Wegovy®

Wegovy is a prescription-only medication from Novo Nordisk for the treatment of obesity and overweight. It contains the same active ingredient as Ozempic – semaglutide – but is specifically approved for weight management and is dosed higher.

The difference from Ozempic:

• Ozempic: Approved for diabetes, max. 2 mg
• Wegovy: Approved for weight management; maintenance dose 2.4 mg. According to the summary of product characteristics (July 2026), in adults whose BMI was at least 30 kg/m² at the start of treatment, the dose can, if necessary, be increased to 7.2 mg once weekly after at least 4 weeks on 2.4 mg.

Wegovy is injected under the skin once a week and in studies has shown average weight loss of about 15% of body weight – significantly more in some patients.

The medication works via the body's own hormone GLP-1, which signals satiety and reduces appetite. As a result, satiety sets in earlier and the feeling of hunger decreases.

Semaglutide mimics the body's own hormone GLP-1 (glucagon-like peptide-1):

1. Appetite regulation in the brain: GLP-1 receptors in the hypothalamus are activated. This leads to an increased feeling of fullness and reduced hunger.

2. Slowed gastric emptying: The stomach empties more slowly. You feel full longer and eat less.

3. Changed food preferences: Many users report that they have less craving for fatty or sweet foods.

The result:

• Significantly reduced appetite
• Smaller portions are enough
• Fewer food cravings
• Lower calorie intake

Study results (STEP trials):

• Average weight loss: 15% of body weight
• About 1/3 of participants lost more than 20%
• Improvement in blood pressure, cholesterol, and blood sugar

Approved indication: Wegovy is approved for adults with:

• BMI ≥ 30 (obesity) OR
• BMI ≥ 27 with at least one weight-related comorbidity (high blood pressure, type 2 diabetes, elevated blood lipids, sleep apnea)

Requirements:

• Diet and exercise therapy alone were not sufficient
• Willingness to make lasting lifestyle changes
• No contraindications

Not suitable in cases of:

• Pregnancy or planned pregnancy

Less suitable:

• Type 1 diabetes
• History of pancreatitis
• Severe gastrointestinal diseases
• Family history of medullary thyroid carcinoma

Important: Wegovy is not a lifestyle drug. It is intended for people with medically relevant excess weight that endangers their health.

Dose escalation schedule:

• Weeks 1-4: 0.25 mg once weekly
• Weeks 5-8: 0.5 mg once weekly
• Weeks 9-12: 1 mg once weekly
• Weeks 13-16: 1.7 mg once weekly
• From week 17: 2.4 mg once weekly (maintenance dose)

Why slow dose escalation? The gradual increase considerably reduces gastrointestinal side effects. Nausea and vomiting are common at the start but improve over time.

If poorly tolerated: If 2.4 mg is not tolerated, the dose can remain at 1.7 mg.

Available pens: Each dose level has its own prefilled pen with 4 injections for 4 weeks.

Use:

• Once weekly, on the same day of the week
• Subcutaneous injection (under the skin)
• Possible sites: abdomen, thigh, upper arm
• Regardless of mealtimes

Injection technique: 1. Take the pen out of the refrigerator 2. Attach a new needle 3. Form a skin fold and insert the needle 4. Press the injection button and hold for 6 seconds 5. Remove the needle and dispose of it

If you would like to change the day: At least 3 days (more than 72 hours) between injections.

Missed dose:

• Within 5 days: Take the missed dose
• After 5 days: Skip it, take the next regular dose

Storage:

• Unopened: Refrigerator (2-8°C)
• After first use: Up to 6 weeks at room temperature or in the refrigerator

Absolute contraindications:

• Hypersensitivity to semaglutide
• Pregnancy and breastfeeding

Relative contraindications:

• History of pancreatitis
• Severe renal insufficiency
• Severe gastrointestinal diseases (gastroparesis)
• Diabetic retinopathy (close monitoring)

Caution with:

• Type 2 diabetes treated with insulin or sulfonylureas (risk of hypoglycemia)
• Gallstone disease
• Tendency toward depression

Very common (>10%):

• Nausea (especially at the start)
• Diarrhea
• Constipation
• Vomiting
• Abdominal pain
• Headache
• Fatigue

Common (1-10%):

• Flatulence
• Heartburn
• Belching
• Dizziness
• Gallstones
• Changes in taste

Uncommon:

• Increased heart rate
• Injection site reactions

Rare but serious:

• Pancreatitis (severe abdominal pain)
• Severe allergic reactions
• Acute kidney failure in cases of dehydration

Tips for managing nausea:

• Increase the dose slowly
• Smaller meals
• Avoid fatty foods
• Eat slowly
• Drink enough fluids

Insulin and sulfonylureas:

• Increased risk of hypoglycemia in people with diabetes
• Dose reduction of these medications often necessary

Oral medications:

• Slowed gastric emptying may affect absorption
• Relevant for time-critical medications

Oral contraceptives:

• Additional contraception in case of severe GI side effects

Warfarin:

• INR monitoring at the start of therapy