Fact-check: Harvard's teaching video on prescribing GLP-1 agonists for weight loss

What the video covers

Dr. Lee-Shing Chang's second teaching video takes the prescriber's view: who the drugs are indicated for, who must not take them, who needs caution, how they are injected, how the two pens differ, how doses are escalated and how to counsel patients about gastrointestinal effects. It ends with a look ahead to SELECT, to dual agonists and to amylin combinations.

What it gets right

Each label point checks out against the Wegovy and Saxenda prescribing information. The indication is chronic weight management as an adjunct to reduced calories and increased activity in adults with a BMI of 30 or more, or 27 or more with at least one weight-related condition. Personal or family history of medullary thyroid carcinoma and MEN 2 are contraindications, based on rodent C-cell tumours that have not been shown in humans; both labels carry that as a boxed warning. Pregnancy is a contraindication for the weight-management products. Gallbladder disease, pancreatitis history, diabetic retinopathy, gastroparesis and concurrent insulin or sulfonylurea use are all listed cautions or warnings, and the video's explanations of each match the label rationale, including proactively reducing insulin or sulfonylurea doses.

The practical section is equally accurate. Injection sites are abdomen, thigh or upper arm. Saxenda is a multi-dose dial pen needing separate pen needles; Wegovy is a single-dose pen with a built-in needle. Saxenda escalates weekly to 3 mg by week five; Wegovy escalates every four weeks from 0.25 mg through 0.5, 1 and 1.7 to 2.4 mg, reaching maintenance at week 17, and each Wegovy strength needs its own prescription. The counselling tips, smaller portions, stopping before full, avoiding fried food, hydration, are the ones the labels and dietitians give.

What it leaves out or overstates

Nothing is wrong; several things are old. Tirzepatide is described as not yet approved; Zepbound was approved for weight management in November 2023 with its own titration and its own contraceptive caution. SELECT is described as underway; it has reported and the cardiovascular indication is on the Wegovy label. The Wegovy label has since added a warning to monitor for suicidal thoughts and behaviour, which the video does not mention, and a 7.2 mg dose has been studied.

The titration described is the label schedule. Many prescribers hold a step longer when nausea persists, and the label permits a delayed escalation. The video does not give adverse-event rates; the Wegovy label lists nausea in 44 percent, diarrhoea in 30 percent, vomiting in 24 percent and constipation in 24 percent of the 2.4 mg group in its pooled trials.

Where to go next

For a dated titration plan built on the label, use the planner on the Semaglutide Hub. Technique videos from a government health system and a university nursing program are in the injections playlist. The GLP-1 Starter site walks through the first weeks. FormBlends offers compounded semaglutide at formblends.com/products/semaglutide; compounded semaglutide comes in vials at pharmacy-specific concentrations, not in the pens described here, and is not FDA approved.