Novo Nordisk reports about 21% weight loss with semaglutide 7.2 mg in STEP UP trial

Novo Nordisk reported on June 21, 2025 that once-weekly semaglutide 7.2 mg produced average weight loss of about 21% in adults with obesity, with about a third of participants losing 25% or more ^[1]. Semaglutide is the molecule in Wegovy, Ozempic and Rybelsus, and the 7.2 mg dose was later approved for weight management under the name Wegovy HD ^[1][2].

What the trial found

The STEP UP trial enrolled 1,407 adults with obesity who were randomly assigned to semaglutide 7.2 mg, semaglutide 2.4 mg (the Wegovy dose already approved at the time) or placebo, all combined with lifestyle intervention, over 72 weeks ^[2]. Results published in The Lancet Diabetes & Endocrinology in November 2025 reported a mean weight loss of 18.7% with the 7.2 mg dose compared with 3.9% with placebo, and 31.2% of participants on the higher dose lost at least 25% of their body weight ^[2]. Novo Nordisk's own announcement described a mean weight loss of 20.7%, and chief executive Mike Doustdar described "even greater weight loss of approximately 21%" ^[2]. The sources do not explain why the company's headline figure and the published trial figure differ.

A separate trial, STEP UP T2D, enrolled about 512 adults with obesity and type 2 diabetes and used the same three treatment arms ^[2]. There, the 7.2 mg dose produced a mean weight loss of 13.2% versus placebo, and 21.3% of participants lost 20% or more of their body weight ^[2].

On side effects, gastrointestinal events were the most common and the overall profile was consistent with earlier semaglutide trials ^[2]. Dysesthesia — unusual sensations such as tingling, burning or numbness — was more frequent with 7.2 mg (18.9%) than with 2.4 mg (4.9%) or placebo (0%) in STEP UP T2D ^[2].

What happened after the results

The FDA approved semaglutide 7.2 mg (Wegovy HD) on March 19, 2026 for long-term reduction of excess body weight in adults with obesity, or with overweight plus at least one weight-related condition ^[2]. It was the first GLP-1 receptor agonist approved under the FDA's Commissioner's National Priority Voucher pilot program and the fourth product approved under that program ^[2]. Novo Nordisk said a US launch in a single-dose pen was expected in April 2026 ^[2]. The dose was already approved in the European Union and the United Kingdom ^[2].

Wegovy injection was first approved by the FDA on June 4, 2021, and 7.2 mg is now listed among its injection strengths, alongside 0.25 mg, 0.5 mg, 1 mg, 1.7 mg and 2.4 mg ^[1]. Wegovy is also sold as a once-daily tablet ^[1].

Why it matters for patients

The data describe a higher-dose option for adults who do not lose enough weight on the 2.4 mg dose — a step up within the same drug class rather than a switch to a different medication or an earlier move to weight-loss surgery ^[2]. The trade-off visible in the numbers is tolerability: the extra weight loss at 7.2 mg came alongside more gastrointestinal side effects and a notably higher rate of dysesthesia in people with type 2 diabetes ^[2].

Wegovy's label carries a boxed warning for thyroid C-cell tumors and warnings about pancreatitis, gallbladder disease, low blood sugar, kidney injury, increased heart rate and other risks ^[1]. The label says Wegovy should not be combined with another semaglutide product or any other GLP-1 receptor agonist ^[1].

How much Wegovy HD will cost, and whether insurers will cover the 7.2 mg dose on the same terms as the 2.4 mg dose, has not been disclosed in these sources.

What happens next

Novo Nordisk said a US launch of Wegovy HD in a single-dose pen was expected in April 2026 ^[2]. Updated results from STEP UP and STEP UP T2D were published in The Lancet Diabetes & Endocrinology in November 2025 ^[2]. Whether Novo Nordisk plans further trials of the 7.2 mg dose for other uses, such as cardiovascular risk reduction or MASH, has not been reported in these sources.