From the Guidelines
Wegovy (semaglutide) should be initiated with a dose escalation schedule, starting with 0.25 mg subcutaneously once weekly, to minimize side effects, and gradually increased to the maintenance dose of 2.4 mg weekly, as recommended by the most recent and highest quality study 1. The dose escalation schedule is crucial to reduce gastrointestinal side effects like nausea, vomiting, and diarrhea that commonly occur with this medication.
- The recommended regimen starts with 0.25 mg injected subcutaneously once weekly for the first month,
- then increases to 0.5 mg weekly for the second month,
- and finally reaches the maintenance dose of 2.4 mg weekly after gradual monthly increases to 1 mg and 1.7 mg. This approach is supported by the American Gastroenterological Association, which suggests using semaglutide 2.4 mg with lifestyle modifications for the long-term treatment of obesity 1. Wegovy should be used alongside a reduced-calorie diet and increased physical activity for optimal results, and it's essential to note that it's prescribed for adults with a BMI of 30 kg/m² or greater (obesity), or 27 kg/m² or greater (overweight) with at least one weight-related condition such as high blood pressure, type 2 diabetes, or high cholesterol. If a dose is missed, it should be taken as soon as possible within 5 days; if more than 5 days have passed, the dose should be skipped, and the next one taken on the regularly scheduled day. The medication works by mimicking a hormone called GLP-1 that targets areas in the brain that regulate appetite and food intake, helping patients feel fuller longer and eat less. It's also important to consider the potential side effects and contraindications, such as nausea, vomiting, diarrhea, and increased risk of pancreatitis and gallbladder disease, as well as the need for gradual dose titration to mitigate these adverse effects 1.
From the Research
Wegovy Dosage for Diet
The dosage of Wegovy (semaglutide) for weight loss is discussed in the following points:
- The study 2 mentions that the STEP trial examined the effects of 2.4 mg, once-weekly, subcutaneous semaglutide on patients with obesity.
- There is no direct information about the dosage of Wegovy in the other studies provided.
- However, the study 2 summarizes and discusses the weight loss results from the SUSTAIN, PIONEER, and STEP clinical trial programs, which led to the Food and Drug Administration approval of Wegovy (semaglutide) for weight loss.
Comparison with Other Weight Loss Medications
Some key points to consider when comparing Wegovy with other weight loss medications are:
- The study 3 discusses the efficacy and safety of phentermine/topiramate in adults with overweight or obesity, and mentions that the weight loss was related to the dose of phentermine/topiramate.
- The study 4 and 5 discuss the long-term effects of weight-reducing drugs in people with hypertension, including orlistat, sibutramine, phentermine/topiramate, and naltrexone/bupropion.
- The study 6 discusses the safety and efficacy of treatment with phentermine/topiramate extended release plus lifestyle modification for weight loss and glycemic benefits in obese/overweight adults with type 2 diabetes.
Key Findings
Some key findings from the studies are:
- The study 2 demonstrates that semaglutide (injected or oral) has superior efficacy compared with placebo and other antidiabetic medications in weight reduction.
- The study 3 shows that phentermine/topiramate therapy resulted in an average weight loss of 7.73 kg (95% CI: 6.60-8.85) in general compared with placebo.
- The study 5 shows that orlistat, phentermine/topiramate, and naltrexone/bupropion reduced body weight in people with elevated blood pressure, with the magnitude of the effect being greatest with phentermine/topiramate.