Higher Dose Semaglutide Shows Promise for Weight Loss, But Side effects and Regulatory Review loom
LONDON – September 15, 2025 – New research published today in The Lancet Diabetes & Endocrinology suggests a higher dose of the medication semaglutide (7.2mg) may lead to greater weight loss in adults with obesity, both with and without type 2 diabetes.Though,experts caution that increased side effects and the need for regulatory approval remain key considerations.
Two phase 3b trials - “Once-weekly semaglutide 7.2 mg in adults with obesity and type 2 diabetes (STEP UP T2D)” by Ildiko Lingvay et al. and “Once-weekly semaglutide 7.2 mg in adults with obesity (STEP UP)” by Sean Wharton et al. – investigated the effects of the increased dosage compared to placebo and the currently marketed standard dose (Wegovy).
Dr. Simon Cork, senior Lecturer in Physiology at Anglia Ruskin University (ARU), explained the findings: ”The studies demonstrate that the higher dose of semaglutide results in reductions in body weight, BMI and systolic blood pressure compared to placebo.” He noted the most notable difference was observed in patients without type 2 diabetes, where the higher dose showed statistically significant weight loss compared to the standard dose. “Interestingly, in patients without obesity, twice as many patients (33% vs 16%) lost over 25% of their body weight on higher dose semaglutide compared to lower dose. This suggests that patients with higher body mass, who would benefit most from more substantial weight loss, may benefit more from high dose semaglutide than that which is currently available.”
While the results are encouraging, Dr. Cork also highlighted an increase in side effects, such as nausea and vomiting, with the higher dose.
The potential for wider access to the 7.2mg dose remains uncertain. Dr. Cork suggests manufacturer Novo Nordisk will be mindful of growing competition in the weight loss market, citing drugs like Mounjaro, which have demonstrated superior weight loss results, and other medications in late-stage trials offering greater efficacy or pill-form governance.
Prof. Lora Heisler,while not directly involved in the studies,emphasized the importance of individualized treatment. “Having more treatment options available to patients is a positive step forward. Some patients may need a higher dose of semaglutide to meet their treatment goals.However, this higher dose of semaglutide (7.2 mg) is still under examination and its benefit needs to be considered alongside safety by regulatory bodies. Every person is diffrent and what is right for one person may not be right for another. It is important for patients to discuss treatment with their health care provider to find out what is best for them, if this higher dose of semaglutide does get approved for widespread use in future.”
Dr. Cork has no declared conflicts of interest. Prof. Heisler is a consultant and receives research funding from various pharmaceutical companies, but not Novo Nordisk.
