weight loss
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Updated
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Wegovy 7.2mg is the highest dose available of semaglutide, a once-weekly weight loss medication that has been widely used for the treatment of obesity over the last few years. It's prescribed for adults living with obesity, taken alongside a reduced-calorie diet and increased physical activity, and works by tapping into one of the body's own appetite-regulating systems.
If you've been moved up to this dose, you've already worked your way through the lower doses. This article walks through what the 7.2mg dose actually is, how the medication works in the body, what the most recent clinical trial shows, and what to expect.
Wegovy contains an active ingredient called semaglutide. It belongs to a class of medicines known as GLP-1 receptor agonists that mimic a hormone called glucagon-like peptide-1 (GLP-1) that your body releases naturally in response to food.
GLP-1 does several things, but two matter most for weight loss:
It slows the rate at which your stomach empties: Food stays in your stomach longer, so you feel full sooner and stay full for longer.
It acts on appetite centres in your brain: The receptors that govern hunger and satiety. The result is reduced appetite and quieter food cravings, particularly the urgent, snack-driven kind.
By mimicking GLP-1, semaglutide gives your body a sustained version of the same biological signal, once a week, by injection. That's why people on the medication often describe a noticeable shift in their relationship with food with less mental noise around eating, smaller portions feeling sufficient, and less reaching for snacks between meals.
The first widely-studied dose of Wegovy for weight loss was 2.4mg. In the landmark STEP 1 trial - a 68-week study of 1,961 adults with overweight or obesity - the 2.4mg dose produced an average weight loss of around 15% of body weight, compared with about 2.5% on placebo.1
The 7.2mg dose has now been tested directly against the 2.4mg dose in a dedicated head-to-head trial. STEP UP was a 72-week, randomised, controlled phase 3b trial of 1,407 adults living with obesity (without type 2 diabetes), comparing once-weekly semaglutide 7.2mg with the established 2.4mg dose and with placebo.² All three groups received the same lifestyle intervention - a reduced-calorie diet and increased physical activity.
The headline findings from STEP UP:²
Average weight loss on 7.2mg was around ~20.7% of body weight, compared with ~4% on placebo.
The 7.2mg dose produced significantly greater weight loss than the 2.4mg comparator in the same trial.
89% of patients on the 7.2mg dose lost at least 5% of their body weight, a clinically meaningful threshold, compared with 38% on placebo.
Of the trial participants, 31% of patients lost 25% or more of their body weight on the 7.2mg dose. None of the placebo group reached that threshold.
Discontinuation was lower on the medication than on placebo (12% vs. 29%), which is an unusual pattern in trials where the active drug carries known gastrointestinal side effects.
The trial excluded adults with type 2 diabetes (who tend to lose less weight on GLP-1 medications), so those numbers reflect outcomes for adults with obesity but without diabetes.
Weight isn't the only thing that changes. In earlier trials, adults on 2.4mg also saw improvements in waist size, blood pressure, cholesterol, and blood sugar.¹ Wegovy isn’t approved to treat those conditions; they're mostly downstream effects of weight loss, not direct treatment effects.
In a separate trial called SELECT, semaglutide 2.4mg cut the risk of major cardiovascular events - heart attack, stroke, or heart-related death - by around 20% in adults who had heart disease alongside their obesity or overweight, over an average of three years.³ It's one reason why we could see these treatments be used for the maintenance of conditions other than weight loss in the future.
Wegovy 7.2mg is delivered via a single-use, pre-filled pen, taken once a week. The dose is already set, meaning there's no dialling, needle attachment, or priming step. The needle stays hidden inside a yellow protective cover, and the injection takes about 5 to 10 seconds from start to finish.
You can inject into the front of your upper thigh, the lower stomach (a couple of inches from your belly button), or the upper arm if someone else is doing it for you. Pick a slightly different spot each week within whichever area you choose.
For a full walkthrough, see our dedicated piece: How to take Wegovy 7.2mg: a step-by-step guide.
Most patients experience some side effects, particularly when stepping up to a higher dose. The most common ones are gastrointestinal:
Nausea, especially in the first weeks after a dose increase
Diarrhoea, constipation, or general gut changes
Stomach pain or bloating
Reduced appetite and early fullness, which is also part of how the medicine is meant to work
Less common but reported: headache, tiredness, dizziness, heartburn, belching, gas, and changes in skin sensation. Most of these settle as your body adjusts.²
There are also rarer but more serious risks worth knowing about. Wegovy can cause:
Pancreatitis: Severe, persistent abdominal pain that sometimes radiates to the back, with or without nausea or vomiting is a sign to stop the medication and seek urgent help.
Gallbladder problems: Including gallstones, sometimes severe enough to need surgery.
Dehydration and kidney problems: Often as a downstream effect of persistent vomiting or diarrhoea.
Low blood sugar (hypoglycaemia): Particularly in patients also taking insulin or sulfonylureas for diabetes.
Because Wegovy slows your stomach down, it can change how other medicines are absorbed. It also matters for surgery and anaesthesia, and anyone scheduled for a procedure under sedation should let the team know they're taking semaglutide.
A few people shouldn't take Wegovy at all. That includes anyone who's had a serious allergic reaction to semaglutide, and anyone that’s pregnant or breastfeeding. It should be stopped at least two months before trying for a baby.
Wegovy 7.2mg is the strongest dose of semaglutide currently available, and the STEP UP trial gives us the clearest picture yet of what that means in practice, with the majority of patients hitting clinically meaningful thresholds.
It's not a different drug. It's the same mechanism, the same weekly injection, the same lifestyle context, just a higher dose for people who need more to get results.
Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989–1002.
Wharton S, et al. Once-weekly semaglutide 7·2 mg in adults with obesity (STEP UP): a randomised, controlled, phase 3b trial. Lancet Diabetes Endocrinol. 2025;13(11):949–963.
Lincoff AM, Brown-Frandsen K, Colhoun HM, Deanfield J, Emerson SS, Esbjerg S, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med. 2023;389(24):2221–2232.
Clinical Pharmacist and Copywriter, Master of Pharmacy (MPharm)
