Wegovy is semaglutide, dosed for weight loss.
You've heard the name on a podcast, in a clinic, maybe from a friend who quietly dropped 30 pounds and won't shut up about it. So what is Wegovy actually doing inside the body, and why is it the prescription people are quietly switching to when willpower stops working?
Wegovy is the brand name for semaglutide 2.4 mg, a once-weekly injection from Novo Nordisk approved by the FDA in June 2021 for chronic weight management. It's the same molecule as Ozempic, but dosed higher and titrated specifically for fat loss. In trials, the average user lost roughly 15% of their starting body weight over 68 weeks. That number is the reason this drug exists in the conversation at all.
🔑 Key Takeaways
- Wegovy is semaglutide 2.4 mg, the highest-dose version of the GLP-1 agonist used in Ozempic, but approved specifically for weight loss rather than diabetes.
- FDA approved June 2021; Health Canada approved 2023, with Wegovy Canada officially launching in pharmacies May 6, 2024.
- The dose builds slowly, 0.25 mg up to 2.4 mg weekly over 16 weeks, because most side effects show up when the body hasn't adjusted yet.
- US cash price is around $499/month through NovoCare for self-pay patients; wegovy canada typically runs $400 to $570 per monthly pen.
- Average weight loss in the STEP 1 trial was about 15% at 68 weeks. STEP 5 confirmed the loss holds at 104 weeks when the drug is continued.
- Most common side effects are gastrointestinal, nausea, diarrhea, constipation, and they peak during titration, not maintenance.
Telehealth Comparison Table
If you'd rather skip the pharmacy run and the prior-auth paperwork, here are the two telehealth providers our readers use most for Wegovy and compounded semaglutide.
What Is Wegovy?
Wegovy is the brand name. The drug inside is semaglutide.
It's a once-weekly injection that mimics a hormone called GLP-1, which your gut releases naturally after a meal to tell your brain you're full. Wegovy keeps that signal switched on for days at a time. Appetite drops. Cravings quiet. The food noise people describe, that constant low-volume thinking about what to eat next, gets meaningfully softer.
The active ingredient is identical to what's in Ozempic. The difference is the dose, the indication, and the labeling. Ozempic was developed and approved for type 2 diabetes at doses up to 1 mg per week. Wegovy was approved at a higher 2.4 mg dose, specifically for chronic weight management. Same molecule, different job.
The FDA approved Wegovy on June 4, 2021. Health Canada followed in late 2023, and Wegovy Canada officially hit pharmacy shelves on May 6, 2024. Since then it's been added two more indications: cardiovascular risk reduction in adults with obesity and heart disease (2024), and MASH liver disease (accelerated approval, 2025).
How Wegovy Works
Most people don't overeat because they're weak. They overeat because the appetite signal is loud.
Semaglutide is a GLP-1 receptor agonist. GLP-1 is a hormone your intestine releases after you eat. It does three things at once: it tells the pancreas to release insulin, it slows the speed at which your stomach empties, and it sends a satiety signal to the brain. Wegovy binds to the same receptors and holds that signal up for a full week per dose, instead of the few minutes the natural hormone lasts.
The downstream effects are practical, not theoretical. You stop thinking about lunch at 10 AM. Portion sizes shrink without effort. Sweet cravings dull. Most people describe it as the appetite being turned down rather than turned off. You can still eat, but you don't feel ambushed by hunger between meals. Over months, that calorie deficit, plus the metabolic effects on insulin sensitivity, drives the weight loss seen in the STEP trials.
Wegovy Dose Schedule
The dose escalates over 16 weeks, on purpose. Starting at the maintenance dose would put most people in the bathroom for a week.
| Week | Weekly Dose | Pen Color (US) |
|---|---|---|
| Weeks 1 to 4 | 0.25 mg | Light gray |
| Weeks 5 to 8 | 0.5 mg | Dark gray |
| Weeks 9 to 12 | 1.0 mg | Light teal |
| Weeks 13 to 16 | 1.7 mg | Dark teal |
| Week 17 onward | 2.4 mg (maintenance) | Navy |
Inject subcutaneously into the abdomen, thigh, or upper arm. Rotate sites each week. Any day, any time, with or without food. If you tolerate the maintenance dose poorly, the FDA label allows staying on 1.7 mg long term as an alternative maintenance dose.
Miss a dose by less than 5 days? Take it as soon as you remember. More than 5 days? Skip it and resume on your next normal day. If you miss two consecutive weeks or more, talk to your prescriber, you may need to drop back down a step before resuming the maintenance dose. The taper rules matter, the side effects come back fast if you skip and reload at the top.
Wegovy Cost in the US
The list price is the headline that scares people off. The real number most patients pay is much lower.
Wegovy's wholesale list price in the US is around $1,349 per month for a 28-day supply. That's the number you see in news headlines. But almost nobody pays it, here's the actual ladder:
- With commercial insurance that covers Wegovy: $0 to $25/month with the Wegovy savings card (Novo Nordisk caps eligible patients at $25/mo for up to 13 fills).
- Self-pay through NovoCare Pharmacy: $499/month flat, direct from Novo Nordisk. Launched March 2024, available to anyone with a prescription regardless of insurance.
- Cash at retail pharmacy: $1,349/month list, often discounted to $1,100 to $1,200 with GoodRx coupons.
- Medicare Part D: covered only for cardiovascular risk reduction, not weight loss alone.
- Medicaid: coverage varies by state.
If insurance won't cover it, the $499 NovoCare option is usually the floor for brand Wegovy. Anything cheaper is either compounded semaglutide through telehealth, or Canadian sourcing. For a deeper breakdown of self-pay routes, see our guide to GLP-1 without insurance.
Wegovy Cost in Canada
Wegovy in Canada is meaningfully cheaper than the US, even before insurance.
A one-month FlexTouch pen in Canada retails for roughly $400 to $570 CAD at most pharmacies, with $540 to $570 being the typical sticker price. Some pharmacies offer bulk pricing, $399 per pen when you buy three at once. Annual cost lands around C$4,726 according to the Canadian Journal of Health Technologies.
Coverage in Canada is messy:
- Provincial drug plans: historically did not cover Wegovy for weight loss alone. A July 2025 CDA-AMC recommendation began shifting that, but most provinces still cover only diabetes-related GLP-1 use.
- Private insurance: most plans require prior authorization. Once approved, copays can drop to $25 to $100/month.
- Out-of-pocket: $400 to $570/month is the realistic range without coverage.
One thing to watch: semaglutide patents expired January 4, 2026. Health Canada is currently reviewing generic applications from Sandoz, Apotex, and Teva. Once generics ship, expected pricing drops to roughly 35% of brand cost, potentially under $150/month. That's the development that will reshape wegovy canada pricing through 2026 and 2027.
The Wegovy pen sold in Canada is also different from the US version. Canadian patients use a multi-dose FlexTouch pen, the same hardware as Ozempic, where you attach a needle and dial the dose. The hidden-needle single-use autoinjector is US-only.
How to Get Wegovy
Wegovy is prescription-only in both the US and Canada. There's no over-the-counter version, no legitimate online vendor selling it without a doctor.
The realistic paths:
- Primary care doctor. Cheapest if your visit is covered. Bring your BMI calculation and any weight-related conditions documented. If your BMI is 30+, or 27+ with hypertension, type 2 diabetes, or high cholesterol, you qualify on paper.
- Telehealth weight-loss clinic. Faster, especially if your local doctor is conservative about prescribing GLP-1s. Most clinics handle the prior auth and ship through partner pharmacies. Brand Wegovy through telehealth typically runs $400 to $600/month; compounded semaglutide through the same clinics runs $99 to $300/month.
- Obesity medicine specialist. Slower to get an appointment but better for complicated cases, multiple medications, prior bariatric surgery, or when you've already tried Ozempic or Saxenda.
- NovoCare direct (US only). $499/month self-pay, no insurance needed, prescription required.
If you're outside the BMI cutoffs but still want to lose weight, brand Wegovy is unlikely to get prescribed. The clinical alternative is compounded semaglutide through telehealth, which most providers will dose more flexibly. Some readers also explore microdosing semaglutide below the standard 2.4 mg target.
Wegovy vs Ozempic vs Zepbound
Three drugs, three different jobs.
| Drug | Active Ingredient | Max Dose | Approved For | Avg Weight Loss |
|---|---|---|---|---|
| Wegovy | Semaglutide | 2.4 mg/week | Weight loss, CV risk, MASH | ~15% (STEP 1) |
| Ozempic | Semaglutide | 2.0 mg/week | Type 2 diabetes | ~10 to 12% off-label |
| Zepbound | Tirzepatide | 15 mg/week | Weight loss, sleep apnea | ~21% (SURMOUNT-1) |
Same family, different mechanisms. Ozempic and Wegovy are GLP-1 single agonists. Zepbound (tirzepatide) is a dual GLP-1/GIP agonist, which is why the average weight loss is higher. The trade-off: Zepbound side effects can hit harder during titration, and supply shortages have been more common.
For a side-by-side decision framework, see our breakdown of Wegovy vs Ozempic and the Zepbound vs Wegovy comparison.
Side Effects of Wegovy
Most side effects are gastrointestinal and most peak during titration.
Common (in STEP trials, more than 5% of patients):
- Nausea (about 44%)
- Diarrhea (about 30%)
- Vomiting (about 24%)
- Constipation (about 24%)
- Abdominal pain
- Headache, fatigue, dizziness
Serious (rare but listed on the label):
- Pancreatitis
- Gallbladder disease and gallstones
- Acute kidney injury (often from dehydration after vomiting)
- Hypoglycemia (especially when combined with insulin or sulfonylureas)
- Diabetic retinopathy worsening (in pre-existing cases)
- Suicidal ideation (post-marketing reports; FDA reviewing)
Boxed warning: Wegovy carries the FDA's strictest warning for thyroid C-cell tumors. The risk in humans is unknown, but the warning means you should not take Wegovy if you have a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2.
Practical tip: most GI side effects fade within 2 to 4 weeks after each dose step-up. If they don't, slowing the titration (staying at one dose for an extra 4 weeks) usually fixes it.
Who Qualifies for Wegovy
Approval criteria are the same in the US and Canada:
- Adults with BMI 30 or higher (obesity), or
- Adults with BMI 27 or higher plus at least one weight-related condition (high blood pressure, type 2 diabetes, dyslipidemia, sleep apnea, or cardiovascular disease)
- Adolescents 12 and older with BMI at or above the 95th percentile for their age and sex
- Adults with established cardiovascular disease who are overweight or obese (CV risk reduction indication, US only since March 2024)
You don't qualify for brand Wegovy if your BMI is under 27, if you have a history of medullary thyroid cancer, MEN 2, or pancreatitis, or if you're pregnant or trying to become pregnant. The drug is contraindicated during pregnancy.
Frequently Asked Questions
Medical Disclaimer: This article is for educational purposes only and does not constitute medical advice. Wegovy is a prescription medication. Talk to a qualified healthcare provider before starting, stopping, or changing any GLP-1 therapy. Pricing, coverage, and availability change frequently, verify current numbers with your pharmacy or provider before making a financial decision.