By Dr. Asnat Raziel, specialist in obesity treatment, metabolic health and healthy longevity; Director of the Multidisciplinary Center for Obesity Treatment, Assia Medical, Assuta Ramat HaChayal
Who can take Wegovy: the short answer
Who can take Wegovy? This is one of the most common questions I hear in the clinic. The short answer: Wegovy targets adults with obesity, or with overweight plus a weight-related disease. However, the decision does not rest on the number on the scale alone. That is why it helps to understand the criteria, the safety limits and what the studies actually showed.
In this article I will explain who meets the indication and who needs extra caution. I will also cover who must not use the drug, and what to check before starting.
What is Wegovy and how does it work?
Wegovy is the brand name of semaglutide at the dose intended for treating obesity. The active ingredient mimics GLP-1, a hormone the gut releases after a meal. This hormone acts on the hunger and satiety centers in the brain. It also slows stomach emptying and reduces appetite.
In practice, many patients say their constant thoughts about food calm down. We call this food noise, and it explains much of why dieting alone is so hard. You inject it once a week, under the skin. Moreover, the dose rises gradually over about four months.
Who can take Wegovy according to the label
According to the FDA-approved prescribing information, Wegovy is approved for weight loss and for keeping the weight off over time. The indication covers two groups of adults:
- Adults with obesity, meaning a BMI (body mass index) of 30 or more.
- Alternatively, adults with overweight, a BMI of 27 or more, plus at least one weight-related disease. For example: high blood pressure, type 2 diabetes, high blood lipids or sleep apnea.
In addition, the drug is approved for teenagers aged 12 and over with obesity. For them, the criterion is not a fixed BMI. Instead, it is a BMI at or above the 95th percentile for age and sex. In the STEP TEENS trial, BMI fell by 16.1% on average in teens on semaglutide. In contrast, it rose by 0.6% in the placebo group.
Beyond weight: the heart and the liver
Moreover, the indication is no longer just “weight loss”. Wegovy is also approved to lower the risk of cardiovascular events in adults with known heart disease and overweight. The SELECT trial included 17,604 participants without diabetes. A major cardiac event (cardiac death, heart attack or stroke) occurred in 6.5% of those on the drug. By comparison, it occurred in 8.0% of the placebo group. In other words, there were about 1.5 fewer events per 100 patients. I covered this in detail in my article on the heart results of the SELECT study. Likewise, the FDA has also approved the drug for inflammatory fatty liver disease (MASH) with moderate to advanced fibrosis, without cirrhosis.
How much weight do people actually lose?
The STEP 1 trial enrolled 1,961 adults with obesity and without diabetes. After 68 weeks, people on Wegovy 2.4 mg lost 14.9% of their body weight on average. In the placebo group, they lost 2.4%. About half of the patients (50.5%) lost 15% or more. Even so, remember that this is an average. Some people lose a lot, while others respond less.
For patients who need greater weight loss, a 7.2 mg dose now also exists. In the STEP UP trial, it led to an average weight loss of 18.7%, compared with 15.6% on 2.4 mg. Regulators in Europe and the US have approved this dose. You will find more details in my article on high-dose Wegovy. On the other hand, digestive side effects are more common at the higher dose.
Who can take Wegovy, and who must not
Who can take Wegovy is only half the question. The other half matters just as much: who should not receive it. According to the label, the drug must not be used in these situations:
- A personal or family history of medullary thyroid cancer (MTC).
- MEN 2 syndrome, a rare genetic syndrome of glandular tumors.
- A previous severe allergic reaction to semaglutide or to any ingredient of the product.
Also, Wegovy should not be used during pregnancy. The label advises stopping treatment at least two months before a planned pregnancy. Furthermore, it must not be combined with another GLP-1 drug, such as Ozempic or Mounjaro.
When Wegovy needs extra caution
In some situations treatment is possible, but only with caution and close follow-up. First, people who have had acute pancreatitis. Second, gallbladder disease or gallstones. Third, kidney disease, because vomiting and diarrhea can cause dehydration. Fourth, diabetes with damage to the retina. Caution also applies to anyone taking insulin or a sulfonylurea, because of the risk of low blood sugar. Finally, before surgery or a gastroscopy under anesthesia, tell the anesthesiologist.
Who can take Wegovy beyond the numbers
The indication is only a starting point. In our clinic we also ask other questions. Is the patient ready for long-term treatment? Can they keep up a protein-rich diet and regular physical activity? And are their expectations realistic?
These questions matter because obesity is a chronic disease. Studies have shown that after stopping treatment, most patients regain a large part of the weight. Therefore, anyone starting Wegovy should see it as part of a broader plan, not a fix for a few months. Before starting, it is worth having the recommended tests and preparing a plan for nutrition and activity.
Side effects worth knowing
The common side effects are mainly digestive: nausea, diarrhea, vomiting, constipation and abdominal pain. They are usually mild to moderate and tend to ease over time. In STEP 1, 4.5% of patients on the drug stopped treatment because of such effects. For a full review, see my article on the side effects of Wegovy.
Injection or pill?
In December 2025, the FDA approved the Wegovy pill, semaglutide 25 mg once a day. In the OASIS 4 trial, patients lost 16.6% of their weight on average, among those who stayed on treatment. The pill especially suits people who are wary of injections. On the other hand, it must be taken on an empty stomach. I described its pros and cons in my article on oral Wegovy.
Wegovy in Israel: prescription and funding
In Israel, Wegovy is available by prescription only. At the time of writing, it is not included in Israel’s national health basket for treating obesity. However, all health funds now offer Wegovy and Mounjaro through their supplementary insurance at a discount of about 50%, under medical conditions. Current prices appear on the health funds’ websites, so check with your own fund.
Bottom line: who can take Wegovy?
So who can take Wegovy? Adults with a BMI of 30 or more, or 27 or more with a weight-related disease, and teens aged 12 and over with obesity. In addition, it is especially suitable for people who also have heart disease or fatty liver. On the other hand, it is not suitable during pregnancy, with a history of medullary thyroid cancer or with MEN 2 syndrome. Ultimately, you should make the decision together with a doctor who knows the full picture. If you are unsure, a proper medical consultation will help you choose the right treatment.
This article provides general information and is not personal medical advice. For any question about your treatment, please consult your doctor.
Questions and answers
Who can take Wegovy with a BMI of 28?
Yes, you can, if you have at least one weight-related disease, such as high blood pressure or type 2 diabetes. Without a related disease, the indication starts at a BMI of 30.
Is Wegovy suitable for teenagers?
Yes, from age 12 with obesity, meaning a BMI at or above the 95th percentile for age and sex. Treatment takes place under the care of a pediatrician or an obesity specialist.
How long before pregnancy should I stop?
According to the label, at least two months before a planned pregnancy. If you become pregnant during treatment, stop the drug and see your doctor.
Do I need to take Wegovy for life?
Not necessarily, but obesity is a chronic disease. After stopping, many people regain weight. For this reason, your doctor sets the length of treatment individually, together with a plan to maintain the result.
References
WEGOVY (semaglutide) injection – Prescribing Information
Once-Weekly Semaglutide in Adults with Overweight or Obesity
Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes
Once-Weekly Semaglutide in Adolescents with Obesity
Wegovy pill approved in the US as first oral GLP-1 for weight management
Leumit: Wegovy in the “Leumit Gold” supplementary insurance (Hebrew)
