New research highlights the effectiveness of higher doses of semaglutide, a key ingredient in weight-loss drugs like Ozempic and Wegovy, in helping people manage obesity. Two studies published on September 14, 2025, in The Lancet Diabetes & Endocrinology journal found that a 7.2 mg weekly dose of semaglutide led to greater weight loss compared to standard doses or a placebo, with manageable side effects. Here’s a closer look at the findings, their implications, and what experts say about using these medications for healthy weight management.
1. What Is Semaglutide?
Semaglutide is the active ingredient in medications like Ozempic, Rybelsus (for type 2 diabetes), and Wegovy (for weight management). It belongs to a class of drugs called GLP-1 receptor agonists, which mimic a hormone that regulates blood sugar and reduces hunger. These medications are available as injections or oral tablets and have become popular for their ability to support significant weight loss.
- How It Works: Semaglutide helps control appetite and stabilize blood sugar, making it easier for people to lose weight and manage conditions like obesity and type 2 diabetes.
- Approved Uses: Ozempic and Rybelsus are FDA-approved for type 2 diabetes, while Wegovy is approved for weight management. Higher doses, like those studied, are considered “off-label” use.
2. Key Findings from the Studies
The two studies, funded by Novo Nordisk (the maker of Ozempic and Wegovy), tested a 7.2 mg weekly dose of semaglutide—triple the standard 2.4 mg dose—against lower doses and a placebo. Both trials included lifestyle advice on diet and exercise.
- Study 1: People with Obesity (No Diabetes)
- Participants: 1,407 adults with obesity (mean BMI of 40), 73% female, average age 47, studied at 95 medical facilities in 11 countries from January 2023 to November 2024.
- Results: Those on 7.2 mg lost an average of 19% of their body weight, compared to 16% for the 2.4 mg group and 4% for the placebo group. Half of the 7.2 mg group lost at least 20% of their weight, and a third lost 25% or more.
- Additional Benefits: The higher-dose group saw greater improvements in waist size, blood pressure, cholesterol levels, and blood sugar control.
- Study 2: People with Obesity and Type 2 Diabetes
- Participants: 512 adults with obesity and type 2 diabetes (mean BMI of 38, mean HbA1c of 8), 52% female, average age 56, studied at 68 facilities from January to May 2023.
- Results: The 7.2 mg group lost an average of 13% of their body weight, compared to 10% for the 2.4 mg group and 4% for the placebo group. They also had larger reductions in waist size and blood sugar levels.
3. Side Effects and Safety
Both studies reported that the 7.2 mg dose caused some gastrointestinal side effects, such as nausea or diarrhea, but these were generally manageable. However, one concern stood out:
- Dyseasthesia: This side effect, which includes skin sensitivity, pain, or burning sensations, was more common in the 7.2 mg group (22.9% vs. 6% in the 2.4 mg group). In the first study, 18.7% of those affected had not recovered by the study’s end, raising questions about long-term effects.
- Expert Caution: Dr. Dan Azagury, a bariatric surgeon at Stanford University, noted that while most side effects resolve when the medication is stopped, the persistence of dyseasthesia requires further study.
4. Expert Opinions on Higher Doses
Experts not involved in the studies praised the effectiveness of higher semaglutide doses but emphasized the need for caution and a comprehensive approach to weight loss.
- Dr. Mir Ali, a bariatric surgeon in California, called GLP-1 medications “the most effective medication available” for weight loss but noted that bariatric surgery is even more effective for those who qualify. He warned that higher doses increase the risk of serious side effects and are considered off-label, which may lead to high out-of-pocket costs due to limited insurance coverage.
- Dr. Dan Azagury described the 7.2 mg dose as a “more effective option” with a side effect profile similar to lower doses, except for the increase in dyseasthesia. He stressed the importance of combining medications with diet, exercise, and medical follow-up for lasting results.
5. Broader Benefits of Semaglutide
Beyond weight loss, semaglutide has shown promise in improving overall health. Previous studies suggest it can:
- Lower Cancer Risk: Some research indicates GLP-1 medications may reduce the risk of certain cancers.
- Improve Heart and Brain Health: These drugs have been linked to better cardiovascular outcomes and potential cognitive benefits.
However, experts like Dr. Ali emphasize that medications alone aren’t enough. A healthy lifestyle, including a balanced diet, daily exercise, and adequate sleep, is critical for sustained weight loss and health improvements.
6. Challenges and Considerations
Using higher doses of semaglutide comes with challenges:
- Off-Label Use: The FDA approves semaglutide for weight management at 2.4 mg weekly (Wegovy). Higher doses like 7.2 mg are not FDA-approved, which could complicate access and insurance coverage.
- Cost: Without insurance, the out-of-pocket cost for semaglutide can be significant, especially at higher doses.
- Long-Term Risks: The studies call for more research to understand the long-term effects of higher doses, particularly regarding side effects like dyseasthesia.
7. The Importance of Lifestyle Changes
Both Dr. Ali and Dr. Azagury stressed that weight-loss drugs are tools, not cures. Without lasting lifestyle changes, weight regain is common when medications are stopped. Comprehensive weight management programs that include dietitians, exercise plans, and regular medical follow-ups are essential for success.
- Dr. Ali: “The goal of any weight loss intervention… is to provide tools to change to a healthier lifestyle and diet. If patients do not make these significant, long-term changes, then no intervention will remain effective.”
- Dr. Azagury: Patients on semaglutide should work with healthcare providers to adjust treatment and incorporate diet and exercise for optimal results.
Conclusion
The two new studies on semaglutide show that a 7.2 mg weekly dose can lead to significant weight loss—up to 19% in people with obesity and 13% in those with type 2 diabetes—outperforming lower doses and placebos. While side effects like gastrointestinal issues and dyseasthesia were noted, they were mostly manageable, though further research is needed. Experts agree that semaglutide is a powerful tool for weight management, but it works best when paired with a healthy lifestyle. As higher doses show promise, they also raise questions about cost, access, and long-term safety, making it crucial for patients to consult their doctors for personalized weight-loss plans.
