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 for obesity: what you need to know
Wegovy for obesity is a once-weekly, high-dose injection of semaglutide. Sold under the brand name Wegovy, it is approved specifically for the long-term treatment of overweight and obesity. It offers doctors and patients one of the most effective options available today, along with proven protection for the heart.
In this guide, I have gathered the essentials: how the medication works, how much weight people lose, which doses are available and where eligibility stands in Israel.
Who is Wegovy for?
Wegovy is intended for adults with a BMI of 30 or higher. It is also suitable for people with a BMI of 27 or higher who have a related condition, such as diabetes, high blood pressure or dyslipidemia. The medication is also approved for adolescents aged 12 and older with obesity.
Over the years, important new indications have been added in the United States. In March 2024, it was approved to reduce the risk of cardiovascular events in people with heart disease and obesity. Then, in August 2025, it was approved to treat inflammatory fatty liver disease (MASH) with moderate to advanced fibrosis.
How it works
Like Ozempic, Wegovy is a GLP-1 receptor agonist. It mimics the natural hormone GLP-1 and increases the feeling of fullness by acting on the central nervous system. This reduces appetite and quiets intrusive thoughts about food.
The medication also helps balance blood sugar. It increases insulin release and suppresses the release of glucagon. In addition, it slows stomach emptying. Together, these effects lead to significant, lasting weight loss.
How effective is Wegovy for obesity? What the trials show
The STEP trials demonstrate the effectiveness of Wegovy at 2.4 mg. In STEP 1, for example, average weight loss reached 14.9% of body weight after 68 weeks, compared with just 2.4% in the placebo group. What’s more, 86.4% of patients lost at least 5% of their body weight.
In STEP 5, follow-up lasted two years. At week 104, weight loss stood at about 15.2%, compared with about 2.6% with placebo. In other words, when treatment continues, the results hold over time.
These results far exceed those of older weight-loss drugs. They are also accompanied by improvements in metabolic markers such as blood pressure, blood lipids and blood sugar control.
Wegovy at the 7.2 mg dose
The STEP UP trial tested a high dose of semaglutide, 7.2 mg a week, in 1,407 adults with obesity. After 72 weeks, average weight loss reached 20.7%. By comparison, the standard 2.4 mg dose led to 17.5%, and placebo to 2.4%.
The new dose was approved in Europe and then in the United States, where the FDA approved it in March 2026 under the name Wegovy HD. I discuss the trial in more detail in my article on the STEP UP study.
However, a higher dose may also increase the frequency of side effects. It is therefore not right for every patient and requires individual tailoring and close monitoring.
Additional health benefits
Beyond weight loss, Wegovy protects the heart. The SELECT trial included 17,604 people with overweight or obesity and heart disease, but without diabetes. The risk of cardiovascular events fell by 20% (6.5% vs. 8.0%). I covered the findings in detail in my article on the SELECT trial.
Fatty liver also improves. In the ESSENCE trial, liver inflammation (MASH) resolved in 62.9% of patients, compared with 34.3% with placebo. Fibrosis improved in 36.8%, compared with 22.4%. You can read more in my article on Wegovy for fatty liver.
Finally, patients often see improvements in insulin resistance, inflammation and obstructive sleep apnea.
Wegovy for obesity in adolescents and in Israel’s health basket
The STEP TEENS trial included 201 adolescents aged 12 to 18. BMI fell by 16.1% after 68 weeks, compared with a 0.6% increase with placebo. I cover this in detail in my article on Wegovy for children.
In February 2026, the committee that decides on Israel’s national health basket (the list of state-funded treatments) voted to include Wegovy for adolescents aged 12 to 18. It is the first obesity medication funded by the state. Adults, however, were not included in the basket at this stage. They can obtain the medication through supplementary insurance plans, according to the criteria of Israel’s health funds (HMOs).
How it is given and dosing
Wegovy is given as a subcutaneous injection once a week, using an easy-to-use pen. Treatment starts at a low dose of 0.25 mg a week. The dose then increases every four weeks: 0.5 mg, 1 mg, 1.7 mg and finally the 2.4 mg maintenance dose. Later on, in countries that have approved it, the dose can be raised to 7.2 mg.
This gradual increase lets the body adjust and helps people stay on treatment. If you prefer a pill, you may consider the Wegovy pill, which was approved in the United States in December 2025.
Safety and side effects
Wegovy is generally well tolerated. Common side effects include nausea, vomiting, diarrhea, constipation and abdominal discomfort. They are usually mild and fade over time. In STEP 1, for example, 4.5% of patients stopped treatment because of gastrointestinal side effects.
There are also rare but important risks, including pancreatitis and gallstones, especially with rapid weight loss. In addition, in 2025 the European Medicines Agency concluded that optic nerve damage (NAION) is a very rare side effect, occurring in up to 1 in 10,000 patients. Careful patient selection, guidance and close medical follow-up are therefore essential. You will find full details in my article on Wegovy side effects.
A comprehensive treatment approach
To get the most out of treatment, it should be part of a comprehensive lifestyle-change program. A protein-rich diet, regular physical activity and behavioral therapy all improve results. Strength training also helps preserve muscle mass.
A holistic approach turns weight loss into a long-term improvement in health. In my clinic, Wegovy for obesity is part of a multidisciplinary program that includes a dietitian and close support.
The bottom line
Wegovy represents a major leap forward in obesity treatment. It offers powerful, sustainable weight loss, along with protection for the heart and liver. Even so, good long-term results require a combination of medication, lifestyle change and ongoing support.
The information in this article is general information only and is not a substitute for personal medical advice. Treatment decisions should be made together with your doctor.
Frequently asked questions about Wegovy for obesity
Is Wegovy suitable for everyone with excess weight?
No. Wegovy is intended for people with a BMI over 30, or over 27 with related conditions such as diabetes, high blood pressure or dyslipidemia. Your doctor will decide whether it is right for you after a full medical evaluation.
When does weight loss start?
Appetite usually decreases within the first few weeks. Significant weight loss, however, develops gradually and typically peaks after about a year of treatment.
Is the weight loss maintained after stopping treatment?
Not always. After treatment stops, the body activates biological mechanisms that increase hunger, so there is a tendency to regain weight. This is one of the reasons obesity is considered a chronic disease that requires ongoing treatment. It is also worth reading about maintaining your weight after stopping GLP-1 medication.
Do I have to change my diet and exercise habits?
Yes. The medication is highly effective on its own, but combining it with good nutrition and physical activity increases weight loss and helps maintain the results.
Wegovy for obesity vs. other medications, safety and cost
What is the difference between Wegovy and Ozempic?
Both are based on semaglutide. Ozempic is intended mainly for diabetes and goes up to 2 mg. Wegovy, by contrast, is intended for obesity and goes up to 2.4 mg, and in some countries 7.2 mg.
What is the difference between Wegovy and Mounjaro?
Mounjaro acts on two hormones, GIP and GLP-1, and on average leads to slightly greater weight loss. The choice depends on the patient, tolerability and cost. You will find a detailed comparison in my article Mounjaro vs. Wegovy.
Can Wegovy be combined with other weight-loss medications?
Sometimes, but only under medical supervision. In certain situations, combining treatments improves results, but it requires careful, individual tailoring.
What should I do about side effects such as nausea?
Nausea is common at the start of treatment. To ease it, it is recommended to:
- Eat small portions
- Avoid fatty foods
- Drink enough fluids
- Sometimes slow down the pace of dose increases
Is the medication safe in the long term?
Current data point to a good safety profile, including cardiovascular benefit over more than three years of follow-up. Even so, long-term treatment requires regular medical monitoring.
Is Wegovy suitable for adolescents?
Yes. The medication is approved for obesity from age 12, under medical supervision. Since 2026, it has also been included in Israel’s national health basket for adolescents. You can find more details in my article on weight-loss injections for adolescents in the health basket.
How much does Wegovy cost?
The price varies by dose and by supplementary insurance coverage. For an up-to-date overview, see my article on how much Wegovy costs.
Is it a miracle drug?
Wegovy is a major breakthrough, but it is not a substitute for a healthy lifestyle. Real success comes from combining medication, new habits and long-term support.
References
Semaglutide Treatment Effect in People With Obesity – STEP 1
Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial
STEP UP: High-dose semaglutide led to 21% weight loss for adults with obesity
Wegovy HD (semaglutide 7.2 mg) approved in the US, providing 20.7% mean weight loss
Semaglutide Effects on Cardiovascular Outcomes in People With Overweight or Obesity – SELECT
Semaglutide Approved for MASH With Moderate to Advanced Fibrosis
Once-Weekly Semaglutide in Adolescents with Obesity
The 2026 drug basket: a free weight-loss injection, for adolescents only (Ynet, in Hebrew)
