Semaglutide 2.4mg (Wegovy)

Semaglutide 2.4mg (Wegovy) is the most comprehensively studied obesity medication in history, with over 17,604 adults in the SELECT trial alone — more than twice the largest tirzepatide study. A selective GLP-1 receptor agonist, it mimics the hormone released after meals to reduce appetite, slow gastric emptying, and modulate reward pathways. FDA approved for chronic weight management in June 2021, Wegovy launched the modern GLP-1 era. The STEP-1 trial showed 14.9% weight loss versus placebo's 2.4% at 68 weeks. The SELECT trial elevated Wegovy to a cardiovascular medicine: a 20% reduction in MACE (HR 0.80), heart failure hospitalization (HR 0.82), and all-cause mortality (HR 0.81) — benefits largely independent of weight loss. Dosing from 0.25mg weekly escalates over 16 weeks to 2.4mg. List price $1,200-$1,349 monthly, offset by NovoCare savings to $199-$349 self-pay. Medicare Bridge begins July 2026. Best for patients with both obesity and established cardiovascular disease.