Wegovy results: First month and beyond

It can be hard to lose weight and keep it off. It’s an issue for a growing number of people, too, given that the prevalence of obesity in the United States increased from 30.5% to 41.9% between the years 2000 and 2020. 

One particularly effective option for weight loss is a medication manufactured by Novo Nordisk called Wegovy. The Food and Drug Administration (FDA) approved Wegovy in June 2021 for adults with obesity or who are overweight with one or more related medical conditions. 

Wegovy is an injectable prescription medication that contains semaglutide. It belongs to a class of medications known as glucagon-like peptide-1 (GLP-1) receptor agonists. It acts like the GLP-1 hormone released in the digestive tract in response to eating, which prompts the pancreas to release more insulin. As a result, it helps lower the amount of sugar in the bloodstream. It also helps slow down the process of digestion and makes people feel fuller sooner.

And while results do vary, many people have had noteworthy success in losing weight while taking Wegovy. 

“It’s been such a pleasure to finally have such an effective tool and to help so many people,” says Kathleen Jordan, MD, a menopause-trained internal medicine physician and chief medical officer of Midi Health. 

Real-world results and success stories of Wegovy users

“The weight loss landscape has really changed with the advent of medications like Wegovy,” says gastroenterologist and obesity medicine specialist Michelle Pearlman, MD. In the past, patients approached her to ask for guidance on weight loss.

“A majority of my patients come to me seeking advice specifically on whether or not they are candidates for GLP-1 medications and to help manage the medication and dietary plan to ensure long-term success,” Dr. Pearlman says.

However, Wegovy isn’t for everyone. Novo Nordisk, the maker of Wegovy, doesn’t recommend it for people with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2.

Case studies of weight loss achieved with Wegovy

In the past, experts considered achieving a 5% weight loss when taking an approved anti-obesity medication to be a clinically meaningful response, as the New England Journal of Medicine notes. Yet in the journal’s double-blind clinical trial of people who took semaglutide over 68 weeks, 69% of participants lost at least 10% of their body weight, and 50.5% lost at least 15% by the 68-week mark. 

Rekha Kumar, MD, an endocrinologist, obesity medicine specialist, and chief medical officer at Found, cautions that people should understand that different people can have different results with weight loss when taking Wegovy, based on a number of factors, including their age, sex, menopausal status, and others. “Although clinical trial results show 15% loss of total body weight at the one-year mark, real-world experience is more variable,” Dr. Kumar says.  

Research from 2023 suggests that, while bariatric surgery may still be more effective in helping people lose the most weight, semaglutide injections are a very effective alternative. Plus, they are less invasive and carry fewer risks of complications than surgery. 

Wegovy user reviews and testimonials

Shannrose Guma, MD, a primary care physician with Mercy Personal Physicians at Ellicott City in Maryland, reports that her patients have been very pleased with their Wegovy experience. Some have lost more weight than others, but no one seems unhappy with their results. 

“Not only did they lose weight, they just felt better overall,” Dr. Guma says, explaining that some patients have told her that their joints hurt less and they have more energy as the weight has come off. Their risk of heart attack and stroke also declines with weight loss. 

Dr. Jordan notes that her patients taking Wegovy also experience some benefits beyond weight loss. For example, they find that they have more mental energy to devote to other aspects of their life besides food. “People talk about getting rid of the ‘food noise,’” Dr. Jordan says. “You’re not thinking about food, eating, and dieting all the time.”

How quickly does Wegovy work?

The starting dose of Wegovy is 0.25 milligrams (mg) per week, and the dosage is gradually increased until it reaches the maintenance level, which is either 1.7 mg or 2.4 mg.

Many people who begin taking Wegovy wonder what kind of first-month results they can expect. It can vary, depending on the dose they’re taking. As you might expect, a lower dose usually results in a smaller amount of weight loss. 

“At lower doses, patients may get results in a month or two, but they are not optimal,” says Sue Decotiis, MD, a triple board-certified medical weight loss doctor in New York City. 

According to Dr. Guma, her patients who take the 0.25 mg starting dose do start losing weight, but the weight loss is more likely with the second dose, which is 0.5 mg. 

A retrospective study published in 2022 in JAMA Network Open found that participants who started taking semaglutide for obesity had an overall total body weight loss of 5.9% at the three-month mark, and that percentage increased to 10.9% by six months. The researchers noted that the people who received a higher dose of semaglutide (2.4 mg) in their weekly subcutaneous injection tended to lose more weight than the people who were on a lower dose (1.7 mg). 

“The most noticeable weight loss usually happens in the first few months, with things starting to level off around the eight-month mark,” Dr. Pearlman says. “The key to getting those results is to kick off the dietary and exercise routine right when you start the medication.”

Wegovy vs. other weight loss drugs

In 2021, Wegovy joined four other FDA-approved medications for weight loss: Qsymia (phentermine-topiramate), Xenical (orlistat), Contrave (naltrexone-bupropion), and Saxenda (liraglutide).

According to clinical trial results, people who took Wegovy experienced more weight loss than people taking other weight loss drugs. For example, a study published in 2023 in the Journal of Investigative Medicine noted that semaglutide was also more effective than liraglutide, which is currently marketed for weight loss as Saxenda.

Wegovy is also compared with Ozempic, and although they have the same active ingredient, semaglutide, Wegovy is delivered in higher doses than Ozempic. As such, Wegovy tends to be more effective for weight loss. However, the higher dose may cause more side effects. The most common side effects of weekly semaglutide injections are gastrointestinal symptoms like diarrhea, nausea, vomiting, and stomach pain.

Also, Ozempic is approved for use in adults with Type 2 diabetes, so its primary purpose is to treat diabetes, with the added benefit that it aids with weight loss. Since it contains the same primary ingredient, Wegovy could also be used off-label to help someone with diabetes manage their blood sugar levels. 

Wegovy’s approval marked a significant change in the landscape of weight loss drugs, according to Dr. Pearlman. “Not only does it offer more substantial weight loss outcomes—upwards of 15% of total body weight—but it also shows promise in enhancing cardiovascular outcomes, which are crucial for patients with pre-existing heart conditions.”. 

Factors that can influence weight loss on Wegovy

Just taking Wegovy alone can help you lose weight. As Dr. Guma notes, you don’t actually have to do anything in addition to taking the medication to experience some weight loss. But you can influence the outcome—and maximize your Wegovy results—by making healthy choices. 

“Taking Wegovy as part of a weight management plan, which includes dietary changes and exercise—specifically resistance training—can lead to some pretty impressive results,” Dr. Pearlman says, adding that she closely monitors her patient’s progress on a monthly basis.

How to maximize weight loss on Wegovy

People who want to achieve the best results with Wegovy need to also understand that it is a long-term commitment. “It’s not something you take on as sort of a crash, one-off, or two-week diet,” Dr. Jordan says. That means making some lifestyle changes and having support to make those changes. 

Dr. Guma explains to patients that they’ll lose more weight if they combine their new medication regimen with a reduced-calorie diet and exercise routine. She recommends 150 minutes of moderate exercise or 75 minutes of intense exercise per week, which echoes recommendations from the American Heart Association. She also says a key component of that exercise routine should be strength training because it helps to build and maintain muscle mass. This can include weights, resistance bands, or bodyweight exercises. The specific amount and intensity can be tailored to each individual’s starting point and fitness level.

“As you lose weight, preserving muscle mass is crucial to avoid frailty and ensure you’re losing fat, not muscle,” Dr. Pearlman says. “This not only helps in maintaining a healthier, more functional body but also in achieving more sustainable weight management outcomes.”

Another essential component is making sure you’re eating enough protein. When people lose weight rapidly, they often tend to lose muscle, and protein can help with that. “Aiming for 60–80 grams per day helps preserve muscle mass during weight loss, boosts metabolism, and enhances satiety, reducing overall calorie intake,” Dr. Pearlman says.

Dr. Decotiis also emphasizes the importance of drinking enough water. “If someone is not well hydrated, the body does not burn fat but burns muscle instead,” she says. That can lead to gaining the weight weight back when they stop taking the drug.”

The bottom line

Clinical trials have shown that Wegovy is an effective weight loss drug, a conclusion backed up by the real-world experiences of many who take it. Not only does it help them lose a significant amount of weight, but it can also free up some of their mental energy to focus on their lives beyond food and weight. While the drug is effective on its own, healthcare experts encourage their patients to eat a healthy diet, including protein, and to include strength training in a regular exercise routine. Wegovy is a long-term medication, and most patients experience weight gain when they stop taking it.