Novo Nordisk is introducing a higher dose of Wegovy

It was recently made clear that Tirzepatide (Zepbound, Mounjaro) is more effective than Semaglutide (Ozempic, Wegovy, Rybelsus):

Semaglutide vs Tirzepatide (Clinical trial)

Finally, a research clinical trial that directly explores the difference between Semaglutide and Tirzepatide for Obesity.

GLP1 GuideGLP1.Guide Staff

That said, Novo Nordisk isn't standing still - they're introducing a higher dosage of Wegovy that was deemed tolerable in trials for people to use and achieve higher weight loss.

Currently the dosages that are listed in the prescription information for Wegovy are:

• 0.25 mg/0.5 mL
• 0.5 mg/0.5 mL
• 1 mg/0.5 mL
• 1.7 mg/0.75 mL
• 2.4 mg/0.75 mL

Novo Nordisk is trying to introduce a 7.2mg dosage, which is quite a bit higher than their existing highest dose.

Is Novo Nordisk Increasing Dosage to Defend Wegovy’s Edge in Obesity?

NVO submits higher-dose Wegovy to EMA, aiming for greater weight loss and stronger defense against rivals in the obesity market.

Zacks Investment ResearchAhan Chakraborty

While this currently applies to Europe (Novo has filed with the European Medicines Agency), Novo has expressed interest in pursuing this for other geographies as well, so it seems to be a wide-ranging strategy.

Are additional side effects expected?

Increasing dosage is often a source of additional side effects (one of the many reasons people can't stick with GLP1s), so the first obvious question is whether there will be any side effects from having such a high dosage.

Luckily, we don't have to rely on anecdata here – GLP1 are some of the most widely researched peptides in the modern era, with massive uptake and usage in popular culture. We can look at the research on whether higher dosages are tolerable and whether they've produced benefits that are worth any increase in side effects.

The studies Novo Nordisk cited: STEP UP

In it's submission to the EMA, Novo Nordisk cited it's STEP UP series of studies (including one for type 2 diabetes):

ClinicalTrials.gov

Novo Nordisk announced the results of this study:

News Details

Novo Nordisk

There's great coverage of the study results from early in 2025:

STEP UP Trial Shows Semaglutide 7.2 mg Achieves Superior Weight Loss vs. 2.4 mg, Placebo

Semaglutide 7.2 mg significantly outperformed semaglutide 2.4 mg and placebo with a 20.7% average reduction in weight and a comparable safety and tolerability profile, further establishing its efficacy in obesity treatment.

Applied Clinical TrialsDavy James

We won't repeat the results here, but simply put over the 72 week study:

• 7.2mg dosage lost 20.7% (2.4mg produced weight loss of 17.5%)
• 33.2% of patients on the 7.2mg dosage experienced weight loss of 25% or greater (2.4mg had 16.7% with a similar result)
• Without considering people that adhered to treatment or did not, 7.2mg produced 18.7% weight loss versus 15.6% for 2.5mg

So the 7.2mg dosage is roughly 20% better. Clearly, tripling the dose does not triple the results.

Unfortunately, Novo Nordisk did not publish the results, so we don't know just how much worse the adverse effects were, and whether it was merely a 20% increase or much more.

The study Novo Nordisk didn't cite

There are a few trials that explore high dosage Semaglutide, thanks to it's longevity as a GLP1 and researched peptide:

High-Dose Semaglutide (Up to 16 mg) in People With Type 2 Diabetes and Overweight or Obesity: A Randomized, Placebo-Controlled, Phase 2 Trial - PubMed

Higher semaglutide doses for type 2 diabetes and overweight or obesity provide modest additional glucose-lowering effect, with additional weight loss, at the expense of more AEs and treatment discontinuations. A study for evaluating high-dose semaglutide in obesity is currently underway.

PubMedVanita R Aroda

This trial explored two higher dosages: 8mg and 16mg. The trial wasn't massive but was at least a couple hundred people, the basic stats being:

• 245 individuals participated
• Participants had type 2 diabetes, and were previously on Metformin
• Participants had a BMI of greater than 27 (BMI of 30 is considered obese)
• 40 weeks

Here were the basic outcomes for the higher dosages:

• 0.3% HbA1c reduction
• 3.4kg body weight reduction
• More frequent adverse events (negative side effects)

If it doesn't seem like the higher dosages produced a huge difference, it's because they didn't. The conclusion the authors reached made it quite clear:

Conclusions: Higher semaglutide doses for type 2 diabetes and overweight or obesity provide modest additional glucose-lowering effect, with additional weight loss, at the expense of more AEs and treatment discontinuations. A study for evaluating high-dose semaglutide in obesity is currently underway.

It doesn't look like higher dosages are a slam dunk for Wegovy (or Novo Nordisk), and the benefits were only modest.

How much could this change things for people taking semaglutide?

The "unlock" of a new dosage certainly is a new avenue for those who are taking Semaglutide right now, but clear that it is not a panacea.

Certainly, this won't be enough to make switching from Tirzepatide to Semaglutide a good choice – Tirzepatide is still more effective by a wide margin. That said, different formulations work differently on different bodies, so some may prefer Semaglutide or even Liraglutide to begin with.

So who does this help? Well, people who are currently on the highest dosage of Semaglutide who were hoping to be able to go up in dosage and get even more results could certainly up their dosages, assuming a lack of negative side effects.