Semaglutide for Weight Loss: Trial Results, Eligibility

Semaglutide is FDA approved for weight loss as Wegovy. In STEP 1, people on Wegovy lost 14.9% of body weight on average, vs 2.4% on placebo.

Brands: Ozempic, Wegovy and Rybelsus
Best result (STEP 1): 14.9% weight loss

Wegovy in brief

How long the drug stays in your body

About 1 week is the half-life. After 7 d, half is gone; after five half-lives (35 d), about 3% is left.

Weight loss in the main trial

In STEP 1 over 68 weeks, body weight dropped 14.9%, compared with 2.4% on placebo.

Prices across time

In US dollars, the maker's price page gives monthly prices for both the list price and self-pay offers.

Sources: FDA label (DailyMed), healthsystemtracker.org, prnewswire.com 1 2.

Who qualifies?

Who qualifies to take semaglutide?
Who sets the rule	Who qualifies
Ozempic	It lowers blood sugar in adults with type 2 diabetes and works with diet and exercise.
Ozempic	When adults have type 2 diabetes and heart disease, it reduces the chance of a heart attack, stroke, or heart-related death.
Ozempic	Adults who have type 2 diabetes and also have chronic kidney disease get a lower risk of kidney disease getting worse, of kidney failure and of heart-related death.
Wegovy	Both injections and tablets lower the chance of heart attack, stroke, or heart-related death in adults with heart disease who have obesity or overweight.
Wegovy	With diet and activity, it supports weight loss and long-term weight maintenance for children aged 12 and older with obesity and for adults with obesity, or overweight plus a weight-related condition.
Wegovy	For adults, the injection treats MASH liver disease with moderate to advanced scarring (no cirrhosis).
Wegovy	In adults, approved tablet uses include weight loss and heart risk.
Rybelsus	It lowers blood sugar in adults with type 2 diabetes and works with diet and exercise.
Rybelsus	When adults with type 2 diabetes are at high risk, it reduces the risk of a heart attack, stroke, or heart-related death.
Medicare GLP-1 Bridge	BMI 35 or higher, no condition needed
Medicare GLP-1 Bridge	Uncontrolled blood pressure, heart failure, or CKD 3a+ must apply alongside a BMI of 30 or higher
Medicare GLP-1 Bridge	Prediabetes, a previous heart attack or stroke, or PAD, together with a BMI of 27 or higher
Typical commercial plan (Aetna policy)	BMI 30 or higher
Typical commercial plan (Aetna policy)	BMI 27 or higher with a weight-related condition
Typical commercial plan (Aetna policy)	for 6 months, a diet and activity program comes first

Sources: FDA label (DailyMed) 1 2 3, medicare.gov 1 2, aetna.com.

Trial results for weight loss

Semaglutide trials in weight loss
Trial	Medicine	Who took part	Length	People	Main result	Comparison
STEP 1	Wegovy	Adults with obesity or overweight, without diabetes	68 weeks	1,961	14.9% weight loss	2.4% on placebo
OASIS 4	Wegovy	Adults with obesity or overweight, without diabetes	64 weeks	307	13.6% weight loss	2.4% on placebo

Source for the trial: STEP 1 (FDA label (DailyMed)).

Which points are different for weight loss?

Semaglutide label notes on weight loss
What changes	What the label says	Labels
Acute Pancreatitis	Can cause inflammation of the pancreas. If severe stomach pain does not clear up, stop the medicine and get care. It sometimes spreads to the back.	All of them
Acute Gallbladder Disease	Gallstones and gallbladder inflammation can happen. Upper right belly pain needs to be reported. So does a fever, or yellow skin or eyes.	All of them

From the FDA labels: FDA label on DailyMed.

The label warnings are on the FDA DailyMed label.

Coverage for weight loss

Medicare Part D does not pay for a GLP-1 used only for weight loss.

Wegovy appears on the Medicare GLP-1 Bridge list at $50 a month for people who meet its rules.

Prior authorization is standard in places where Medicaid covers weight-loss GLP-1s.

Sources: humana.com, CMS, KFF.

Other weight loss choices

GLP-1 medicines and weight loss
Medicine	For weight loss	How it is taken	Trial result
Wegovy	FDA approved	weekly injection or daily tablet	14.9% weight loss
Zepbound	FDA approved	weekly injection	20.9% weight loss
Foundayo	FDA approved	daily tablet	11.1% weight loss
Saxenda	FDA approved	daily injection	7.4% weight loss
Ozempic	Not an approved use	weekly injection	Not listed
Rybelsus	Not an approved use	daily tablet	Not listed
Mounjaro	Not an approved use	weekly injection	Not listed
Trulicity	Not an approved use	weekly injection	Not listed
Victoza	Not an approved use	daily injection	Not listed
Byetta	Not an approved use	twice-daily injection	Not listed