What is Wegovy

Wegovy Overview

Wegovy is a GLP-1 (glucagon-like peptide-1) agonist prescribed to manage weight in those who are obese or overweight. The active ingredient semaglutide was first approved in 2017 under the brand name Ozempic for type 2 diabetes. However, Wegovy contains semaglutide given at a higher dosage and was approved in 2021 for weight loss. It can also treat a serious form of liver disease and reduce the risk of major cardiovascular events, such as heart attacks and strokes.

How Wegovy Works

The main effects of Wegovy are attributed to semaglutide. It works by mimicking the effects of the GLP-1 hormone, which attaches to receptors in the gut, brain, and pancreas, among other areas. The GLP-1 hormone is naturally released by the pancreas after a meal, although in lower and shorter‑lasting amounts than those achieved with a GLP‑1 agonist.

Slows Gastric Emptying

Wegovy works for weight loss by slowing how fast food moves out of the stomach, a process called gastric (stomach) emptying. By slowing this process, Wegovy can help you feel full faster and longer. As a result, you’ll likely eat fewer calories throughout the day, which ultimately leads to weight loss. 

Effects on Appetite and Reward Signaling

In addition, Wegovy is believed to directly affect certain areas of the brain involved in appetite and dopamine reward signaling. Therefore, you might feel less inclined to eat, which can lead to fewer cravings and overall “food noise.” 

Regulates Blood Sugar 

Apart from its direct effects on weight loss, semaglutide in Wegovy can help manage blood sugar levels and insulin release. Its effects on blood sugar are why semaglutide was first approved for type 2 diabetes, with weight loss being a secondary effect at the time. Through its effects on blood sugar and weight loss, Wegovy has also been found to have overarching benefits for reducing cardiovascular risk and liver inflammation. 

FDA-Approved Uses and Indications

Wegovy is routinely prescribed for various FDA-approved uses, which may be different for the injection and tablet. The Wegovy injection is officially approved for the following indications:

• Weight management in adults and children 12 and older with obesity (body mass index (BMI) of 30 or more)
• Weight management in adults who are overweight (BMI of 27 to 29) with at least one weight-related condition, such as high blood pressure or high cholesterol
• Noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH), which is a progressive liver disease caused by fat buildup and inflammation
• Reducing the risk of major cardiovascular events, such as stroke, heart attack, or death, in adults with heart disease who are obese or overweight

The Wegovy tablet is approved for the same indications except for MASH. Only the injection is approved for MASH.

Wegovy is not approved for type 2 diabetes alone, although it may help manage blood sugar in people with diabetes who use it for weight loss. The approved brand-name version of semaglutide for type 2 diabetes is Ozempic.

Due to its weight-loss effects, Ozempic may sometimes be prescribed off-label for cosmetic purposes in people who are not overweight or obese. However, its safety for people who are not overweight or obese has not been well-studied in clinical trials. 

Wegovy Dosing Schedules

Wegovy comes as a subcutaneous injection (under the skin) and an oral tablet. For those with type 2 diabetes, it’s important to check blood sugar levels before and throughout treatment with Wegovy. 

Dosing Schedule for Wegovy Injection

Wegovy injections come in prefilled, disposable pens with a strength of:

• 0.25 mg/0.5 mL
• 0.5 mg/0.5 mL
• 1 mg/0.5 mL
• 1.7 mg/0.75 mL
• 2.4 mg/0.75 mL

The dosage for Wegovy injections typically starts low and gradually increases over time. Most people don’t see the maximum benefits of the medication until a maintenance dose is reached. 

• Weeks 1 through 4: Starting dosage of 0.25 mg once weekly
• Weeks 5 through 8: 0.5 mg once weekly
• Weeks 9 through 12: 1 mg once weekly
• Weeks 13 through 16: 1.7 mg once weekly
• From Week 17: Maintenance dosage of 2.4 or 1.7 mg once weekly

For most people using Wegovy injections for weight loss or MASH, the recommended maintenance dosage is 2.4 mg once weekly. If side effects become intolerable or treatment with 1.7 mg once weekly is working sufficiently, it’s possible to stay on a dosage of 1.7 mg weekly. 

Before injecting Wegovy, it’s important to follow a doctor or healthcare provider’s instructions. They will often show patients how to properly inject Wegovy for the first time. 

The injection pen should be stored at 2°C to 8°C (36°F to 46°F) before the first use, although it can also be stored at 8°C to 30°C (46°F to 86°F) for up to 28 days. It should not be frozen or kept in direct sunlight or extreme heat.

Dosing Schedule for Wegovy HD

Wegovy HD was approved for use by the FDA based on data from the STEP UP trial. It will be available in April 2026. It is a 7.2 mg weekly injection to be used in patients who have tolerated 2.4 mg for 4 weeks or more, who will require further weight loss. 

Dosing Schedule for Wegovy Oral Tablets

Wegovy is the first approved daily pill for weight loss. It comes as a tablet in the following strengths:

• 1.5 mg
• 4 mg
• 9 mg
• 25 mg

Like the injection, Wegovy oral tablets are started at a lower dose. The dosage can then be increased slowly over time. 

• Days 1 through 30: 1.5 mg once daily
• Days 31 through 60: 4 mg once daily
• Days 61 through 90: 9 mg once daily
• From Day 91: 25 mg once daily

The maintenance dosage is 25 mg once daily. For those who are unable to tolerate this dosage schedule, a healthcare provider may recommend staying on a lower dose for longer. 

The tablets need to be taken on an empty stomach in the morning with no more than 4 ounces of water. The tablets should be swallowed whole without crushing or chewing them. In addition, it’s important to wait at least 30 minutes before eating, drinking, or taking other medicines.  

Tablets should be stored at room temperature, or 20°C to 25°C (68°F to 77°F), away from sunlight and moisture. 

Switching From Injections to Oral Tablets and Vice Versa

Depending on preferences and treatment response, it’s possible to switch between Wegovy injections and tablets. The typical process for those on the 2.4 mg injection of Wegovy is to switch to the once-daily 25 mg tablet on the day the next injection is due. For people on the 25 mg oral tablet, it’s recommended to switch to the weekly 2.4 mg injection the day after the last oral dose. 

How Well Does Wegovy Work? What the Studies Show

Multiple clinical trials show that Wegovy is an effective drug for promoting weight loss in people with obesity or overweight. These studies mainly used the average percentage of body weight loss after a specific period to measure the drug’s effectiveness.

The STEP (Semaglutide Treatment Effect in People with obesity) trials were key studies for Wegovy’s approval for weight loss. These trials found that people on Wegovy saw an overall average weight loss from 10% to 16% after 68 weeks of treatment. Still, the STEP 4 trial showed that consistency is important, as stopping treatment often leads to weight regain. 

Table: The Efficacy of Wegovy in Clinical Trials

Trial Name	Population	Duration	Primary Focus	Key Outcomes
STEP 1	Adults with obesity or overweight (without diabetes)	68 weeks	Weight loss	Average weight loss of 14.9% (15.3 kg/33.7 lb), with 86% of participants losing 5% or more body weight
STEP 2	Adults with obesity or overweight and type 2 diabetes	68 weeks	Weight loss	Average weight loss of 9.6% (9.7 kg/21.4 lb)
STEP 3	Adults with obesity or overweight (with intensive behavioral therapy)	68 weeks	Weight loss	Average weight loss of 16.0% (16.8 kg/~37 lb)
STEP 4	Adults with obesity or overweight (withdrawal study)	68 weeks	Weight maintenance	Participants continuing Wegovy experienced an additional 7.9% weight loss versus a 6.9% weight regain in those switched to placebo
SELECT	Adults with known heart disease and obesity or overweight (without diabetes)	34 months	Cardiovascular outcomes	20% reduction in major adverse cardiovascular events (MACE) and average weight loss of 9.4% maintained over 2 years

These results reflect clinical trial results in controlled settings. Individual results may vary based on factors like dosage, adherence, lifestyle factors, and baseline laboratory values.

In addition to weight loss, these trials showed that Wegovy also had benefits on cardiovascular risk factors, including blood pressure, cholesterol, and blood sugar. The SELECT trial found that Wegovy reduced the risk of heart attacks, strokes, and even death in people with heart disease. Participants taking Wegovy experienced around a 20% reduced risk of cardiovascular events. 

Wegovy Safety and Precautions

Wegovy is considered a safe medication when used as directed by a healthcare provider. Side effects are more likely to occur at the start of treatment or when increasing the dose. However, in most cases, side effects are temporary and mild. 

The most common side effects of Wegovy include:

• Nausea
• Vomiting
• Stomach pain
• Constipation
• Diarrhea
• Headache
• Fatigue
• Runny nose or sore throat
• Dizziness

More serious side effects can also occur. These side effects may include:

• Inflammation of the pancreas (pancreatitis)
• Gallbladder issues
• Low blood sugar (hypoglycemia) 
• Kidney problems from dehydration
• Serious stomach problems
• Vision changes
• Heart rate changes
• Increased risk of food or liquid getting into the lungs while under anesthesia 

In addition, Wegovy may cause allergic reactions in some people. Symptoms of an allergic reaction include rash, trouble breathing, and swelling of the face or throat. 

Some people may need to use caution with Wegovy due to potential side effects. Tell a healthcare provider about a history of any of the following before starting Wegovy:

• Problems with the pancreas
• Diabetic eye disease (retinopathy)
• Problems digesting food or other gastrointestinal conditions
• Previous weight loss surgery
• Pregnancy, breastfeeding, or plans to become pregnant or breastfeed

Wegovy comes with a black box warning for thyroid cancer on its drug label. Based on a potential link to thyroid tumors, it’s recommended to avoid using semaglutide products in people with a personal or family history of thyroid tumors or multiple endocrine neoplasia syndrome type 2 (MEN 2). However, some real-world studies suggest that the risk of cancer may not be as high in humans, so it’s best to consult a healthcare provider before starting treatment.

Potential Drug Interactions on Wegovy

Like other prescription medications, Wegovy comes with potential drug interactions. That’s why it’s important to tell a healthcare provider about all other medications being taken, including prescription medication, over-the-counter drugs, and herbal supplements. 

Wegovy may interact with the following:

• Insulin and certain diabetes medications, including sulfonylureas (such as glyburide, glipizide, and glimepiride): Using Wegovy with these medications can increase the risk of low blood sugar.
• Oral medications: Because Wegovy slows the emptying of the stomach, it may decrease the absorption of medications taken by mouth. In some cases, that could mean decreased effectiveness of the oral medications, which could be a concern for drugs that rely on proper absorption, such as warfarin and levothyroxine.

Real-world studies have shown that many drugs taken by mouth often don’t experience any significant impact in absorption, although these involve taking 1 mg of semaglutide. It’s important to monitor the potential effects with a healthcare provider, as they might recommend a dosage change.

Access, Cost, and Coverage of Wegovy

Cost is another factor when it comes to treatment with Wegovy. Brand-name drugs usually have higher costs than other medications with generic versions available. Unfortunately, Wegovy won’t have a generic version until its patent expires in the early 2030s.

Insurance coverage for Wegovy varies based on the plan. Some insurance plans may offer coverage for Wegovy when it’s prescribed for weight loss or other approved uses. However, it may have high out-of-pocket costs since it’s a brand-name drug. In any case, many plans will have restrictions, including prior authorization or documentation that the drug is medically necessary.

Without insurance, the retail cost of Wegovy can be over $1,000 per month. Different savings options may help reduce the retail cost, such as patient assistance programs, price shopping at different pharmacies, and using a prescription discount card. Compounded semaglutide may also be an option for some people if it’s purchased from a reputable platform and used with medical guidance.

Policy Lab partners with OnlineSemaglutide to offer compounded GLP-1 medications like semaglutide at a reduced cost. Compounded drugs contain the same active ingredient as their brand-name counterparts and can be just as effective. A medical evaluation is still needed to ensure they’re being used safely. 

The Importance of Clinical Research for Approved Uses

Breakthrough results and approvals for medications can take years of research and development. Large-scale clinical trials need to be carried out to show that the medication is effective and safe, and these don’t happen without participants. Clinical trials seek to enroll volunteers to help be a part of these trials that could change the treatment landscape.

Those who are interested in becoming a clinical trial participant can use a resource like Policy Lab to find potential clinical trials to join. Policy Lab also offers educational resources and helps connect people with studies that align with their interests and needs. 

FAQs

Does Wegovy need to be refrigerated?

Yes, Wegovy needs to be refrigerated before the first use. It can be kept out of the fridge at room temperature, but for no more than 28 days before it needs to be discarded. 

Can you take Wegovy while pregnant or breastfeeding?

It’s not recommended to take Wegovy while pregnant or breastfeeding. Doing so may cause harm to an unborn baby or a child who is nursing. 

How much does Wegovy cost without insurance?

Wegovy can cost over $1,000 per month without insurance, although the cost may vary by location, pharmacy, and dosage. Prescription discount cards and price shopping are potential ways to lower out-of-pocket costs. 

What is the difference between Wegovy and Ozempic?

Wegovy and Ozempic both contain semaglutide, but Wegovy is primarily approved for weight loss, while Ozempic is mainly used for type 2 diabetes. Wegovy contains semaglutide that is given at a higher maintenance dose than Ozempic.

Does Wegovy cause hair loss?

Hair loss is not a common side effect of Wegovy. However, it has been reported in clinical trials as a potential side effect. Still, it is not considered a permanent or severe side effect of Wegovy.