The different semaglutide variants available in the UK

What the trial data established about semaglutide before the variants branched

Semaglutide's clinical profile was built on large, rigorous trials before the current variant landscape existed. The pivotal STEP 1 trial, published in the New England Journal of Medicine, enrolled 1,961 adults with obesity and found an average body-weight reduction of around 15% over 68 weeks at the 2.4mg weekly dose, alongside lifestyle support. That result set the foundation for Wegovy's licensed weight-management indication. A question our prescribers hear most weeks is whether Ozempic achieves the same thing, it doesn't, and the licensing makes that explicit. Ozempic uses lower maintenance doses (up to 1mg or 2mg weekly) calibrated for blood-sugar control in type 2 diabetes, not the appetite-suppression titration schedule that produces meaningful weight loss in people without diabetes.

The biological mechanism is shared across all variants. Semaglutide is a GLP-1 receptor agonist: it mimics the gut hormone GLP-1, slowing gastric emptying, reducing appetite signals in the brain, and supporting better blood-sugar regulation. The difference between products comes from dose, delivery, formulation and the population each was trialled and approved for, not from any alteration to the molecule itself.

Understanding that shared mechanism helps explain why the variants are not interchangeable, even though the active ingredient is the same. Licensing bodies don't grant indications based on chemistry alone; they grant them based on trial evidence in specific populations at specific doses. Using a diabetes dose for weight loss, or sourcing a product through channels that bypass clinical review, sidesteps all of that evidence. The NHS semaglutide medicines page sets out the distinctions clearly and is a useful first reference.

Wegovy injection: the weight-management standard, now up to 7.2mg

Wegovy (semaglutide injection, Novo Nordisk) is the variant licensed specifically for weight management in the UK. The titration pathway starts at 0.25mg weekly and increases roughly every four weeks, with 2.4mg having been the standard maintenance dose since the original NICE appraisal. Then, on 14 April 2026, the MHRA approved a dedicated single-dose 7.2mg pen (one pre-set weekly injection with a built-in covered needle that locks after use) for adults with a BMI of 30 or above. Trials at 7.2mg reported an average weight loss of around 20.7% over 72 weeks, narrowing the gap with tirzepatide at higher doses. You can read more about the injection's full clinical profile on the Wegovy overview page.

Eligibility under the private licence covers adults with a BMI of 30 or above, or 27 to 29.9 with at least one weight-related condition such as high blood pressure, high cholesterol or obstructive sleep apnoea. Lower BMI thresholds can apply for some ethnic backgrounds under UK guidance. NICE's recommendation (TA875) governs NHS access, which is currently routed through specialist weight management services and involves criteria around comorbidities and a maximum treatment duration of two years. The NHS route has long waiting lists in most areas; private prescription is the alternative for people who meet the clinical criteria but can't wait. If you're considering the injection, how to access Wegovy online legitimately is worth reading before you start.

Side effects follow the GI-led pattern common to GLP-1 medicines: nausea, vomiting, diarrhoea, constipation and burping are most common, especially in the early weeks or after a dose increase. They're typically mild-to-moderate and ease with time. Severe, persistent stomach pain that radiates to the back needs urgent medical attention, pancreatitis is an infrequent but serious risk flagged by the MHRA. Our page on whether Wegovy can cause ovarian cysts addresses another side-effect question that comes up regularly among women considering treatment.

Wegovy tablets: the oral semaglutide variant approved for weight loss

On 11 June 2026, the MHRA approved Wegovy tablets (oral semaglutide co-formulated with an absorption enhancer called SNAC) as the first oral GLP-1 medicine licensed for weight management in the UK. The titration schedule runs from 1.5mg daily, through 4mg and 9mg, up to a 25mg maintenance dose, with at least a month at each level. It's taken first thing in the morning, on a completely empty stomach, with a small amount of plain water. Everything else (food, coffee, other oral medicines) waits at least 30 minutes. No refrigeration needed, which makes it straightforwardly travel-friendly.

Phase 3 data from the OASIS 4 trial (307 adults with obesity or overweight plus at least one weight-related condition, 64 weeks) reported an average weight loss of around 13.6% compared with around 2.4% for placebo, regardless of adherence. Among participants who stayed fully on the treatment protocol, the figure rose to around 17%. GI side effects were common in the trial (reported by 74% of the semaglutide group versus 42% on placebo) but were generally mild to moderate and tended to settle. The Wegovy tablet is not yet available on the NHS; a NICE appraisal would be needed first. For a closer look at how it compares with the injection day-to-day, the semaglutide dosing information page goes into more detail.

A note on Rybelsus, which sometimes comes up in the same search: Rybelsus is also oral semaglutide, but it uses different tablet strengths (3mg, 7mg and 14mg) and is licensed for type 2 diabetes management, not weight loss. If you want a fuller picture of how the oral and injectable forms sit alongside each other, our guide to semaglutide 2 covers the detail in one place.

Ozempic and the question of off-label use

Ozempic (semaglutide injection, Novo Nordisk) is licensed in the UK for type 2 diabetes. It contains the same active molecule as Wegovy but at doses and in a titration schedule designed for blood-sugar management. The MHRA has been explicit: Ozempic is not assessed or approved for weight loss, and prescribing it off-label for that purpose is outside the licensed indication. Shortages of Ozempic caused significant problems for people with type 2 diabetes in 2023 and 2024 when off-label demand grew; that history is part of why regulators and prescribers take the distinction seriously.

At nume, our prescribers work within licensed indications. If semaglutide for weight management is clinically appropriate for you, the relevant product is Wegovy, not Ozempic. If you have type 2 diabetes and weight management is part of your treatment goal, that's a conversation that happens in full context, your GP and our clinical team, including the approach taken by our lead prescriber, would look at the whole picture before any decision is made.

For anyone thinking about semaglutide treatment, one practical note on what to expect from a legitimate supply: when a prescription is approved, the pen or tablet pack is dispatched via DPD in plain, unbranded packaging, trackable on your phone, no indication of contents on the outside. It's a small thing, but it matters to a lot of people. If you're ready to explore which variant might suit your situation, checking your eligibility through a free consultation is the right starting point. Our prescribers review every consultation personally, the same day it's submitted. Separately, the FAQs page covers common questions about the process if you want to read more first.