (National Health Surveillance Agency) approved using Semaglutide 2.4 mg, called Wegovy, an injectable medication for obesity in Brazil.
According to data from the Brazilian Department of Health, 26% of the Brazilian population is obese, approximately 41 million people, and 60% of Brazilians are overweight. The World Obesity Federation published that in 2030, about 30% of Brazilians will be obese. Therefore, we will have an increase in these already alarming numbers.
In the years 2021 and 2022, the New England Medical Journal and Nature, with significant scientific impact, published the result of a clinical study called STEP, carried out in obese adults without diabetes and treated with Semaglutide 2.4 mg, injectable, once a week. In the previous study, about 15% of the weight was lost in 2 years. Most patients were female, with a mean age of 47 years, and had grade 2 obesity, with a body mass index ≥ 35 kg/m2. Regarding side effects, the most common were those associated with the digestive system, such as nausea and intestinal changes.
In Brazil, injectable semaglutide is already used for diabetic patients, with a maximum dose of 1.0mg. Although ANVISA does not release it for obesity, many people already use this substance for weight loss. The novelty at the beginning of the year is the release of semaglutide for obesity at a dose of 2.4 mg, injected into the subcutaneous tissue once a week. We still don't have the price or the commercialization of this medication in Brazil; already released in the United States in 2021, costing around $ 1350.00 per month. We emphasize that semaglutide is not approved by the public health system, nor is it part of the subsidized medications in the popular pharmacy program. Therefore it will not be economically accessible for everyone.
We must remember that obesity is a chronic disease with several causes, so not everyone can use this substance for weight loss. And depending on the clinical picture of each one, other medications may be associated or used alone. It is also important to emphasize that, along with drug treatment, it is necessary to adjust the diet, practice regular physical activity, psychological follow-up, and, often, bariatric surgery. Therefore, we have a multidisciplinary treatment where medication is part of, but not alone.
As a chronic disease with no cure, only control, treatment, and follow-up is for life. And preferably with a specialized professional. This dramatically increases the chances of successfully controlling this disease so common in Brazil.
Links:
https://www.nature.com/articles/s41591-022-02026-4
https://www.nejm.org/doi/full/10.1056/NEJMoa2032183
https://www.gov.br/anvisa/pt-br/assuntos/medicamentos/novos-medicamentos-e-indicacoes/wegovy-semaglutida