Wegovy Users More Likely to Reach Key Obesity Treatment Targets, STEP UP Study Finds

Findings from the phase 3b STEP UP trial, presented at ObesityWeek 2025, showed that individuals with obesity treated with semaglutide (Wegovy^®) were more likely to achieve body mass index (BMI) and waist-to-height ratio targets associated with a lower risk of obesity-related complications than those receiving placebo.

The analysis included adults with obesity who received either the approved 2.4 mg or investigational 7.2 mg dose of semaglutide. Participants receiving Wegovy lost an average of 21% of their body weight, and a greater proportion reached both a BMI <27 kg/m² and a waist-to-height ratio <0.53 compared with none in the placebo group (19.5% for semaglutide 7.2 mg; 13.2% for semaglutide 2.4 mg).¹

Among those who met both treatment targets, most achieved healthy levels for two or more cardiovascular risk factors, including blood pressure, cholesterol, and blood glucose. More than half achieved healthy levels for all four measured risk factors, indicating a low cardiovascular disease risk profile.¹

“These new results demonstrate that most people on Wegovy^® who achieve certain BMI and waist targets also benefit when it comes to lowering their cardiovascular risk factors,” Emil Kongshøj Larsen, executive vice president and head of International Operations at Novo Nordisk, said in a press release.³ “This shows the efficacy of Wegovy® in not only helping people lose excess weight but also preventing obesity-related complications and improving overall health.”

Carel le Roux, MD, PhD, University College Dublin, who presented the analysis, noted that using BMI and waist-to-height ratio targets “has been shown to be associated with a lower risk of obesity-related complications,” reinforcing the broader health benefits of semaglutide therapy.³

STEP UP Trial Details

The 72-week STEP UP trial was a randomized, double-blind, placebo-controlled, parallel-group superiority study including 1407 adults with a BMI ≥ 30 kg/m² without diabetes. It compared once-weekly semaglutide 7.2 mg to 2.4 mg and placebo, each combined with lifestyle intervention. Key secondary endpoints included the proportion of participants achieving ≥10%, 15%, 20%, and 25% weight loss.¹

A companion 72-week study (STEP UP T2D) evaluated the same doses in 512 adults with obesity and type 2 diabetes, with weight loss as the primary endpoint.³

Regulatory Status

The higher-dose semaglutide 7.2 mg formulation is currently under review by the European Medicines Agency, the UK Medicines and Healthcare products Regulatory Agency, and other global regulators. Novo Nordisk expects a European decision around the end of 2025 and plans submission to the US Food and Drug Administration.³

References

1. Le Roux CW, Garvey WT, Kolnes KJ, et al. STEP UP: Efficacy of Semaglutide in Obesity Treatment Targets and Cardiovascular Risk Thresholds. Oral presentation at ObesityWeek 2025; November 4–7; Atlanta, US.
2. Wharton S, Freitas P, Hjelmesæth J, et al. Once-weekly semaglutide 7.2 mg in adults with obesity: the randomized, controlled, phase 3b STEP UP trial. Lancet Diabetes Endocrinol. 2025; S2213-8587(25)00226-8.
3. Novo Nordisk Wegovy® users achieved waist and BMI targets linked to improved health and low risk of obesity-related complications. Novo Nordisk. News release. November 5, 2025. Accessed November 6, 2025. https://www.novonordisk.com/content/nncorp/global/en/news-and-media/news-and-ir-materials/news-details.html?id=916449#