Wegovy (semaglutide): Overview, how it works, and more

What is Wegovy?

Over the last year or two, the word Ozempic has become a cultural shorthand for the entire category of prescription weight-management medications—but it’s not actually even in that category. Ozempic,a brand name for semaglutide, is FDA-approved to treat type 2 diabetes. It just so happened, however, that Ozempic was incredibly effective for weight loss, to the point where it got its own version FDA-approved just for that, Wegovy, and spurred a whole new generation of weight-management medications. Let’s catch you up on how semaglutide works, the difference between Ozempic and Wegovy, and what makes someone a good candidate for weight-loss medication.

How does Wegovy (semaglutide) work for weight loss?

Semaglutide, which is what’s known as a GLP-1 agonist, works by mimicking a hormone called glucagon-like peptide, or GLP-1, that's already in your body. This hormone is naturally released when you eat and it tells your body to increase insulin to bring blood sugar levels back down. Semaglutide also slows the emptying of the stomach and signals the brain that you are full. By taking semaglutide, you activate the GLP-1 receptors in your body for a prolonged period of time, helping to manage your blood sugar, slow down the emptying of your stomach, and reduce your appetite.

These actions combine to help you feel full for longer and reduce how many calories you eat, leading to more weight loss than past medications. “It’s evolved our field at a pace few of us could have anticipated,” says Dr. Amanda Velazquez, M.D., director of obesity medicine at the Center for Weight Management and Metabolic Health at Cedars-Sinai Medical Center in Los Angeles.

These medications also support a more nuanced approach to obesity treatment—that losing weight isn’t simply a matter of willpower or discipline. “People sometimes think that taking these medications is the easy way to lose weight,” says Gary Foster, PhD, a clinical psychologist and Chief Scientific Officer at WeightWatchers. “But that way of thinking minimizes the complications of obesity. There are a lot of biological factors that impact the way we think about food, the way we focus on food, and the cravings we have. Two people can sit in front of the same plate of food and have different brain reactions to that food. It’s not that one person has more willpower; it’s that they are experiencing food differently.”

That said, it’s still important to combine semaglutide with healthy habits to maximize the benefits. “Pairing the medication with lifestyle changes supports your whole health,” says Dr. Kimberly Gudzune, M.D., medical director for the American Board of Obesity Medicine and an associate professor of medicine at Johns Hopkins. “We know that a nutritious diet high in fruits, vegetables, and lean protein is good for your body regardless of weight. And we know physical activity is good for your body regardless of weight.” A lifestyle program like WeightWatchers GLP-1 Program can help you develop and sustain those habits in a way that supports semaglutide.

How much weight can you lose on Wegovy?

In a large clinical trial published in the New England Journal of Medicine, participants who had obesity or who had overweight with a weight-related condition like high blood pressure lost an average of 15% of their body weight in a little over a year. This was an average of 33 pounds lost in 68 weeks. The participants in the trial did not have diabetes and paired the 2.4mg weekly doses of semaglutide with lifestyle intervention.

Medication and weight-loss plateau

As much as semaglutide can help you lose weight quickly, the pace doesn’t last forever. The same trial in the New England Journal of Medicine that showed a 15% weight loss found that weight tended to stop dropping and hold steady after 60 weeks, on average. This is similar to results found in other GLP-1s, which also ultimately lead to a weight-loss plateau.

What’s the difference between Ozempic and Wegovy?

While both Ozempic and Wegovy are the same drug, semaglutide, given by weekly injection, there are some key differences between the two. Ozempic was FDA-approved in 2017 for controlling blood sugar in those with type 2 diabetes. Then, in 2020, Ozempic received a label expansion, approving its use for those with cardiovascular issues—who may or may not be living with obesity—to reduce the risk of heart attack and stroke.

Wegovy, on the other hand, is FDA-approved for weight management. It was approved in 2021 for adults who are either living with obesity (having a body mass index of 30 or greater) or living with overweight (a BMI of 27 or greater) plus at least one qualifying health condition, such as high blood pressure, type 2 diabetes, or high cholesterol. In 2024,the FDA also approved Wegovy to reduce the risk of cardiovascular-related death, heart attack, and stroke in adults with cardiovascular disease.

The two versions of semaglutide also come in different dosages: Ozempic maxes out at 2mg per dose, while Wegovy is approved to be given at a slightly higher dose of 2.4mg.

Who should use Wegovy (semaglutide) for weight loss?

If you have been unable to lose weight through lifestyle modifications such as diet and exercise and fit the medical qualifications, you may be a candidate for semaglutide. “People sometimes describe that before taking semaglutide, they were constantly thinking about food, but once that noise was quieted, they found it easier to make the [lifestyle] changes they always wanted,” says Gudzune. “That drives home that a lot of this is not in your control as much as you’d like it to be.”

As with any drug, deciding whether or not to take semaglutide is best done in partnership with your healthcare provider. For example, there are some people who are advised not to take the medication, including those who have a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2). It is also not recommended for some people with a history of pancreatitis.

How much does Wegovy (semaglutide) cost?

This all comes down to whether or not the drug is covered by your insurance. If it is, you’re only out your cost share. But if it’s not, you may be paying a lot more: The list price for Wegovy is $1,349 for a month’s supply. That said, you may be able to use a prescription discount card or qualify for a manufacturer-sponsored patient assistance program. To get a better idea of how much Wegovy will cost you, check with your insurer, healthcare provider, or pharmacist.

The fact that these drugs aren’t widely covered is something obesity specialists like Gudzune want to see change in the future. “Hopefully more insurance companies see the value of having weight-management medications covered,” she says. “Treatment decisions should be made based on what the best option is for the patient rather than what they can afford.”

What is “budget Wegovy”?

Because semaglutide costs so much if you’re paying out of pocket, those whose insurance plans don’t cover it might be intrigued by what’s known as “budget Wegovy.” But don’t be so quick to give this lower cost option a try. The medication referred to as budget Wegovy on social media is usually an over-the-counter stool softener or a laxative–drugs that should only ever be used as prescribed or as instructed on the label (like to treat constipation), not to help you lose weight.

There is another option you might hear about that’s being described as “nature’s Wegovy.” This supplement, berberine, is available over-the-counter and has been compared to semaglutide because it can have a stabilizing effect on blood sugar levels. But berberine doesn’t have the same impact on appetite, food noise, or gastric emptying as semaglutide.

If you want to take Wegovy but can’t afford it, talk to your healthcare provider about other safe FDA-approved medications that might work for you.

What happens after you stop taking Wegovy?

Semaglutide is designed to be taken for the long-term, even after you hit your goal weight. That’s because when you stop taking it, you will likely regain some, or all, of the weight you lost. In fact, a study published in Diabetes, Obesity, and Metabolism found that people who stopped taking semaglutide gained back, on average, two-thirds of the weight they lost within a year.

“This idea of a drug being a quick fix or jump start, those are terms we need to abandon from our lexicon,” says Gudzune. “If you think about treating high blood pressure, you don’t stop taking it once your blood pressure is controlled. The same concept applies to obesity. This is a long-term treatment for a chronic condition.”

The bottom line

Wegovy, which is a brand name of the drug semaglutide, is a GLP-1 receptor agonist that works by mimicking the action of a naturally occurring hormone in the body. When taken as a weekly injection, it helps regulate blood sugar levels, slow down the rate at which food is digested, and increase fullness after you eat. It can help people living with obesity—or with overweight and a qualifying health condition—lose on average 15% of their body weight, usually with few side effects. That said, it is a long-term treatment for a chronic condition, not something you stop taking once you lose weight.