What is the recommended dosage of Wegovy (semaglutide) for weight loss?

From the Guidelines

Wegovy (semaglutide) should be initiated at a dose of 0.25 mg subcutaneously once weekly and gradually increased every 4 weeks as tolerated by the patient to minimize side effects, with a final maintenance dose of 2.4 mg weekly. This dosing regimen is based on the most recent and highest quality study available, which recommends a gradual dose escalation to reduce gastrointestinal side effects such as nausea, vomiting, and diarrhea 1. The medication should be used in conjunction with a reduced-calorie diet and increased physical activity for optimal weight management results.

Key Considerations

• The dose escalation schedule is crucial to minimize side effects and improve patient tolerance.
• Wegovy is indicated for adults with a BMI of 30 or higher (obesity) or adults with a BMI of 27 or higher (overweight) who have at least one weight-related condition such as high blood pressure, type 2 diabetes, or high cholesterol.
• The medication works by mimicking a hormone called GLP-1 that regulates appetite and food intake, helping patients feel fuller longer and reducing hunger signals.

Monitoring and Contraindications

• Patients should be monitored for common side effects such as nausea, vomiting, diarrhea, and injection site reactions.
• Contraindications include pregnancy, breastfeeding, personal or family history of medullary thyroid cancer or MEN2, and pancreatitis.
• Caution should be used in patients with a history of pancreatitis, cholelithiasis, or suicidal ideation and behavior 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

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, as they focus on different medications such as phentermine/topiramate and orlistat.
• However, the study 2 provides information on the efficacy of semaglutide in weight reduction, which led to Food and Drug Administration approval of Wegovy (semaglutide) for weight loss.

Key Findings

Some key findings related to weight loss medications are:

• Phentermine/topiramate therapy resulted in an average weight loss of 7.73 kg (95% CI: 6.60-8.85) in general compared with placebo, as reported in the study 3.
• The study 4 found 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.
• The study 5 reported that treatment with phentermine/topiramate extended release plus lifestyle modification resulted in significant weight loss and improvement in glycemic control in obese/overweight adults with type 2 diabetes.

Adverse Events

The studies also report on adverse events associated with weight loss medications, including:

• The study 3 found that phentermine/topiramate increased the risk of nervous system-related adverse events, such as dysgeusia, paresthesia, and dry mouth.
• The study 4 reported that the incidence of gastrointestinal side effects was consistently higher in participants treated with orlistat compared to placebo.
• The study 5 found that common adverse events associated with phentermine/topiramate extended release included paraesthesia, constipation, and insomnia.