Wegovy is the first of the new “miracle” weight loss drugs approved by the FDA. Wegovy causes weight loss in a remarkable fashion in almost everybody, but there is a lot going on to make this happen. The drug companies will tell you weight loss from Wegovy is due to its two main effects on the stomach and brain, but the drug companies are not telling the whole story about Wegovy.

This image provided by Novo Nordisk in January 2023, shows packaging for the company’s Wegovy drug. 

How Does Wegovy Work to Cause Weight Loss?

Working along with weight-loss experts and robotic gastric bypass experts at the Florida Surgical Weight Loss Specialists, world-renowned endocrinology expert and endocrine surgeon Dr. Jim Norman took Wegovy as a 4-month experiment to find out how Wegovy works to cause weight loss and he discovered 10 different mechanisms which are described here for the first time--things the drug companies don't discuss.

Full dose Wegovy 2.4 mg injectable pen given once weekly.

This is my detailed account of how Wegovy worked for me to cause weight loss from 195 pounds to 170 in just over four months. Importantly, we perform thyroid, parathyroid and adrenal surgery--we do not do weight loss surgery and do not prescribe Wegovy or any other weight loss drugs--so this is my non-biased report. It is also important to know that I took Wegovy, but the same mechanisms are likely occurring for Mounjaro and Saxenda.

I’m not morbidly obese, but I’m tired of trying to lose 20 pounds for the past 20 years, thinking about calories every time I put something on my plate or grab a cocktail. This experiment was conducted with me changing nothing about what kinds of food I eat, and with no increase in my daily activity or increase in excercise. I did nothing different except inject myself with a Wegovy pen once a week, yet this experiment shows these miracle drugs cause weight loss 10 very different ways which I list here and then discuss in detail below.

10 Ways Wegovy Causes Weight Loss

1. Wegovy prevents eating of big meals – usually cannot finish entire meal
2. Wegovy suppresses appetite—you just don’t get hungry
3. Wegovy causes weight loss through intermittent fasting
4. Wegovy causes weight loss through development of ketosis (Atkins-like diet)
5. Wegovy requires less reliance upon “will power” to lose weight
6. Wegovy prevents getting second portions
7. Wegovy prevents eating deserts
8. Wegovy decreases food cravings
9. Wegovy decreases appetite for alcoholic beverages
10. Wegovy teaches portion control

What is Wegovy? And How Does Wegovy Cause Weight Loss?

Wegovy is the trade name for semaglutide, a weight loss drug made by Novo Nordisk. This new class of drugs are called GLP-1 agonists and there are only two approved for weight loss at this time (Wegovy and Saxenda (liraglutide), both made by Novo Nordisk), but there are other drugs in this category that are expected to come out shortly specifically aimed at weight loss rather than diabetes (e.g., Eli Lilly’s tirzepatide (Mounjaro)). 

Wegovy is a GLP-1 agonist (defined below). All GLP-1 agonists to date were designed and developed for diabetes but it was noticed that many people taking the drug for diabetes lost 15% or so of their body weight. That drug, Ozempic, is the same drug as Wegovy (semaglutide) but used at a slightly lower dose, and was approved by the FDA for diabetes in 2017 and launched in 2018. The manufacturer (Novo Nordisk) subsequently completed additional clinical trials using semaglutide at a slightly higher weekly dose, but the trial was designed for weight loss instead of diabetes. The results were remarkable and semaglutide was approved for weight loss in adults by the FDA in June, 2021 and released under the trade name Wegovy. Today, (January 03, 2023 the FDA approved Wegovy for use in teens 12 years and above. In my opinion (as a patient and as an endocrine specialist/surgeon) the GLP-1 agonists are the miracle weight-loss drugs we have been waiting for.

Novo Nordisk (and the other manufacturers who are soon to release similar drugs) claims there are two mechanisms by which Wegovy causes weight loss—1) slowing gastric emptying, and 2) stimulating the satiety center in the brain making you feel full. Of course, I agree with them but that doesn’t really explain what you feel and how/why you lose weight. Here I will take a deeper dive into those two mechanisms and show that Wegovy causes weight loss in 10 very different ways. We can presume the other GLP-1 agonists will do the same thing, and we also should presume that not every person that takes these drugs will experience all of the different effects that this drug had on me.

1) Wegovy Causes Weight Loss by Preventing Eating Big Meals.

This is by far the most noticeable effect of taking Wegovy. For me, the lower dose that you start on for a few months didn’t have this effect, but once I got to the 1.7 mg injection dose this effect was immediately noticeable. When I put my usual amount of food on my plate, I simply could not eat it all. It seems that you are full when you have eaten half of what you would normally eat. The sense of fullness you get after a big meal just seems to come on rather quickly after about one fourth of my typical meal, and by the time I ate half of my usual portion I was full. Eating any further feels quite uncomfortable and you feel “stuffed”. Remember when your mother told you to “clean your plate”? Well, you just can’t do that when taking Wegovy.

One of the amazing things about taking Wegovy for weight loss is that my weight loss (average 1.3 pounds per week) has occurred without any change in the food I eat. As part of my experiment, I did not change anything about what I put on my plate. I still eat bread, pasta, and whatever I want—but as you read below, the drug has completely changed how much and when I eat it. If I have a piece of two of bread before my meal it simply means I’m not going to be able to eat as much of the rest of my meal. I changed nothing in my diet and I still lost weight. Note: if you need to lose weight, this is not recommended—you need to eat right also. I was just experimenting.

2) Wegovy Suppresses Appetite—you just don’t get hungry.

The most difficult thing about dieting is that you get hungry and thus want to eat. This leads to eating between meals (snacking) or eating bigger meals. But as soon as I began the higher doses of Wegovy (1.7 mg injection) the difference was remarkable. When my family asks if I’m ready for dinner, I’ll look at my watch and realize that its dinner time and I’m not at all hungry. Sometimes I just get busy and forget a meal.

The makers of these GLP-1 drugs will tell you this is one of the primary functions of the entire class of drugs called GLP-1 agonists which are designed to mimic the naturally occurring hormone glucagon (thus the name Glucagon-Like-Peptide, or GLP-1 for all the drugs in this class). Glucagon is normally released from the pancreas after we have a big meal and signals our brain to stop eating. It gives you that “sense of fullness” which is termed satiety. When you inject the GLP-1 agonist under your skin every week, you have an extra dose of this man-made glucagon stimulating the satiety center of your brain 24/7. Thus, you feel full and don’t really get very hungry—and it is truly remarkable. I can go many hours without food and I’m not hungry.

3) Wegovy Causes Weight Loss Through Intermittent Fasting.

Intermittent fasting has become a very common weight loss diet over the past few years and is focused primarily on when to eat, rather than what to eat. The goal is typically to fast about 16 hours per day, while eating only during an 8-hour span. Most commonly this is done by having the first meal of the day about noon, a mid-day snack, and a typical dinner—but then having nothing to eat after dinner until noon the next day. During the 16 hours of fasting your body will deplete all its sugar stores and then convert to using fat as an energy source. There is much written about intermittent fasting diets and it works very well as a means to weight loss for many people.

I found that Wegovy caused me to adopt intermittent fasting techniques subconsciously. I don’t think about food and I’m not hungry, so after dinner I don’t eat. And when I get up in the morning, I’m not hungry until noon. Thus, with essentially zero effort, taking my Wegovy injection once a week has put me on an intermittent fasting diet. I have all the potential benefits of an intermittent fasting diet yet I don’t have to plan and it takes no thought. It just happened.

4) Wegovy Causes Ketosis Which Burns Fat (Atkins-like diet).

The Adkin’s (Low Carb) diet was the most popular diet for over a decade made famous by the cardiologist Robert Atkins. His revolutionary diet is still extremely popular and is the type of diet people are following when they are on a low-carbohydrate diet (avoiding simple carbs like bread and pasta, as well as complex sugars like cookies and candy). The key to the success of a low carb, high protein diet is that the body switches to fat as its primary energy source. When this transition to burning fat preferentially occurs it results in the production of ketones which can be measured in the urine as proof that you are successfully burning fat.

Through the combination of intermittent fasting and much smaller portions, Wegovy resulted in ketones being seen in my urine 5 out of 7 days just before my noon meal (shown on the test-strip in the photo below). Thus, without much effort at all, my body is preferentially using fat as its energy source and I’m losing fat, not lean muscle mass. As an endocrine specialist, the importance of this cannot be overstated—with little effort, we save the muscle and consume our fat stores. As I ponder about how I could have lost more weight faster, I suppose that with modest effort I could have avoided bread and other carbs so that my preferential burning of fat was more pronounced, but my experiment was to not add any other variables and eat like I always eat.

Wegovy caused Dr. Norman's body to be in a state of ketosis on about 70% of the days he was using the drug.

5) Wegovy Causes Weight Loss with Minimal Reliance on Will Power.  

People who are able to lose weight successfully on any diet are those that have the will power to follow the plan. But that is very hard to do for most people (including me!) and the reason why 90% of diet plans don’t work for 90% of people. Diets are hard! Cheating on your diet plan only once or twice a week can undermine the entire weeks’ diet efforts. But with Wegovy, I find it takes minimal will power to stick to the “diet” that the drug has induced upon my body. Since I’m not hungry, and since I have a feeling of fullness for hours after even a small meal, this is the easiest “diet” I’ve ever been on.

For everybody I know who has been on a serious diet to lose weight, they are thinking about the diet all day long. The diet becomes a central part of their day and they plan their meals accordingly. This is all part of the will power required to avoid eating the things we used to eat that got us to this poundage. But this is not so when taking Wegovy. Weight loss is never on my mind. I don’t have to think about it. I don’t have to plan my meals. I just don’t think about food, and when I do, I can’t eat much of it. It takes almost no will power to lose weight on Wegovy. But as I noted before, with a little effort I could cut out some carbs, eaten a little healthier, and likely have an even better result.

In my next article I’ll discuss the three ways that Wegovy will fail and not cause weight loss (snacking, sweets, and accessibility to food). I now realize that it is very possible to fail to lose weight on Wegovy. In my opinion, failure will come to those who rely completely on the drug and don’t put forth even a little will power.

6) Wegovy Prevents Getting Second Portions. 

One of the key reasons for obesity is over-eating. And of course, we all love a good meal, so why not clean your plate and then go back for a little bit more of mom’s great meatloaf. But you can’t do that on Wegovy. Another key mechanism by which Wegovy causes weight loss is by preventing even the thought of a second helping. Since you are full after half of your regular portion, you couldn’t eat a second portion if mom herself put it on your plate. I find that if I force myself to eat my full regular portion, I become very uncomfortable. So, I only eat half of what I used to. No way I go back for seconds, even if I hurt mom’s feelings.

7) Wegovy Causes Weight Loss by Preventing Eating Deserts. 

We all love deserts, and avoiding them takes will power for all of us. But the weekly injection of Wegovy makes me so full after a meal that I don’t even want to look at the dessert menu. Be careful here, however! I find that Wegovy does not decrease my craving for sweets, and it is easy to cheat between meals and have a slice of pie or some cookies. See my next article on this topic—sweets and snacking between meals is the Achilles Heel of these miracle weight loss drugs and the number one reason they won’t work.

8) Wegovy Prevents Craving of Foods. 

There are certain foods that I love, and for some reason, I just get a craving for something every now and then and end up at the local pasta restaurant because I love chicken alfredo. However, I found that once I was beyond the starting dose and reached the full dose of Wegovy (2.4 mg injection) I no longer had these cravings. Even when my wife suggests she is going to cook my favorite meal, I simply shrug. This is a very different departure from my old reaction, and clearly this has an effect on what I eat, and where I eat it. I just don’t crave food like I used to. Ho hum.

9) Wegovy Causes Weight Loss by Decreasing Desire for Alcohol. 

One of the first ways many men try to lose weight is by cutting back on their alcohol intake. There are brands of beer that market their low carbohydrate content far more than their taste. Many of my friends have switched from beer to vodka-based drinks over the years in an effort to decrease carb intake. Although I’m not a big drinker, I like my bourbons and old fashions, and I enjoy a glass of wine or two with dinner once or twice a week. But that changed dramatically and completely subconsciously once I reached the 1.7 mg dose of Wegovy. It is hard to explain, but I don’t crave my evening bourbon any more, and somehow, it just doesn’t taste as good. And when I’m at a restaurant for dinner, I feel full sooner and my second glass of wine has nearly disappeared.

Despite knowing about the “empty calories” in alcohol, and that all successful diets put a big effort on avoiding alcohol, this was completely unexpected. Wegovy has cut my alcohol consumption by 75% without even trying and without a single bit of will power on my part. This probably plays a role in getting into ketosis in the mornings, but clearly this is a benefit to my overall health in other ways as well.

10) Wegovy Causes Weight Loss by Teaching Portion Control. 

The centerpiece of every successful diet, especially the long-term success, is learning portion control. From the time when our mom told us to “clean your plate” before we were allowed to leave the dinner table, we have developed a habit of eating everything on our plate. Well you simply cannot do that once you are on the higher doses of Wegovy (noticeable for me at 1.7 mg injection and then at the full dose, 2.4 mg injection). After just a few days I found myself putting less food on my plate and again, this was completely subconscious. I learned that I can’t eat a full plate, and so I just give myself smaller portions.

I eat out a lot, and Wegovy has changed my restaurant ordering dramatically. I used to look at the appetizer menu, selecting something “to share” about half the time. This never happens any more—I don’t want it and it doesn’t sound so appetizing. I’ve learned portion control and know I won’t be able to eat an appetizer and a main meal. If I decide to order a salad with my meal, I know to order a much smaller entre, or even from the kid’s menu if the restaurant allows it. I learned portion control without even trying and without realizing it was happening.

It is my belief that learning better portion control may be the most important aspect of successful long-term weight control for people once they stop taking Wegovy. It teaches better habits in many ways; no trips for seconds, avoiding deserts, avoiding alcohol, and others—but it is eating smaller portions at every meal that will likely be the cornerstone of long-term weight control.

Read next article: 4 Ways Wegovy Saxenda and Mounjaro Will NOT Cause Weight Loss

About the Norman Parathyroid Center

Located in Tampa, Florida, the Norman Parathyroid Center is the leading parathyroid gland tumor treatment center in the world, performing nearly 3,800 parathyroid operations annually at the new Hospital for Endocrine Surgery. Well known for cure rates over 99% via an operation that typically lasts about 20 minutes, the Norman Parathyroid Center's success centers on a teamwork approach by the most experienced parathyroid surgeons in the world.
www.parathyroid.com | (813) 972-0000

About the Clayman Thyroid Center

Founded by one of the nation's best-known thyroid surgeons, the Clayman Thyroid Center is the highest volume thyroid cancer referral center in the United States. Operating at the new Hospital for Endocrine Surgery, the Center boasts the most experienced thyroid surgeons in the US who provide personalized care allowing the greatest opportunity for cancer cure, wellness and cosmetic, and functional, outcomes via all types of thyroid surgery from minimal incision to scarless thyroid surgery to advanced cancer care.
www.thyroidcancer.com | (813) 940-3130

About Hospital for Endocrine Surgery

The Hospital for Endocrine Surgery is a campus of HCA Florida South Tampa Hospital focused on compassionate patient care and highly specialized treatment of endocrine tumors. We provide a wide array of services necessary for the diagnosis and surgical treatment of tumors of the thyroid, parathyroid and adrenal glands. Our team includes doctors, surgeons, nurses and technicians who have dedicated their careers to delivering the highest cure rates using the most advanced techniques available. HCA's Hospital for Endocrine Surgery is the nation's highest volume hospital for thyroid, parathyroid, and adrenal tumors and cancers.
www.hospitalforendocrinesurgery.com

• For more information about thyroid surgery at the Hospital for Endocrine Surgery, visit www.thyroidcancer.com
• For more information about parathyroid surgery, visit our website www.parathyroid.com
• For more information about adrenal surgery, visit our website www.adrenal.com

About the Florida Surgical Weight Loss Specialists

As one of the nation’s highest volume robotic gastric bypass centers, Florida Surgical Weight Loss Specialists is dedicated to helping patients achieve a healthier lifestyle through weight loss surgery. Led by a team of highly specialized bariatric surgeons and weight loss specialists, Florida Surgical Weight Loss Specialists are recognized for weight loss surgery. They do not prescribe Wegovy or other weight loss drugs. 
www.floridasurgeicalweightlossspecialists.com

Disclaimer:  Dr Norman and his partners and associates at the Hospital for Endocrine Surgery do not provide advice about weight loss. This article is meant to be informative and educational and is not meant to give or provide any medical advice. The author is not a weight-loss physician and does not provide weight loss advice and does not prescribe Wegovy or any other weight loss drugs. It is important to note that Ozempic and Mounjaro are only approved for diabetes at this time, but many people are trying them for their weight loss properties. We are not advocating the off-labeled use of these diabetes drugs for weight loss. Any weight loss program should be taken very seriously and should only be done with the oversight of a physician qualified to provide advice and treatment. Please note that all of these drugs have potential side effects. None of the potential side effects were discussed in this article. 

It is important to note that Dr Norman's experience with Wegovy is his personal experience and yours may be very different. Dr Norman is not advocating for the use of these drugs off-label, and notes that any person taking these drugs should be under the care of a licensed professional who is expert in their use and potential side effects.