Lisa Robillard has struggled with her weight since she was 10 years old.

Over the years, she has tried at least 15 fad diets advertised on magazine covers. Sometimes she lost weight, then would gain it all back, plus an additional pound or two.

“You can put somebody skinny who looks really great on a magazine cover and say they did the ‘fill-in-the-blank diet,’ but that’s unrealistic for somebody who has chronic obesity,” said Robillard, 54. “It was a constant roller coaster of gaining and losing weight … and I couldn’t figure out why it was so difficult for me.”

The Alexandria, Virginia, resident never tried to control her weight with medications until she participated in the clinical trial for a new useof the diabetes drug semaglutide. In 68 weeks she lost 63 pounds.

“With the trial, that light went up,” she said. “That was the first time I realized: ‘Wait a minute, this isn’t about willpower. There’s a physical aspect to this.’”
Lisa Robillard, 54, has struggled with her weight since she was a child and tried fad diets for years. “It was a constant roller coaster of gaining and losing weight … and I couldn’t figure out why it was so difficult for me,” she says.

On Friday, the Food and Drug Administration approved the 2.4 mg dose of semaglutide – under the brand name Wegovy – that Robillard and about 800 other trial participants took as a treatment for chronic obesity. Doctors say it could become the gold standard to treat the chronic and stigmatized health condition that afflicts more than 40% of adult Americans, according to the Centers for Disease Control and Prevention.

But the drug may be hard to get for many with the disease, experts say, because of cost, lack of insurance coverage and weight bias among health care providers.
What is Wegovy and how does it work?

Semaglutide already exists at a lower dose as an anti-diabetic medication under the brand names Ozempic and Rybelsus made by the same pharmaceutical company, Novo Nordisk.
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The drug hasbeen used off label by some doctors to treat obesity, said Dr. Jamie Kane, director of Northwell Health’s Center for Weight Management, who is not affiliated with the drug company.

Semaglutide mimics a naturally occurring hormone that tells the brain when the body is full after a meal. The drug also slows down digestion so food stays in the stomach longer. The mechanisms work together to reduce appetite and increase fullness.

One of the challenges with long-term dieting and restricting calories for people who struggle with their weight is that they always feel hungry, said Dr. Rekha Kumar, medical director of the American Board of Obesity Medicine and associate professor of clinical medicine at Weill Cornell Medicine.

“This can increase longer-term adherence because it increases fullness,” said Kumar, who is on the speaker’s bureau for the obesity drug Saxenda, also created by Novo Nordisk. “They can finally lose weight and feel full.”

Robillard felt her cravings dissipate within the first few weeks of the trial. She was able to eat “normal-sized portions” and stopped when she felt full, something that was rare in the past.

Study trials show Wegovy is more effective than any other weight loss management drug on the market. More than 50% of the participants lost more than 15% of their body weight over 68 weeks.

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