Complete guide: GLP-1 drugs: a complete guide to semaglutide and beyond
What is Wegovy used for?
Wegovy is the brand name of semaglutide in the presentation intended for weight management and the diseases that accompany it. According to the current label published on DailyMed, it has three indications: to reduce the risk of major adverse cardiovascular events in adults with established cardiovascular disease and either obesity or overweight; to reduce excess body weight and maintain the reduction long term in adults and pediatric patients aged 12 years and older with obesity, and in adults with overweight who have at least one weight-related comorbid condition; and to treat noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH) with moderate to advanced liver fibrosis in adults1.
The current label groups two dosage forms, the injection and the tablet, and the injection additionally includes pediatric patients aged 12 and older1. When someone searches for «injectable semaglutide», they almost always mean the Wegovy and Ozempic presentations: two products with the same molecule and different labels (see the next section).
Wegovy vs Ozempic: is it the same semaglutide?
It is the same molecule, but not the same product. The Ozempic label indicates the drug to improve glycemic control in adults with type 2 diabetes, to reduce major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease, and to reduce sustained eGFR decline, end-stage kidney disease and cardiovascular death in adults with type 2 diabetes and chronic kidney disease2. The Wegovy label, by contrast, covers weight, cardiovascular risk without requiring diabetes, and MASH1.
The difference also shows in the trials behind each label. SUSTAIN-6, which supports Ozempic's cardiovascular profile, tested once-weekly semaglutide 0.5 mg or 1.0 mg in people with type 2 diabetes at high cardiovascular risk: major cardiovascular events occurred in 6.6% with semaglutide and 8.9% with placebo (HR 0.74)13. The STEP program, which supports Wegovy, tested a 2.4 mg weekly dose in obesity5. That is why «semaglutide 2.4 mg» is associated with Wegovy: it describes the dose studied in the weight trials, not a different molecule.
For clinicians, the practical consequence is to read the product's indication, not only the name of the active ingredient. A broader review of the class is in the GLP-1 guide: semaglutide, tirzepatide and retatrutide.
Body weight: what STEP 1, STEP 2, STEP 5 and STEP Teens measured
In STEP 1, a randomized trial in adults with overweight or obesity, the mean change in body weight at week 68 was −14.9% with semaglutide and −2.4% with placebo, a difference of −12.4 percentage points. Of those treated, 86.4% lost at least 5% of body weight versus 31.5% with placebo, and 50.5% lost at least 15% versus 4.9%5. STEP 2 repeated the design in adults with overweight or obesity and type 2 diabetes6.
STEP 5 extended follow-up to two years: the weight change at week 104 was −15.2% with semaglutide, a difference versus placebo of −12.6 percentage points7. In adolescents aged 12 to under 18 with obesity (STEP Teens), body mass index changed −16.1% with semaglutide and +0.6% with placebo at week 689; this trial underpins the label's inclusion of pediatric patients aged 12 and older1.
These figures are group averages under trial conditions, with a lifestyle intervention in both arms. They do not predict an individual's result.
Heart, kidney and liver: uses beyond weight
Cardiovascular risk. SELECT assigned 17,604 adults with established cardiovascular disease and overweight or obesity, without diabetes, to semaglutide 2.4 mg or placebo. The composite outcome (cardiovascular death, nonfatal myocardial infarction or nonfatal stroke) occurred in 6.5% of the semaglutide group and 8.0% of the placebo group (HR 0.80). Adverse events leading to discontinuation were more frequent with semaglutide: 16.6% versus 8.2%10.
Heart failure. In adults with heart failure with preserved ejection fraction and obesity, semaglutide improved the KCCQ symptom score by 16.6 points and reduced body weight by 13.3% versus 2.6% with placebo11.
Kidney. The FLOW trial, in adults with type 2 diabetes and chronic kidney disease, found a 24% lower risk of the composite kidney outcome with semaglutide (HR 0.76)14; that evidence supports Ozempic's kidney indication, approved by the FDA in January 202524.
Liver. In ESSENCE, resolution of steatohepatitis without worsening of fibrosis occurred in 62.9% of treated patients versus 34.3% with placebo, and improvement in fibrosis without worsening of steatohepatitis in 36.8% versus 22.4%12. The FDA approved the indication under the accelerated pathway, based on a laboratory surrogate endpoint, and requires additional data to confirm the effect on a clinically meaningful outcome3.
Semaglutide versus other options: what the head-to-head trial says
In SURMOUNT-5, which compared tirzepatide directly with semaglutide in obesity over 72 weeks, the mean weight change was −20.2% with tirzepatide and −13.7% with semaglutide15. The comparison does not change what each label authorizes, but it helps place semaglutide within the class; its mechanism and that of tirzepatide are explained in the article on the dual GIP/GLP-1 agonist.
None of these trials supports a «best for everyone» conclusion: they measure groups with specific inclusion criteria, and the choice between drugs depends on the label, comorbidity and clinical judgment.
Safety, warnings and what happens after stopping
The Wegovy label carries a boxed warning for the risk of thyroid C-cell tumors: semaglutide caused dose- and treatment-duration-dependent thyroid C-cell tumors in rodents, and it is unknown whether this occurs in humans. It is contraindicated in people with a personal or family history of medullary thyroid carcinoma or with multiple endocrine neoplasia syndrome type 21. An analysis of this signal is in GLP-1 and thyroid cancer.
In SELECT, discontinuations for adverse events were double those with placebo10. And in the STEP 1 extension, after semaglutide was withdrawn and only the lifestyle intervention continued, participants regained two-thirds of the weight they had lost over the following year8. That is one reason the label speaks of «maintaining weight reduction long term»1.
Sources
- DailyMed (U.S. National Library of Medicine). WEGOVY (semaglutide) injection / tablet, prescribing information: Indications and Usage, Boxed Warning. Revised 6/2026. dailymed.nlm.nih.gov ↗
- DailyMed (U.S. National Library of Medicine). OZEMPIC (semaglutide) injection, prescribing information: Indications and Usage. Revised 5/2026. dailymed.nlm.nih.gov ↗
- U.S. Food and Drug Administration. FDA approves treatment for serious liver disease known as MASH. Content current as of 15 Aug 2025. fda.gov ↗
- Pharmaceutical Technology. Novo Nordisk secures FDA approval for Ozempic in diabetes with CKD. 29 Jan 2025. pharmaceutical-technology.com ↗
- Wilding JPH, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1). N Engl J Med. 2021;384:989-1002. PubMed 33567185 ↗
- Davies M, et al. Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2). Lancet. 2021. PubMed 33667417 ↗
- Garvey WT, et al. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial. Nat Med. 2022. PubMed 36216945 ↗
- Wilding JPH, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022;24:1553-1564. PubMed 35441470 ↗
- Weghuber D, et al. Once-Weekly Semaglutide in Adolescents with Obesity (STEP Teens). N Engl J Med. 2022. PubMed 36322838 ↗
- Lincoff AM, et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (SELECT). N Engl J Med. 2023. PubMed 37952131 ↗
- Kosiborod MN, et al. Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity (STEP-HFpEF). N Engl J Med. 2023. PubMed 37622681 ↗
- Sanyal AJ, et al. Phase 3 Trial of Semaglutide in Metabolic Dysfunction-Associated Steatohepatitis (ESSENCE). N Engl J Med. 2025. PubMed 40305708 ↗
- Marso SP, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes (SUSTAIN-6). N Engl J Med. 2016. PubMed 27633186 ↗
- Perkovic V, et al. Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes (FLOW). N Engl J Med. 2024. PubMed 38785209 ↗
- Aronne LJ, et al. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity (SURMOUNT-5). N Engl J Med. 2025. PubMed 40353578 ↗
Informational article. It summarizes news, official statements and published studies; it is not medical or legal advice. Sources were checked on the publication date.