Wegovy(Semaglutide): Weight Loss Injection FDA Approved with Few Side Effects

Medically reviewed and updated for 2026
Dr. Richard Lipman MD
Board-Certified Internist and Endocrinologist

Wegovy Offers Fast Weight Loss, Glucose Control and New Higher Doses

Wegovy, a fast-acting weight-loss injection, is a breakthrough treatment for obesity. I have treated hundreds of patients with Wegovy and find it to be safe, offering rapid weight loss with few side effects. It is an FDA-approved medication in the GLP-1 receptor antagonist class. It obtained FDA approval in June 2021 for the short-term and long-term treatment of obesity.

Surprisingly, it’s not a new drug at all, but simply an increased dosage of the diabetic drug Ozempic (chemical name semaglutide) that millions of people around the world have used for more than 9 years for diabetes. As an endocrinologist and diabetologist, I have treated hundreds of diabetics with Ozempic and Wegovy. 

Wegovy is redone Ozempic: Years of experience

Wegovy, a high dose of semaglutide, produces even greater weight loss than Ozempic. Ozempic-treated diabetics experience significant weight loss despite the major difficulties diabetics have with obesity.  The Ozempic standard dose is a 1 mg injection once a week, while the Wegovy dose is 2.0-7.2 mg per injection, also taken once a week. Wegovy, a higher dose of semaglutide, produces even greater weight loss than Ozempic.

In April 2026, the Wegovy dose was increased from 2.4 to 7.2 mg. Preliminary reports show that patients have accepted this dose and have experienced significant weight loss. In the first 8 patients I have treated few side effects have been noted. Although Wegovy is available in oral form, greater weight loss is observed with once-weekly injections. The Wegovy Weight Loss Injection, administered once weekly at 7.2 mg, yields the greatest weight loss.

Weight Loss With Wegovy: 7.2 mg Dosage: Say Goodbye to Weight Loss Plateaus!

The STEP UP trial studied more than 1,400 adults with obesity, comparing a higher dose of semaglutide (7.2 mg) to the 2.4 mg dose and a placebo over 72 weeks. The findings were notable. On average, people taking 7.2 mg lost 21% of their body weight, which is about 50.7 lb for someone who started at 249 lb. Those on the 2.4 mg dose lost about 17.5%, and people on the placebo lost 2.4%. The 7.2 mg dose had a safety and tolerability profile similar to the 2.4 mg dose, yet it is 3 times stronger!
Figure 1 shows a common plateau taking Wegovy.

Figure 1: Wegovy Weight Loss Plateau

Wegovy weight loss plateau. The new 7.2 dose will quickly eliminate the plateau; see above.

How Much Weight Loss Can You Expect from Wegovy and  Ozempic?

Wegovy helps patients lose an average of about 15-20% of their body weight, almost double the rates produced by other prescription treatments. Early studies showed that more than a third of overweight patients lost 20% or more of their body weight when taking Wegovy because people start at different weights, have different ages, genders, and metabolisms. It’s best to evaluate weight loss as a percentage of the starting or baseline weight. When using Wegovy with Dr. Lipman’s high-protein, low-carb food plan, weight loss is even more significant.

In a recent trial, 40% of participants lost 20% or more of their body weight over a year (an example might be  a 40 lb. weight loss in a 200 lb. individual). 

Figure 2: New Wegovy 7.2 HD pen

The amount of weight loss depends on several variables

1. Dose of medications–the higher the dose, the greater the weight loss
2. Initial weight: Weight loss is always related to starting weight. The more you weigh, the more you lose per week.
3. Duration of treatment: You do not develop a tolerance to these medications as you do with the typical Weight loss medication like phentermine. You continue to lose weight as long as you take the medication.
4. Age and gender. Men lose weight faster than women, and
younger people lose weight faster than older people.
 5.  Individuals with extensive food noises before treatment can
lose significant weight.

  Figure 3: Plateau on Wegovy at dose of 2.4 mg

Note in the graph above, after 10 weekly injections,  the average participant who took Wegovy lost 16% of their body weight, and those receiving a placebo lost only 4% of body weight on the same diet and exercise plan. Note the weight regain after 52 weeks with a placebo.

Who Should Take Wegovy (Semaglutide)

Wegovy is indicated for adults who are obese (body mass index ≥30) or overweight (body mass index ≥27). It can also be used with a BMI >27 in patients with type 2 diabetes, hypertension, and high cholesterol. The drug is used for short-term weight management but has been especially designed and tested for long-term weight loss and control. This is in conjunction with a reduced-calorie meal plan and increased physical activity. FDA-approved Wegovy is based on phase 3 data showing that It helped 33% of patients lose more than 20% of their body weight over a 68-week clinical trial period. This high-dose version of Wegovy -semaglutide is a first of it’s kind obesity medication in that it is dosed on a once-weekly basis by injection.

How does the Wegovy weight loss injection produce weight loss if it’s only once a week?

Wegovy, like its lower-dose diabetes drug, Ozempic, acts on GLP-1 receptors in the brain, stomach, liver, pancreas, and muscle. The most critical effects occur in the brain, where Wegovy binds to GLP-1 receptors to reduce appetite, hunger, and cravings, especially for sweet and salty foods that produce pleasure.  In the stomach, it reduces gastric emptying time, thereby producing a sense of fullness. This results in reduced hunger and earlier satiety. Wegovy affects muscles by increasing sugar uptake and the pancreas by increasing insulin production and decreasing glucagon secretion (a hormone that causes hunger).  All of these effects result in less food intake and weight loss.

Here is how Wegovy/Ozempic produces such significant weight loss -note the interaction with many organs in the body, the final result being less food intake:

Wegovy Results in a Marked Decrease in Food Intake

 A recent study from Germany, where participants consumed as much food as they desired, found that the placebo participants ate 2676 calories a day while the Wegovy participants ate only 1736 calories, a reduction in energy intake of more than 33%! The major effects in this study were an average of 10% reduction in hunger, 15% increase in satiety, and 17%  increase in fullness. Note that this finding is important in that there was no planned diet or exercise program. The weight reduction was due to a marked decrease in daily food intake of more than 900 calories. (Most diet plans strive for a reduction of about 500 calories a day or 1 lb. weight loss.) WEIGHT LOSS REPORTS show MORE THAN 20% OF INDIVIDUALS LOSE 20% OF THEIR EXCESS WEIGHT. WEIGHT LOSS IS ALMOST AS GOOD AS A GASTRIC BYPASS.

Animal studies have shown that Wegovy affects the brain by blocking GLP-1 receptors in the hypothalamus and hindbrain that are involved in appetite regulation, food intake, food preferences, reward, and meal termination. This is in the lateral parabrachial nucleus. More recent studies have shown benefits on the brain and other internal organs such as the liver, blood vessels, and even addiction from these semaglutides.

How is Wegovy Taken?
Wegovy is supplied in a single-dose pen injector.  It is self-administered subcutaneously once a week on the same day of the week, in the arm, abdomen, or thigh. There are 5 doses ranging from 0.25 mg to 2.4 mg. Dosing starts at 0.25 mg weekly for 4 weeks. The dose is increased in 4-week intervals until reaching 2.4 mg. This becomes the maintenance dose. It is used as long as needed; recent studies have participants taking it for 63 weeks with control of weight gain.  Lower starting doses are recommended for older individuals and those with gastric issues or prior intolerances.

Table below shows dosages of Wegovy available from  Wegovy 7.2 HD pen based on number of “clicks”

Wegovy vs. Ozempic:  Same Drug- but Higher Dose

Both drugs are the same active ingredient, but Wegovy is administered at higher doses after the initial titration. The max dose of Ozempic is 1 mg, and the max dose of Wegovy is 2.4 mg. That’s the only difference. Same side effects, which are dose-related, as is the weight loss.

The most common side effects reported by more than 5 % of patients include nausea, vomiting, constipation, abdominal pain, headache, fatigue, dyspepsia, and reflux. The side effects are due to Wegovy’s effects on the stomach, including delayed gastric emptying for hours. This results in fullness for long periods of time and less hunger.

What are warnings about Wegovy?
Ozempic and Wegovy are the same drug–just a higher dose.  Like Ozempic, the higher-dose Wegovy is contraindicated in patients with medullary thyroid cancer or in patients with Multiple Endocrine Neoplasia Syndrome. There is an increase in thyroid nodules and possible thyroid C-cell tumors.  Acute pancreatitis has also been reported in this group of medications but is extremely rare.  Wegovy should not be taken with insulin. All of these side effects are extremely rare, as evidenced by the widespread use and safety of Ozempic, which is chemically identical to Wegovy.

How is Wegovy taken? Wegovy is taken as a Single Injection Once a Week:
Four self-injecting Wegovy pens are supplied in each monthly box.  The pens are all the same dose, and there is no dose adjustment like Ozempic.  The first month, the once-a-week injection consists of 0.25 mg. There are 5 boxes for the 5 doses from 0.25 mg a week to the strongest of 7.2 mg a week. Each month, the dosage is increased to 7.2 mg/week. This is the “maintenance dose.” Wegovy is a prescription drug requiring a personal evaluation by a licensed physician.

Reviews and Ratings of Wegovy from the Literature

Here are some of the early ratings of Wegovy when it first was released in the summer of 2021. My patients have had excellent responses to the drug with 4-5 patients losing more than 100 lbs in 4-6 months. The average weight loss among the first 30 patients over 3 months was  3.5 lbs. per week. The most weight loss I have observed is 130 lbs in a patient who started at over 400 lbs.