Wegovy 7.2 mg approval: Europe, the US and what's next

My articles

Wegovy 7.2 mg approval: what was approved, for whom and how to switch

By Dr. Asnat Raziel, bariatric surgeon specializing in obesity treatment, metabolic health and healthy longevity; Director of the Multidisciplinary Center for Obesity Treatment, Assia Medical, Assuta Ramat HaChayal, Tel Aviv

Wegovy 7.2 mg approval: what was approved and for whom

The Wegovy 7.2 mg approval came in 2026 in both Europe and the United States. This weekly maintenance dose is three times higher than the familiar 2.4 mg dose. It is meant for adults with obesity who need further weight loss. In the STEP UP trial, patients lost about 21% of their body weight, and about a third of them lost 25% or more.

The active ingredient is still semaglutide, the same GLP-1 satiety hormone. So the difference is in strength, not in the drug itself. In this article, I focus on the approvals, on how the switch works in practice and on what to expect. For an in-depth analysis of the trial data, read my article on the STEP UP trial results. If you want to know whether you are a good candidate, see who needs high-dose Wegovy.

The European approval

On February 17, 2026, the European Commission approved the 7.2 mg dose for all 27 EU countries. The approval followed a positive recommendation from the European medicines committee in December 2025. At first, patients took the dose as three 2.4 mg injections on the same day, once a week.

Later, in July 2026, Europe also approved a dedicated pen that delivers 7.2 mg in a single injection. That made treatment much more convenient. In the UK, the dose had been approved even earlier, on January 6, 2026.

The US approval: Wegovy HD

On March 19, 2026, the FDA approved Wegovy HD, a weekly 7.2 mg injection. The FDA is the US Food and Drug Administration. The indication is for adults with obesity who have tolerated the 2.4 mg dose well for at least four weeks and need further weight loss. The drug has been available in US pharmacies since April 7, 2026.

Approval timeline at a glance

Because the news came in stages, here is the whole sequence in one place:

December 2025: positive recommendation from the European medicines committee.
January 6, 2026: approval in the UK.
February 17, 2026: European Commission approval for all 27 EU countries, as three 2.4 mg injections.
March 19, 2026: FDA approval of Wegovy HD in the United States.
April 7, 2026: Wegovy HD reaches US pharmacies.
July 2026: EU approval of a single-injection 7.2 mg pen.
Israel: as of early November 2026, no published approval.

The STEP UP trial: 1,407 participants, 72 weeks

The approvals are based on the STEP UP trial, published in The Lancet Diabetes & Endocrinology. It included 1,407 adults with obesity, without diabetes. The average BMI was 39.9, and the average weight was 113 kg. Participants received 7.2 mg, 2.4 mg or placebo, along with a reduced-calorie diet and physical activity, for 72 weeks.

At the same time, the STEP UP T2D trial included 512 participants with type 2 diabetes. There, patients on the high dose lost 13.2% of their body weight, compared with 3.9% on placebo. In addition, average blood sugar (HbA1c) fell by 1.5 percentage points more than with placebo.

How much weight do people lose?

Among those who took the drug as planned, the average weight loss was 20.7% with 7.2 mg. By comparison, it was 17.5% with 2.4 mg and 2.4% with placebo. In an analysis that included all participants, including those who stopped, weight loss was 18.7%, compared with 15.6% and 3.9%. For example, a person who starts at 110 kg may lose about 23 kg on average.

Moreover, 33.2% of patients on the high dose lost 25% or more of their body weight. On the 2.4 mg dose, the rate was 16.7%. In other words, the high dose roughly doubled the rate of deep weight loss.

What was lost: fat or muscle?

According to the company, about 84% of the weight lost was fat, and muscle function was preserved. In addition, an MRI sub-study found a drop in fat volume and in fat that infiltrates the muscle. A chair-rise test showed that function was not harmed. However, muscle volume fell slightly, so strength training and protein are very important. More on this in my article on how to preserve muscle.

Side effects after the switch

It is important to be precise here. The higher dose slightly increases side effects. Digestive side effects affected 70.8% of patients on 7.2 mg. By comparison, the rate was 61.2% on 2.4 mg and 42.8% on placebo. Most were mild to moderate and faded over time.

In addition, a less familiar side effect appeared: dysaesthesia, an unusual skin sensation such as tingling, numbness or sensitivity to touch. It affected 22.9% on the high dose, compared with 6.0% on 2.4 mg and 0.5% on placebo. Serious side effects occurred in 6.8% on the high dose, compared with 10.9% on 2.4 mg. Practical information appears in my article on Wegovy side effects.

Infographic: Wegovy 7.2 mg approval - timeline, results and who can switch

How to switch after the Wegovy 7.2 mg approval

The switch is not automatic. First, the patient needs to be on 2.4 mg for at least four weeks and tolerate it well. Second, the doctor checks whether there is a medical need for further weight loss. Only then can the dose go straight up to 7.2 mg. This approach fits the idea of treat-to-target dosing, rather than one dose for everyone.

Keep in mind that a high dose is not necessarily the right choice for everyone. Some patients reach their goal on 2.4 mg. Others prefer to switch to a different drug. For a comparison, see my article on Mounjaro versus high-dose Wegovy.

What about Israel?

Earlier estimates suggested that registration in Israel would come at the end of 2026 or the beginning of 2027. However, as of early November 2026, I have not found a published approval for the 7.2 mg dose in Israel. The decision depends on Israel’s Ministry of Health. Meanwhile, the highest dose marketed here is 2.4 mg.

The Wegovy 7.2 mg approval in the bigger picture

In Europe, Wegovy is now available at doses of 0.25, 0.5, 1.0, 1.7, 2.4 and also 7.2 mg. Beyond weight loss, it has data on reducing major heart events, on easing symptoms of heart failure with preserved ejection fraction and on reducing knee pain. Read about heart protection in my article on how Wegovy protects the heart.

Questions and answers

Can I start directly on 7.2 mg?

No. Your doctor raises the dose gradually up to 2.4 mg, and only after at least four weeks on that dose can it go up. The gradual approach helps the body adapt and reduces side effects.

What should I do if I feel tingling in my skin?

Tell your doctor. In most cases the sensation is mild and passes. However, the doctor may consider lowering the dose if it bothers you.

The bottom line on the Wegovy 7.2 mg approval

The new Wegovy dose adds a powerful tool for people who did not reach their goal on the standard dose. On average, people lose about 21%, and a third of patients lose a quarter of their body weight. On the other hand, digestive side effects and skin sensations are more common. Ultimately, the decision to raise the dose should be made with a doctor, based on goals, tolerability and overall health.

This article is general information and does not replace personal medical advice.