The NHS has greenlit a significantly stronger dose of the popular weight loss injection Wegovy, offering a new clinical option that could help patients shed more than a fifth of their total body weight.
A New Maintenance Dose for Greater Weight Loss
The UK's Medicines and Healthcare products Regulatory Agency (MHRA) has approved a 7.2 mg dose of semaglutide for use as a maintenance treatment. This new 'mega dose' is three times higher than the current maximum NHS prescription of 2.4mg, administered as a once-weekly injection.
The decision follows the pivotal STEP UP clinical trial, which demonstrated compelling results. Participants using the 7.2mg dose alongside a healthy diet and exercise achieved an average weight loss of up to 20.7 per cent. Notably, around one third of the trial subjects – all with a BMI over 30, classifying them as obese – saw a remarkable reduction of 25 per cent or more after 72 weeks when compared to a placebo.
Flexibility, Side Effects, and Expert Caution
This higher dose is intended for individuals who have plateaued on the standard 2.4 mg maintenance dose for at least four weeks. Sebnem Avsar Tuna, General Manager of Novo Nordisk UK, stated that the approval provides healthcare professionals with greater flexibility to tailor obesity treatment, supporting evidence-based health outcomes.
However, the stronger formulation comes with notable side effects. The most common issues were digestive problems like nausea and stomach upset, which primarily occurred during dose escalation and led some trial participants to stop treatment. Professor Alex Miras, an obesity expert at Imperial College London, has expressed caution, noting the massive jump in dosage.
"Tripling the dose only gives a marginal extra benefit, but the dose increase is massive," Professor Miras told the Daily Mail. "I'm concerned many patients won't tolerate such a high dose. In clinical practice people already struggle at 2.4mg." He also highlighted concerns about cost and predicted uptake might be low.
The Future of Obesity Treatment in the UK
Currently, the 7.2mg dose is given as three separate injections, but drug manufacturer Novo Nordisk has applied for approval of a single-injection pen delivering the full dose, expected later this year.
Semaglutide, part of the GLP-1 receptor agonist class, mimics a gut hormone to regulate appetite and blood sugar. Sold as Ozempic for diabetes and Wegovy for weight management, it has revolutionised obesity care. While under 200,000 people access these jabs through the NHS, the health think-tank the King’s Fund estimates over 1.4 million are using them privately, underscoring the huge demand and ongoing debate around access to these transformative drugs.
