Wegovy — branded semaglutide for chronic weight management.

Wegovy is semaglutide formulated and branded by Novo Nordisk for chronic weight management. FDA-approved in 2021 for adults with BMI ≥30, or BMI ≥27 with at least one weight-related comorbidity (T2DM, hypertension, dyslipidemia, sleep apnea).

Same active molecule as Ozempic (also semaglutide, but FDA- approved for T2DM instead of weight management). Same as compounded semaglutide available through 503A pharmacies. The choice between branded Wegovy and compounded comes down to cost, insurance coverage, and patient preference.

Semaglutide is a GLP-1 receptor agonist. It mimics glucagon-like peptide 1, which slows gastric emptying, increases insulin secretion in response to glucose, suppresses glucagon, and acts centrally on satiety pathways in the hypothalamus.

The combined effect: patients eat less, feel full sooner, have steadier blood glucose, and lose weight progressively over 12–18 months. The SELECT trial (n=17,604) showed 20% reduction in major adverse cardiovascular events independent of weight loss, so the cardiovascular benefits are real and measurable.

Wegovy tends to fit:

• Adults with BMI ≥30, or ≥27 with comorbidity (FDA criteria)
• Patients with insurance plans that actually cover Wegovy (still uncommon)
• Patients who want branded supply over compounded for risk-tolerance reasons
• Patients building a 12–24 month metabolic protocol, not a short-term intervention

Wegovy uses a fixed five-step dose escalation: 0.25mg → 0.5mg → 1mg → 1.7mg → 2.4mg, once weekly subcutaneous, increasing every 4 weeks. The escalation reduces nausea — going faster increases dropout rates significantly.

Maintenance dose is 2.4mg/week. Some patients respond fully at 1.7mg and don't need to escalate further. We individualize based on response and tolerance.

Mean weight loss at 68 weeks in STEP-1 trial: 14.9%. Real-world results vary; 10–18% is the common range. Cardiovascular benefit from SELECT trial: 20% reduction in MACE. Side effects: nausea, constipation, occasional vomiting during dose escalation. Mostly tolerable with slow titration and dietary adjustments.

We'll prescribe branded Wegovy when insurance covers it or when the patient prefers branded supply. We'll quote compounded semaglutide where the FDA 503A pathway permits as the cost-comparable alternative. Both prescribed through the same physician relationship with the same lab cadence and side-effect management. No upsells either direction — the right choice is whichever fits the patient's situation.