Is Wegovy stronger than Ozempic?

Wegovy reaches a higher maximum dose (2.4mg vs 2mg), which produces slightly more weight loss. At equal doses, they're identical. The difference is modest — about 2-3% additional body weight loss at the highest Wegovy dose compared to the highest Ozempic dose.

Can my doctor prescribe Ozempic for weight loss?

Yes, off-label prescribing is legal and common. However, insurance may not cover Ozempic when prescribed for weight loss (vs diabetes). Your doctor can prescribe it, but you may face prior authorization hurdles or need to pay out of pocket.

Do I need to switch from Ozempic to Wegovy?

Not necessarily. If Ozempic at your current dose is producing satisfactory weight loss and your insurance covers it, there's no medical reason to switch. Switching makes sense if you want the higher 2.4mg dose or if Wegovy becomes easier to obtain on your insurance.

Are the side effects different between Ozempic and Wegovy?

At equivalent doses, side effects are identical. Wegovy's higher maximum dose may produce somewhat more GI side effects at the 2.4mg level simply because it's a higher dose of the same drug. The titration schedule helps manage this.

Ozempic vs Wegovy: Same Drug, Different Purpose — Which One Do You Need?

Ozempic and Wegovy are the same molecule — semaglutide, made by the same company (Novo Nordisk), injected the same way (weekly subcutaneous injection). The difference is regulatory, not chemical. Ozempic is FDA-approved for type 2 diabetes at doses up to 2mg. Wegovy is FDA-approved for chronic weight management at 2.4mg. This distinction affects which one you're prescribed, what your insurance covers, and how you titrate the dose.

The Key Differences

FDA Approval

Ozempic: type 2 diabetes management. Wegovy: chronic weight management (BMI ≥30, or ≥27 with a weight-related comorbidity). Using Ozempic for weight loss without diabetes is "off-label" — legal and common, but it complicates insurance coverage.

Dosing

Ozempic titrates: 0.25mg → 0.5mg → 1mg → 2mg. Wegovy titrates more gradually: 0.25mg → 0.5mg → 1mg → 1.7mg → 2.4mg. The additional intermediate step and higher maximum dose reflect the weight management indication, where higher doses produce greater weight loss.

Insurance Coverage

This is where the distinction really bites. Most insurance plans cover Ozempic for diabetes. Far fewer cover Wegovy for weight management. Medicare covers Ozempic for diabetes but currently excludes all anti-obesity medications including Wegovy. See our complete guide to GLP-1 costs and insurance for strategies to navigate coverage.

Efficacy Comparison

At equivalent doses, they're identical — same drug, same effect. But Wegovy's higher maximum dose (2.4mg vs Ozempic's 2mg) produces modestly more weight loss. The STEP trials (Wegovy at 2.4mg) showed approximately 15% body weight loss. Ozempic's SUSTAIN trials (primarily at 1mg) showed approximately 4-6% weight loss as a secondary endpoint (the primary endpoint was glucose control).

The difference isn't really about the drug — it's about dose optimization for the primary outcome being measured.

Which Should You Take?

If you have type 2 diabetes: Ozempic is the straightforward choice. It's indicated, well-covered by insurance, and provides both glucose control and weight loss. If you need additional weight loss beyond what Ozempic 2mg provides, discussing a switch to or addition of Wegovy is reasonable.

If you don't have diabetes but want weight loss: Wegovy is the on-label option. Insurance coverage is the main hurdle. If Wegovy isn't covered but Ozempic is (some plans have formulary quirks), your prescriber may prescribe Ozempic off-label — though doses are capped at 2mg rather than the 2.4mg available with Wegovy.

If cost is the primary concern: Whichever has better coverage on your specific plan. Both have manufacturer savings programs that can significantly reduce copays for commercially insured patients.

Can You Switch Between Them?

Yes. Since they're the same molecule, switching is straightforward — typically at an equivalent dose. Your prescriber may adjust the transition depending on your current dose and which direction you're moving. No washout period is needed.

Supply Considerations

Both have experienced intermittent shortages due to extraordinary demand. Wegovy supply has been more constrained. Having flexibility between the two (if your insurance allows) provides a backup option during shortages.

Regardless of which formulation you take, combining the medication with proper nutrition and exercise produces significantly better outcomes than medication alone. Understanding how tirzepatide (Mounjaro/Zepbound) compares can also help you make an informed choice if semaglutide isn't the right fit.