Semaglutide's First UK Approval — and How the Licence Has Grown Since

The year the picture changed: what happened when the MHRA approved Wegovy in 2021

For years, semaglutide existed in UK medicine cabinets only as Ozempic, a weekly injection licensed solely for type 2 diabetes. When the MHRA first approved Wegovy, it drew a clear line. This was the same molecule at a higher maintenance dose (2.4 mg weekly), in a different pen, authorised for a different purpose: weight management in adults with a BMI of 30 or above, or 27 or above alongside at least one weight-related condition such as high blood pressure, high cholesterol or obstructive sleep apnoea.

The two products have always been legally separate. A prescriber cannot hand out Ozempic for weight loss (the licence does not cover it) and patients who need the detail on that distinction can find it explained on our Ozempic versus Wegovy page. The 2021 approval was significant precisely because it created a lawful route for semaglutide to be prescribed outside a diabetes diagnosis. Wegovy also carries a Black Triangle (▼) designation, meaning the MHRA monitors it with additional vigilance, and reports of suspected side effects go directly to the Yellow Card scheme.

If you want the specific approval date and regulatory sequence laid out clearly, the semaglutide approval date page covers the full chronology. What matters here is the context: in 2021, the MHRA gave the UK its first properly licenced weight-management use of semaglutide, and the STEP 1 trial data that underpinned it showed around 15% average weight loss over 68 weeks at 2.4 mg, published in the New England Journal of Medicine.

How the Wegovy licence has expanded since that first approval

Three changes arrived in quick succession between early 2026 and summer 2026, each adding to what the original 2021 approval made possible.

First, in January 2026 the MHRA approved a 7.2 mg maintenance dose, initially supplied as three 2.4 mg pens taken in a single week. Then on 14 April 2026 a dedicated single-dose 7.2 mg pen was cleared, carrying an auto-dosing mechanism and a covered needle that locks after use. The full UK approval history for Wegovy details this timeline. Clinical data for the 7.2 mg dose showed around 20.7% average weight loss at 72 weeks, narrowing the gap with tirzepatide results. One thing worth knowing: the 7.2 mg pen is approved only for adults with BMI 30 or above and does not extend to the cardiovascular indication. Specific dose availability is always confirmed at consultation.

Second, on 11 June 2026 the MHRA approved Wegovy tablets, oral semaglutide co-formulated with an absorption enhancer. The UK became the first country in Europe to hold this licence, and the tablet's phase 3 trial (OASIS 4, 64 weeks) reported around 13.6% average weight loss against placebo. Among participants who adhered fully to treatment, that figure reached approximately 17%. The tablet is taken once daily, first thing in the morning on an empty stomach, with a small amount of plain water, waiting at least 30 minutes before food or other oral medicines. No refrigeration required, which is exactly the kind of practical detail patients ask about.

Third, on 3 July 2026 the MHRA granted a conditional approval for semaglutide (Wegovy) in MASH, metabolic dysfunction-associated steatohepatitis, a form of fatty liver disease with moderate-to-advanced fibrosis. This is covered separately on the semaglutide MASH approval page. It is a distinct clinical setting; nume prescribes for weight management.

What NICE has said, and what that means for NHS access today

A question our prescribers hear most weeks is whether Wegovy is available on the NHS. The honest answer is: in principle yes, in practice many people wait a long time. NICE recommended semaglutide under TA875 (published March 2023), but only within specialist weight management services, for a maximum of two years, for adults with a BMI of 35 or above and at least one weight-related comorbidity. Thresholds are 2.5 kg/m² lower for South Asian, Chinese, Middle Eastern, Black African or African-Caribbean backgrounds. If less than 5% weight loss is achieved after six months on the maintenance dose, continuing treatment is reviewed. The detail on eligibility and what different approval routes mean in practice is on the Wegovy approval for weight loss page.

NICE has not yet appraised Wegovy tablets (oral semaglutide), so they are available by private prescription only at this stage. For those exploring the cost side of treatment, our Wegovy price comparison page explains what legitimate private prescriptions include and what market pricing looks like. A broader look at what semaglutide is sits on the semaglutide overview page, and anyone ready to talk through their own circumstances can speak to our prescribers through a free consultation.

Age, eligibility and what the licence does not cover

Semaglutide (Wegovy) is licensed for adults. The medicine is not licensed for use under 18, during pregnancy, while breastfeeding, or when trying to conceive, in any of those situations the prescriber's guidance takes precedence, and the Patient Information Leaflet sets out the formal position. Anyone curious about how age and eligibility interact with the approval can read more on the Wegovy age approval page.

The licence also does not make Wegovy right for everyone who technically qualifies on BMI. A prescriber considers the whole clinical picture: current medicines, relevant conditions, whether a tablet or injection suits the individual better. The weight loss treatment overview sets out how different options compare at a high level. If semaglutide's journey from a single 2021 approval to a medicine with four UK indications tells you anything, it is that this is a rapidly developing area, and staying informed matters. The team at nume keeps across regulatory changes so our prescribers can advise on what is actually current.