Wegovy Programme - Month 2 Onwards - Building on Your Progress

Welcome to Month 2 of your Wegovy journey with healthwords.ai! Now that you’ve successfully completed the first month of treatment, you're ready to build on that solid foundation. Here’s what you can expect and what’s important in this next phase of your weight loss programme. This Healthwords Weight Loss Programme incorporates the provision of Wegovy by UK-registered doctors and pharmacists, alongside comprehensive counselling and support from world-class health coaches, nutritionists and dieticians.

Eligibility criteria

To participate in the programme, you must:

• Completed Month 1 - You should have been actively using Wegovy and following the healthwords.ai programme for at least 1 month. If you have not completed month 1, you can start HERE.
• should have had your progress reviewed by your healthcare professional, including any necessary adjustments to your personalised health plan.
• be 18 or over.
• have a body mass index (BMI) of 30 or more (adjusted to ≥27.5 for people from black, Asian and other ethnic minority backgrounds)
• have a diagnosis of diabetes (type 1 or type 2), hypertension or both
• have a smartphone or tablet
• not be pregnant.
• not have an active eating disorder diagnosis
• not have had bariatric surgery in the last two years
• not be at a higher risk of harm than benefit by participating in a weight management programme
• be motivated to change their lifestyle and can commit to the 12-week programme
• registered at a GP practice in England

What’s New in Month 2?

Continued dose adjustment

During Month 2, your dosage may increase again as you progress towards the optimal dose that supports your weight loss goals.

Focus on habits

This month, we’ll work with you to refine the healthy eating, exercise, and behavioural habits introduced in Month 1. Building on these changes will help ensure long-term success.

Managing side effects

While side effects like nausea may still occur, many users find that these lessen over time. If any symptoms persist, let us know right away so we can support you.

How it works

Clinical care

You will first have a clinical assessment reviewed by a registered medical or healthcare professional to ensure that the programme will be suitable and safe for you. Once you qualify, you will receive your initial prescription and supply of Wegovy.

A thorough consultation with a monthly prescription review will then be carried out by the clinical team to ensure that you are safely making progress.

The typical treatment time with Wegovy ranges from 3 to 12 months, depending on your starting point and target weight.

Digital wrap-around lifestyle support

From our chosen partners at Liva Healthcare, you will be able to access personalised support to help manage your weight, eat more healthily and be more physically active, which have been proven to reduce the risk of developing long-term health conditions or can help manage them. Your support will include:

• Digital one-to-one contact

• Specialist and personalised healthy lifestyle support from a health coach over 12 weeks, available via your smartphone or tablet with Liva’s app. You can connect with a health coach of your choice, with multiple languages spoken.

• Convenient app access via your smartphone. You’ll have support in your pocket, with no need to travel or arrange follow-up appointments.

• Monitoring and tracking of your personal health goals. With the Liva app, you will receive psychological, lifestyle and nutritional advice, and connect with a closed community of other people on the same journey as you, to help you gain confidence and keep up positive lifestyle changes in the long term.

Get Started

In your initial one-to-one video consultation with your health coach, you will provide some information about yourself, your health and well-being. They will help you prepare for the journey ahead and come up with an action plan to help you achieve your goals over the 12 weeks.

Get Focused

The first 6 weeks of the programme focuses on understanding how lifestyle can have an effect on your health and well-being. You’ll work towards your action plan with support from your health coach through weekly in-app check-ins (all via video message and text) and community group chat.

Maintain

For the remainder of the programme, you will continue to build confidence in maintaining your new, healthy choices. You will continue to track and monitor your progress on the Liva app, even after the programme ends.

The first step is to read more below before taking an eligibility check so that our clinicians can assess your suitability for this programme.

About Liva Healthcare coaching support

Liva Healthcare is a world-class provider of evidence-based healthy lifestyle change programmes for anyone living with obesity or those diagnosed with diabetes, hypertension or both.

Liva offers a unique hybrid digital therapeutics platform that combines personalised, one-to-one lifestyle coaching with innovative digital-first delivery.

Its team of dedicated healthcare professionals create tailored behaviour and lifestyle change programmes to support patients in their journey to prevent, manage and treat obesity, type 2 diabetes, pre-diabetes and other cardiometabolic conditions. The safety and efficacy of Liva’s digital therapeutic programmes are well-supported by extensive evidence from randomised controlled trials (RCTs) and other clinical studies.

Other successful programmes Liva has run in partnership with the NHS include:

• NHS Diabetes Prevention Programme,in which users reduced their chances of getting type 2 diabetes by more than a third (37%).

• NHS England Type 2 Diabetes Path to Remission Programme | Liva Healthcare, a 12-month pilot in which users reduced their weight by up to 10-15% of their starting weight.

For further information, contact: support-uk@livahealth.com.

About Wegovy

Product Summary

What is Wegovy?

WEGOVY® (semaglutide) is an injectable prescription medicine that may help people with obesity and those who have weight-related medical problems to lose weight and keep it off.  Wegovy should be used with a reduced-calorie meal plan and increased physical activity.

Who is eligible to use Wegovy?

Wegovy is recommended for weight management along with a reduced-calorie diet and increased physical activity in people who are obese with a body mass index (BMI) equal to or above 30kg/m2, or a BMI equal to or above 27kg/m2 with at least one weight-related health condition (such as type 2 diabetes, dyslipidemia or hypertension).

Wegovy is also approved in the US by the FDA as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management.

How does Wegovy work?

The active ingredient semaglutide is a type of drug known as a GLP-1 analogue, which works by mimicking the actions of the GLP-1 hormone in the body.  GLP-1 is a naturally occurring hormone that regulates appetite, glucose metabolism, and insulin secretion.

By activating GLP-1 receptors, Wegovy helps to increase feelings of fullness, slow down stomach emptying, and regulate blood sugar levels. This improved satiety, reduced calorie intake, and improved blood sugar control help people lose weight.

Wegovy is, therefore especially useful for patients who are not only very overweight but who also have type 2 diabetes or other weight-related medical conditions such as high blood pressure, and even those with risk of heart failure, as some studies suggest.

Dosage and how to use Wegovy

There are five different doses of Wegovy: 0.25 mg, 0.5mg, 1 mg, 1.7 mg, and 2.4 mg. Each dose comes in its own colour pen.

What is the recommended dosage of Wegovy?

Wegovy is typically started at a low weekly dose of 0.25 mg and increased over the course of 16 weeks as prescribed by the healthcare professional, in order to reach the optimal dose of 2.4 mg once weekly.

The dosage will normally be increased at 4-week intervals under the directions of the prescriber, depending upon the response as below:

• In the first month, the dose will most likely begin at 0.25mg.

• In the second month, the dosage is increased to 0.5mg once weekly.

• In the third month, the dosage is increased to 1mg once weekly.

• In the fourth month, the dosage is increased to 1mg once weekly.

• At week 16, a review to check that at least a 5% decrease in body-weight is achieved before continuing.

• A final increase to 2.4mg once weekly will take effect in the fifth month and beyond. You should keep taking this amount for the duration of your treatment.

Wegovy's different coloured prefilled injectable pen doses make it simple to identify the correct dose each week.

Patients will be given specific recommendations and instructions to help them take the right amount of Wegovy each week. Additional support from healthcare professionals will be provided as part of a comprehensive weight management plan in case of concerns or questions.

How to use Wegovy safely

Detailed instructions for use can be found in the patient leaflet that comes with the pens. Please read them thoroughly before use.

• Wegovy is given as an injection under the skin (subcutaneous injection).

• Do not inject Wegovy into a vein or muscle.

• The best places to give the injection are the upper arms, stomach or upper legs.

• Before you use the pen for the first time, ask your doctor or nurse how to use it.

Patients with diabetes

Tell your doctor if you have diabetes.

• Your doctor may adjust the dose of your diabetes medicines to prevent you from getting low blood sugar.

• Do not mix Wegovy up with other medicines that you inject (e.g. insulins).

• Do not use Wegovy in combination with other medicines that contain GLP-1 receptor agonists (such as liraglutide, dulaglutide, exenatide or lixisenatide).

When to use Wegovy

You should use this medicine once weekly on the same day each week.

You can give yourself the injection at any time of the day, regardless of meals.

How long can people use Wegovy?

Most patients on Wegovy should achieve their target weight within 6-12 months of starting. However, under certain circumstances, the treatment can be continued for up to 2 years.

It is important to note that Wegovy is only recommended for use for a maximum of 2 years under the monitoring and review of a prescriber. Further research is being carried out to see whether this can be extended.

For a small minority of patients who do not see at least a 5% reduction in body weight by week 16, the prescribers may discontinue the treatment if there is little benefit in continuing.

Product Ingredients

• The active substance is semaglutide.
• The other ingredients are disodium phosphate dihydrate, propylene glycol, phenol, sodium hydroxide/hydrochloric acid (for pH adjustment), and water for injection.

Sodium content: This medicine contains less than 1 mmol sodium (23 mg) per dose, i.e. essentially ‘sodium-free

Warnings and Restrictions

Who should not take Wegovy?

You should not take Wegovy if:

• you have had a serious allergic reaction to any of the ingredients in Wegovy

• you’re pregnant, planning to become pregnant, or are breastfeeding. This medicine should not be used during pregnancy, as it is not known if it may affect your unborn child. It is therefore recommended to use contraception while using this medicine.

If you wish to become pregnant, you should stop using this medicine at least two months in advance.

If you become or are pregnant, think you may be pregnant or are planning to have a baby while using this medicine, talk to your doctor straight away, as your treatment will need to be stopped.

You should not use this medicine if you are breastfeeding, as it is unknown if it passes into breast milk.

• you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC)

• you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

In addition, you should tell your doctor, pharmacist or nurse before using Wegovy, or during treatment if you:

• have diabetes: Wegovy must not be used as a substitute for insulin.

• have problems with your pancreas or kidneys.

• have diabetes with a history of diabetic retinopathy. Talk to your doctor if you experience eye problems while taking this medicine.

• have been depressed, suicidal or have had mental health issues.

• have severe and ongoing pain in the stomach area. If you have these symptoms, see a doctor straight away as this could be a sign of an inflamed pancreas (acute pancreatitis).

• have low blood sugar (hypoglycaemia): taking a sulfonylurea such as gliclazide or others, or insulin with Wegovy might increase the risk of low blood sugar levels (hypoglycaemia).

Other precautions:

• Effects on the digestive system: During treatment with Wegovy, you may feel sick (nausea), be sick (vomit), or have diarrhoea. These side effects can cause dehydration (loss of fluids). It is important that you drink enough fluids to prevent dehydration. This is especially important if you have kidney problems. Talk to your doctor if you have any questions or concerns.

• Your doctor may ask you to test your blood sugar levels. This will help your doctor decide if the dose of the sulfonylurea or insulin needs to be changed to reduce the risk of low blood sugar.

• Fast improvements in blood sugar control may lead to a temporary worsening of diabetic eye disease.

Children and adolescents

The safety and efficacy of Wegovy in children below 12 years of age have not been studied and it is not recommended for use in this population.

Driving and using machines

Wegovy is unlikely to affect your ability to drive and use machines. Some patients may feel dizzy when taking Wegovy, mainly during the first 3 months of treatment (see section 4). If you feel dizzy, you should not drive or operate machines until you feel better. If you need any further information, talk to your doctor, pharmacist or nurse.

For diabetics using this medicine in combination with sulfonylurea (e.g. gliclazide) or insulin, low blood sugar (hypoglycaemia) may occur, which may reduce your ability to concentrate.

Do not drive or use machines if you get any signs of low blood sugar.

Other medicines and Wegovy

Tell your doctor, pharmacist or nurse if you are using, have recently used or might use any other medicines.

What are the possible side effects of Wegovy?

Wegovy may cause serious side effects, including:

• possible thyroid tumours, including cancer. You should not use Wegovy if you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

• inflammation of your pancreas (pancreatitis)

• gallbladder problems

• increased risk of low blood sugar (hypoglycemia) in patients with type 2 diabetes

• kidney problems and kidney failure

• serious allergic reactions

• change in vision in patients with type 2 diabetes

• increased heart rate

• depression or thoughts of suicide

If you notice signs of any of these serious side effects, you should contact your doctor or healthcare professional.

Less serious and more common side effects may include:

• nausea

• diarrhoea

• vomiting

• constipation

• lower stomach pain

• headache

• tiredness

• upset stomach

• dizziness

• feeling bloated

• belching and gas

• heartburn

Contact your doctor or healthcare professional if any of these side effects are difficult to manage or don’t go away.

Storage

• Keep this medicine out of the sight and reach of children.

• Do not use this medicine after the expiry date which is stated on the pen label and carton after ‘EXP’.

• The expiry date refers to the last day of that month.

• Do not freeze Wegovy and do not use it if it has been frozen.

• Keep the pen cap on in order to protect from light.

Before opening:

Store in a refrigerator (2°C to 8°C). Keep away from the cooling element.

During use

• You can keep the pen for 6 weeks when stored at a temperature below 30°C or in a refrigerator (2°C to 8°C) away from a cooling element.

• Do not use this medicine if you notice that the solution is not clear and colourless.

• Do not throw away any medicines via wastewater or household waste.

• Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

Additional instructions

For more information, you can watch the official video from the manufacturer here: Wegovy Instructional Video

Clinical Evidence

What are the key benefits of Wegovy for Weight Management?

Significant weight loss: Wegovy has been proven to be an effective tool for weight loss.

In a 68-week medical study of 1961 adults living with obesity or excess weight with a related medical problem, about one in three achieved a 20% reduction in weight (in conjunction with a plan of reduced-calorie meals and increased physical activity).

•  83% of adults taking Wegovy lost 5% or more weight, compared to 31% taking a placebo

•  66% of adults taking Wegovy lost 10% or more weight, compared to 12% taking a placebo

•  48% of adults taking Wegovy lost 15% or more weight, compared to 5% taking a placebo

•  30% of people taking Wegovy lost 20% or more weight, compared to 2% of people taking a placebo

Improved glucose control: Wegovy's mechanism of action extends beyond weight loss. It can also help regulate blood sugar levels, making it particularly beneficial for individuals with type 2 diabetes.

Cardiovascular benefits: Some studies suggest that GLP-1 receptor agonists like Wegovy may have cardiovascular benefits, including a reduction in cardiovascular events.

Long-term solution: Wegovy can be used for an extended period, offering ongoing support for individuals working towards their weight management goals.

Source: www.wegovy.com

FAQ’s

Is Wegovy safe?

Yes, Wegovy is safe for most people to take if a doctor has said it<u> is</u>~~’s~~ suitable for you. However, there are certain conditions and health circumstances that may make your doctor less likely to prescribe the medication. For example, if you have or have had pancreatitis, your doctor might not prescribe Wegovy. It’s also not safe to use if you’re pregnant or plan to become pregnant, and you should stop using Wegovy two months before you plan to become pregnant. It<u> i</u>’s not known if Wegovy passes into your breast milk, so avoid it if you are breastfeeding or plan to breastfeed.

Can I drink alcohol while taking Wegovy?

Yes, you can drink alcohol while taking Wegovy. There are no known interactions between Wegovy and alcohol. However, alcohol and Wegovy both lower blood sugars, so it is advisable that you monitor your reaction to the medication in case you become light<u>-</u>headed or dizzy.

Can I drive while taking Wegovy?

Yes, you can drive while taking Wegovy, but it is recommended that you proceed with care until you are sure how Wegovy affects you.

Can I take Wegovy long-term?

Wegovy has been approved by the MHRA for the long-term treatment of obesity and can be used for as long as it remains beneficial.

Is Wegovy addictive?

There is no evidence to suggest that Wegovy is addictive.