Wegovy in 2025: updated approvals, trial results and what changed

What the 2025 head-to-head trial actually showed

A question our prescribers hear most weeks is whether Wegovy or Mounjaro is more effective. SURMOUNT-5, published in 2025, was the first rigorous head-to-head to address that directly. The open-label trial ran for 72 weeks across 751 adults with obesity and no diabetes, and it found that tirzepatide produced greater average body-weight reduction than semaglutide 2.4 mg. That result has been widely discussed, and it matters, but it does not make semaglutide a lesser medicine.

The STEP 1 trial, published in the New England Journal of Medicine, reported approximately 15% average weight loss over 68 weeks at the 2.4 mg maintenance dose. For many people, that is clinically meaningful and well-tolerated. The appropriate medicine is a clinical judgement about your health history, any conditions you have, how you respond to treatment, and which format suits your life, factors a prescriber weighs individually. You can read a broader comparison of the two medicines on our semaglutide overview.

NICE's appraisal of tirzepatide (TA1026, updated September 2025) noted that indirect comparisons favour tirzepatide, while acknowledging that both agents are effective weight-loss medicines. Picking the "better" treatment in the abstract is the wrong framing; picking the right one for you is what a consultation exists to do.

The 7.2 mg approval and what higher-dose semaglutide adds

The most significant regulatory development for Wegovy in this period was the approval of a higher maintenance dose. The MHRA first authorised 7.2 mg semaglutide in January 2026; in April 2026 it approved a dedicated single-dose 7.2 mg pen, one weekly injection, pre-set, with an auto-dosing mechanism and a covered needle that locks after use. The MHRA's announcement confirmed the pen is licensed for adults with a BMI of 30 or above. The dose ladder remains the same: treatment begins at 0.25 mg and is titrated upward by the prescriber, typically in monthly steps, with 7.2 mg now the maximum.

Trial data at the higher dose reported around 20.7% average weight loss over 72 weeks, figures that close the gap with the highest tirzepatide doses in the SURMOUNT programme. Whether you would be a candidate for 7.2 mg, and when in your treatment journey that discussion might happen, is a matter for your prescriber based on your response and tolerability.

The NHS has not yet commissioned 7.2 mg semaglutide; access under NICE TA875 remains limited to specialist weight management services for up to two years. For anyone considering private treatment, the cost context for Wegovy has shifted alongside these approvals.

Safety developments: what the MHRA flagged in 2025 and 2026

Alongside the efficacy story, the MHRA's regulatory attention to GLP-1 medicines intensified. In January 2026 it issued a Drug Safety Update highlighting acute pancreatitis as an infrequent but serious known risk: severe stomach pain, particularly pain that radiates to the back and does not settle, with or without vomiting, requires urgent medical attention. This does not mean pancreatitis is common (it is not) but it is the kind of symptom that should never be waited out.

Common side effects remain GI-led: nausea, diarrhoea, constipation, indigestion, and fatigue are the most frequently reported, most noticeable when starting or after a dose increase, and typically settling within days to a couple of weeks. Injection-site reactions are possible. Anyone using oral contraceptives alongside Wegovy should discuss this with their prescriber; for tirzepatide specifically, NHS guidance recommends adding a non-oral method for the first four weeks of treatment and after each dose increase. Similar considerations apply to anyone on HRT.

Patients on any GLP-1 medicine can report suspected side effects directly to the MHRA through the Yellow Card scheme. The NHS medicines page for semaglutide lists the full side-effect profile and when to seek help. These are living documents, updated as post-market data accumulates, worth bookmarking rather than relying on memory.

NHS access in 2025 and the private alternative

The NHS route to Wegovy runs through NICE TA875. That guidance restricts it to adults with a BMI of 35 or above plus at least one weight-related condition, within a specialist service, for no more than two years, ethnic-background thresholds sit 2.5 kg/m² lower throughout. Waiting lists are long in most parts of England, and criteria differ in Scotland, Wales and Northern Ireland. For those who meet private eligibility (BMI of 30 or above, or 27 or above with a qualifying condition), a regulated online pharmacy offers a clinical route without a referral or a wait.

If you are thinking about how Wegovy fits into your options, the weight-loss treatment overview sets out the full landscape. Discussions about how Wegovy revenue performed through 2024 are covered on that page for anyone following the market context, and you can also see how Wegovy sales have tracked into 2025 for a more current picture of demand and availability. And if you have questions from the broader patient community, the Wegovy forum roundup pulls together the themes our clinical team sees most often.

Wegovy is a prescription medicine. Clinical suitability is not a box-tick, it requires a real assessment of your health, not an online quiz with an automatic green light. Speak to our prescribers to find out whether Wegovy is the right fit for you.