FDA ReviewedUpdated July 5, 2026
Wegovy Guide
Wegovy is the brand-name formulation of semaglutide 2.4mg, specifically FDA-approved for chronic weight management in adults with obesity (BMI ≥30) or overweight (BMI ≥27) with at least one weight-related condition. It is a weekly subcutaneous injection developed by Novo Nordisk.
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By Eli Marsden · Founding Editor
Editorially reviewed (not clinically reviewed) · How we verify contentLast reviewed
At a Glance
How Wegovy Works
Wegovy delivers semaglutide 2.4mg — the highest approved dose — via once-weekly self-injection. It mimics the GLP-1 hormone to signal fullness to the brain, slow stomach emptying, and reduce overall caloric intake. The higher 2.4mg dose was specifically engineered to maximize the weight-loss effect beyond the 1mg dose used for diabetes.[2]
Dosing Schedule
Wegovy uses a gradual dose escalation to minimize side effects. Always follow your prescriber's guidance and the current FDA label[1].
Weeks 1–40.25mg/week
Weeks 5–80.5mg/week
Weeks 9–121.0mg/week
Weeks 13–161.7mg/week
Week 17+2.4mg/week (maintenance)
Side Effects
Common: nausea (44%), diarrhea (30%), vomiting (24%), constipation (24%), abdominal pain (20%), headache, fatigue. Side effects typically peak during dose escalation and diminish within 4–8 weeks. Serious (rare): pancreatitis, gallstones, kidney injury, heart rate increase, suicidal ideation (under review by FDA).[1][2]
This is not a complete list. Consult your healthcare provider or prescriber for full safety information. The complete adverse reaction profile is published in the current FDA prescribing information[1].
Clinical Trial Results
The STEP-1 trial showed Wegovy users lost an average of 14.9% of body weight (about 34 lbs) over 68 weeks compared to 2.4% in placebo. The SELECT cardiovascular outcomes trial (N=17,604) demonstrated a 20% reduction in major adverse cardiovascular events in obese patients with established CVD.[2][3][4]
Where to Get Wegovy
These telehealth providers offer access to semaglutide or compounded equivalents with online consultations and home delivery.
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Starting prices for compounded GLP-1 medications from top providers, sorted cheapest first. Compounded semaglutide from licensed 503A and 503B pharmacies is legal under federal compounding law[5], with additional tolerances historically allowed while the molecule has appeared on the FDA Drug Shortage List[6]. Both compounded and brand-name prescriptions are generally FSA/HSA eligible under IRS Publication 502[7]. Prices may vary based on dose and promo availability.
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| Calibrate Health | $25/mo | Visit |
| FitRx | $25/mo | Visit |
| NovoCare Pharmacy | $25/mo | Visit |
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Wegovy Head-to-Head Comparisons
Short-form verdict pages comparing Wegovy to other GLP-1 options with trial-anchored data, FDA-label dosing, and current manufacturer pricing.
Wegovy vs Zepbound
Zepbound delivered 20.9% TBWL in SURMOUNT-1 vs Wegovy's 14.9% in STEP-1 — and SURMOUNT-5 head-to-head confirmed Zepbound −20.2% vs Wegovy −13.7% over 72 weeks.
Last verified 2026-05-27
Wegovy vs Mounjaro
Mounjaro is FDA-labeled for type 2 diabetes only; Wegovy is FDA-labeled for obesity + CV risk reduction. SURMOUNT-5 head-to-head: tirzepatide -20.2% vs semaglutide -13.7%.
Last verified 2026-05-27
Wegovy vs Ozempic
Wegovy and Ozempic are the same molecule (semaglutide) from Novo Nordisk — Wegovy is FDA-labeled for obesity (max 2.4 mg); Ozempic for type 2 diabetes (max 2 mg).
Last verified 2026-05-27
Wegovy vs Foundayo
Wegovy delivered −14.9% TBWL in STEP-1 (68 wk weekly injection); Foundayo delivered −11.1% in ATTAIN-1 (72 wk, 17.2 mg oral). Wegovy adds SELECT CV benefit; Foundayo skips needles.
Last verified 2026-05-27
Wegovy vs Saxenda
STEP-8 head-to-head: Wegovy 2.4 mg weekly produced -15.8% body weight vs Saxenda 3.0 mg daily -6.4% at 68 weeks. Same manufacturer, weekly beats daily.
Last verified 2026-05-28
Wegovy vs Trulicity
Wegovy delivered -14.9% body weight in STEP-1 vs Trulicity's ~3 kg in T2D trials. Trulicity wins on T2D CV outcomes (REWIND, MACE -12%) and pediatric coverage from age 10.
Last verified 2026-05-28
See all drug-vs-drug verdicts.
Pivotal Wegovy Trial Walkthroughs
Endpoint-by-endpoint breakdowns of the trials that shaped the Wegovy label, with primary-source numbers and FAQs.
STEP-1
STEP-1 is the pivotal NEJM trial that established once-weekly semaglutide 2.4 mg as a category-defining obesity drug. This deep-dive walks through every reported endpoint — body weight, waist, blood pressure, hs-CRP, HbA1c, IWQOL-Lite-CT, SF-36 — with the actual numbers from the Wilding 2021 publication and the ClinicalTrials.gov results posting, plus adverse-event incidence and FAQs about run-in, dose tolerance, and durability after treatment ends.
Phase 3 · N=1,961 · Last verified 2026-05-27
SELECT
SELECT (Lincoff 2023, NEJM, PMID 37952131) was the first cardiovascular-outcomes trial of a GLP-1 receptor agonist run in adults with obesity but no diabetes. Across 17,604 participants followed a mean 39.8 months, weekly semaglutide 2.4 mg reduced the primary three-point MACE composite by 20% versus placebo. The result moved semaglutide from a weight-loss drug into the cardioprotection conversation and underpinned Wegovy's March 2024 FDA label expansion to reduce MACE risk in adults with obesity and established cardiovascular disease.
3 · N=17,604 · Last verified 2026-05-27
STEP-4
STEP-4 is the canonical "if I stop, will the weight come back" trial. After a 20-week open-label run-in on semaglutide 2.4 mg during which participants lost a mean 10.6% of body weight, 803 responders were randomized 2:1 to either continue weekly semaglutide for 48 more weeks or switch to placebo. Those who continued lost another 7.9% on top of run-in losses. Those switched to placebo regained 6.9% over the same 48 weeks — a 14.8 percentage-point swing. Waist circumference, systolic blood pressure, and SF-36 physical-functioning scores all moved in the same direction: maintained on drug, partially reversed off it. STEP-4 is the trial that turned obesity drugs into chronic-disease therapy in the regulatory and clinical conversation.
Phase 3a · N=803 · Last verified 2026-05-27
STEP-2
STEP-2 is the companion to STEP-1 — the pivotal trial that established once-weekly semaglutide 2.4 mg for adults with overweight or obesity who also have type 2 diabetes. Novo Nordisk randomized 1,210 adults with BMI ≥27 and HbA1c 7-10% to semaglutide 2.4 mg, semaglutide 1.0 mg (the Ozempic dose), or matching placebo for 68 weeks, with monthly lifestyle counseling in every arm. Mean weight loss at week 68 was −9.6% on the 2.4 mg dose versus −7.0% on 1.0 mg and −3.4% on placebo, with HbA1c falling by 1.6 percentage points on both active doses. The trial provided the regulatory case that Wegovy works in patients with T2D and informed why the obesity-dose effect on weight is blunted, but not erased, by diabetes.
Phase 3 · N=1,210 · Last verified 2026-05-28
Wegovy Patient Questions, Answered
Real patient questions about Wegovy pulled from named subreddits and answered with peer-reviewed trial data.
Top 10 Semaglutide Side-Effect Questions from Reddit, Answered
10 questions · 15 PubMed citations
Last verified 2026-05-27
Top 10 GLP-1 Insurance Coverage Questions from Reddit, Answered
10 questions · 12 PubMed citations
Last verified 2026-05-28
Top 10 GLP-1 Injection Technique Questions from Reddit, Answered with FDA Labels
10 questions · 11 PubMed citations
Last verified 2026-05-28
Top 10 GLP-1 Plateau Questions from Reddit, Answered
10 questions · 10 PubMed citations
Last verified 2026-05-28
Wegovy Reference Cards
Scannable cheat sheets for dose schedules, missed-dose rules, and red-flag side effects — every number verified against the DailyMed FDA label.
Wegovy Dose Ladder (2026 Cheat Sheet)
FDA-label Wegovy titration on one page — 5 step doses, recommended week-to-week timing, missed-dose protocol, and the side-effect red flags that mean call your doctor. DailyMed-sourced, current 2026.
4 min read · Last verified 2026-05-27
GLP-1 Injection Site Rotation: 8-Week Cheat Sheet (2026)
Wegovy, Ozempic, Zepbound, and Mounjaro all share the same three FDA-approved injection sites: abdomen, front of thigh, and back of upper arm. Reusing the same spot week after week causes lipohypertrophy — thickened fatty tissue that absorbs the drug erratically, leaving appetite suppression and weight-loss results inconsistent. This cheat sheet maps the approved sites, gives an 8-week rotation example, and lists the technique mistakes that send users back to the prescriber.
4 min read · Last verified 2026-05-28
Saxenda Dose Ladder (2026 Cheat Sheet)
FDA-label Saxenda titration on one page — the 5-step daily ladder, the 3-day re-titration rule, the red-flag side effects that mean call the prescriber, and the practical case for moving to a weekly GLP-1. DailyMed-sourced, current 2026.
5 min read · Last verified 2026-05-28
GLP-1 to GLP-1 Switching (2026 Cheat Sheet)
Wegovy → Zepbound, Ozempic → Mounjaro, Saxenda → Wegovy — FDA labels do not address head-to-head switching directly. Starting-dose matrix, wait times between drugs, and red flags during the transition on one scannable page.
5 min read · Last verified 2026-05-28
Ranked PubMed Studies on Wegovy
Curated lists of the highest-impact peer-reviewed studies on Wegovy and related GLP-1 drugs. Every PMID live-verified via PubMed esummary.
Top 10 PubMed Studies on Semaglutide for Weight Loss (2026)
Ten peer-reviewed semaglutide weight-loss studies anchored to the STEP program (STEP-1 to STEP-8, STEP-TEENS, STEP-HFpEF), the SELECT cardiovascular outcomes trial, and OASIS-1 high-dose oral. Each entry includes the PMID, trial design, primary endpoint, and editorial summary.
10 ranked papers · Last verified 2026-05-27
Top 10 PubMed Studies on GLP-1 Cardiovascular Outcomes (2026)
Ten landmark cardiovascular outcomes trials that established GLP-1 receptor agonists as cardioprotective drugs beyond glycemic control. Covers MACE reduction in type 2 diabetes (LEADER, SUSTAIN-6, REWIND, HARMONY OUTCOMES, AMPLITUDE-O, PIONEER 6), the SELECT paradigm-shift in obesity without diabetes, kidney outcomes in FLOW, heart failure in STEP-HFpEF, and the foundational neutral ELIXA post-ACS trial. Each entry includes the PMID, NCT, primary endpoint, and editorial summary.
10 ranked papers · Last verified 2026-05-27
Top 10 PubMed Studies on Compounded GLP-1 Safety and Quality (2026)
Ten peer-reviewed papers that document the safety, quality, and regulatory landscape of compounded GLP-1 receptor agonists. No published head-to-head bioequivalence randomized trial has compared compounded semaglutide or tirzepatide against brand-name Wegovy, Ozempic, Mounjaro, or Zepbound. The literature instead consists of FAERS and EudraVigilance pharmacovigilance studies, poison-control case series, mass-spectrometry impurity analyses, an FDA-shortage 503A-vs-503B regulatory review, the 2025 American Diabetes Association statement, the 2024 Obesity Medicine Association position, a direct-to-consumer market analysis, and clinical-guidance reviews. Each entry includes PMID, source journal, study design, and editorial summary explaining what the paper documents and what it does not establish.
10 ranked papers · Last verified 2026-05-28
Top PubMed Studies on GLP-1 Drugs and Bone Health / Fracture Risk (2026)
Ten peer-reviewed studies that frame the emerging GLP-1 bone-health question. The evidence base is younger and thinner than for cardiovascular or kidney outcomes — most randomized data is from DEXA substudies of obesity weight-loss trials, not dedicated fracture endpoints. Rapid weight loss is known to reduce bone mineral density by roughly 1-3% at the hip and lumbar spine over 12-18 months regardless of how it is achieved, and DEXA substudies of liraglutide and semaglutide have generally found GLP-1-mediated weight loss produces comparable BMD reductions to diet-induced loss. Whether the GLP-1 receptor itself confers an independent bone-protective effect — as proposed by Iepsen's foundational 2015 JCEM trial — remains contested. RCT-level meta-analyses (Mabilleau 2014, Cheng 2019, Zhang 2025) have shown no overall fracture-risk signal in type 2 diabetes populations. Observational and pharmacovigilance work (Ko 2023 JAMA Netw Open, Xiao 2025 FAERS) point toward neutral or favorable fracture profiles versus comparators. Each entry includes PMID, journal, study type, and editorial summary.
10 ranked papers · Last verified 2026-05-28
Related Research on Wegovy
Deep-dive articles from our research desk with primary-source trial data, FDA label verification, and editorial analysis.
Ozempic Legs: Loose Skin, Muscle Loss, and Leg Changes Explained
What 'Ozempic legs' actually are — subcutaneous fat loss, lean-mass reduction, and loose/saggy skin that make legs look thinner, older, hollow, or veiny after GLP-1 weight loss — who's most at risk, and how to prevent and manage it.
9 min read4 citations
First Signs Ozempic Is Working: Early Indicators a GLP-1 Is Taking Effect
How to know if Ozempic is working — the early signs that appear in the first 1–2 weeks (reduced food noise, earlier satiety, smaller portions, mild GI effects) and what meaningful weight loss actually looks like as the dose titrates up.
8 min read4 citations
Ozempic Muscle Cramps: Electrolytes, Dehydration, and What Helps
Muscle cramps on Ozempic are not a direct GLP-1 effect. The credible mechanism is secondary: reduced intake, GI fluid losses (vomiting, diarrhea), and rapid weight loss shift electrolytes. Evidence, honest framing, and what helps.
9 min read3 citations
Endoscopic Sleeve Gastroplasty (ESG): The Evidence vs GLP-1s and Surgery
Endoscopic sleeve gastroplasty (ESG) is an incisionless stomach-tightening procedure that produced 13.6% weight loss in the MERIT randomized trial - on par with semaglutide, below tirzepatide and surgery. The honest evidence on efficacy, safety, cost, reversibility, and how it compares to a GLP-1.
12 min read12 citations
Gastric Balloon vs GLP-1: Which Wins on Weight Loss, Durability, and Safety?
No head-to-head trial exists, but the shape is clear: a temporary 6-month gastric balloon delivers ~7-15% weight loss that partly reverses after removal, versus a GLP-1's ongoing ~15-21% sustained while taken. The balloon also carries FDA death reports a GLP-1 does not. For most people a GLP-1 or ESG is stronger; the balloon's niche is a short-term jump-start.
10 min read7 citations
ESG vs GLP-1 (Semaglutide and Tirzepatide): The Head-to-Head Evidence
A one-time incisionless procedure or a weekly injection for life? ESG produced ~13.6-16% weight loss vs ~14.9% for semaglutide and ~20.9% for tirzepatide, but no head-to-head trial exists. Efficacy, durability, cost over time, risk, and the combination that beats either alone.
12 min read6 citations
Frequently Asked Questions
Sources & methodology — as of July 2026
- 1.FDA — Wegovy (semaglutide) Approval History via Drugs@FDA— U.S. Food & Drug Administration.
- 2.STEP 1 Trial — Once-Weekly Semaglutide in Adults with Overweight or Obesity (Wilding JPH et al.)— New England Journal of Medicine.PMID: 33567185.
- 3.SURMOUNT-5 Trial — Tirzepatide vs. Semaglutide Head-to-Head in Obesity (Garvey WT et al.)— New England Journal of Medicine.PMID: 40334173.
- 4.SELECT Trial — Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (Lincoff AM et al.)— New England Journal of Medicine.PMID: 37952131.
- 5.FDA — Compounding and the 503A Pharmacy Framework— U.S. Food & Drug Administration.
- 6.FDA — Drug Shortages Database (current shortage listings)— U.S. Food & Drug Administration.
- 7.IRS Publication 502 — Medical and Dental Expenses (HSA/FSA eligibility)— Internal Revenue Service.
Key terms, explained
New to GLP-1s? Tap any term for a quick, plain-English definition.
- Semaglutide · Drugs and brands
- Ozempic · Drugs and brands
- GLP-1 receptor · Mechanism
- STEP-1 · Major trials
- SELECT · Major trials
- Titration · Dosing
- Ozempic face · Side effects
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