Wegovy

Overview

Wegovy (semaglutide 2.4 mg) is a once-weekly GLP-1 receptor agonist approved by the FDA for chronic weight management. It 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. At the 2.4 mg dose, the appetite-suppression and metabolic effects are optimized for weight management.

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/obesity and established cardiovascular disease — 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