Wegovy

Overview

Wegovy (semaglutide 2.4 mg) is a once-weekly GLP-1 receptor agonist FDA-approved for chronic weight management, for cardiovascular risk reduction in adults with established cardiovascular disease and obesity or overweight, and for noncirrhotic MASH with moderate to advanced liver fibrosis. The 7.2 mg dose (approved March 2026) and once-daily Wegovy tablets (approved December 2025) are not scored here. Wegovy is the higher-dose, obesity-indication formulation of semaglutide, the same active ingredient in Ozempic. The STEP clinical trial program established its weight loss efficacy, and the SELECT trial demonstrated a significant reduction in major adverse cardiovascular events.

Mechanism of Action

Semaglutide binds to the GLP-1 receptor, mimicking the incretin hormone GLP-1. This enhances glucose-dependent insulin secretion, suppresses glucagon, delays gastric emptying, and reduces appetite through hypothalamic signaling. The 2.4 mg and 7.2 mg weight-management doses are higher than the diabetes doses sold as Ozempic.

Clinical Evidence

STEP 1 demonstrated 14.9% mean body weight reduction over 68 weeks versus 2.4% with placebo. The SELECT trial (2023) showed a 20% reduction in major adverse cardiovascular events (MACE) in adults with overweight or obesity and established cardiovascular disease but without diabetes (hazard ratio 0.80) — a landmark result that positioned Wegovy as the first obesity medication with proven cardiovascular benefit.

Side Effects & Safety

Nausea is the most frequently reported side effect (up to 44% in STEP trials), followed by diarrhea, vomiting, and constipation. Most GI events are mild-to-moderate and decrease over time. The dose-escalation schedule (starting at 0.25 mg) is designed to improve tolerability. Rare but serious risks include pancreatitis, gallbladder events, and thyroid C-cell tumors (observed in rodent studies).

FAQ