Does Wegovy work better for certain age groups compared to other drugs?

Clinical trials included adults up to their mid-70s, and weight loss benefits were seen across age groups. There’s limited evidence directly comparing older versus younger adults, but no major differences in effectiveness have been noted, though older people may be more sensitive to side effects.

Who was included in the trials

The large clinical trials of semaglutide, such as the STEP programme, included adults with overweight or obesity up to about 75 years old. This means we have solid evidence for both younger and older adults, though very elderly groups (over 75) were under-represented. Across the age ranges studied, the pattern of weight loss was consistent: participants lost significant amounts of weight regardless of whether they were in their 30s, 50s, or 70s.

Wegovy’s performance by age

Analyses of STEP trial data showed that average weight loss of around 15% over 68 weeks was seen across all adult age groups. While older adults sometimes reported side effects like nausea or gastrointestinal discomfort more frequently, the overall effectiveness of Wegovy did not decline with age. This suggests that semaglutide works reliably in adults of different generations, provided the dosing schedule is followed carefully.

Comparisons with other medicines

For drugs such as Orlistat, Saxenda, or Mysimba, there is less evidence focused on older adults. Orlistat has been widely used across age groups, but its side effects — oily stools and digestive discomfort — may be harder for older people to manage. Saxenda (liraglutide) has been trialled in a broad adult population, but results suggest smaller average weight reductions (around 6–8%) than Wegovy. Mysimba (naltrexone/bupropion) may pose challenges for older adults because of risks linked to raised blood pressure and interactions with other medicines. Compared with these, Wegovy appears to offer both stronger results and a safety profile that is manageable with careful supervision.

Sensitivity to side effects

One area where age may make a difference is tolerability. Older adults sometimes experience stronger gastrointestinal side effects with GLP-1 receptor agonists. They may also be more likely to take other medicines, increasing the risk of interactions. For this reason, NHS clinicians emphasise careful monitoring in older patients starting Wegovy. Dose escalation is particularly important, as it allows the body to adapt gradually and reduces the likelihood of early withdrawal due to side effects.

NHS guidance

NICE does not set strict upper age limits for Wegovy use. Instead, eligibility is based on BMI, related health conditions, and clinical judgement. This means that people in their 60s or early 70s can still be offered Wegovy through specialist weight-management services if they meet the criteria. The key consideration is whether the expected benefits outweigh the risks in each individual case.

Why long-term outcomes matter

The importance of effective weight management often grows with age, as older adults are more likely to have conditions such as type 2 diabetes, heart disease, or sleep apnoea. Because Wegovy has demonstrated improvements in cardiovascular outcomes as well as weight loss, it may be particularly valuable in older age groups where these risks are highest. Other drugs do not have the same level of evidence for reducing serious long-term complications.

What the evidence shows overall

Wegovy works well across adult age groups studied, from younger adults through to those in their 70s. While older people may need closer monitoring for side effects, no major differences in effectiveness have been reported compared with younger adults. Compared to other weight-loss medicines, Wegovy offers both stronger evidence and broader benefits, making it a suitable option for a wide age range under clinical supervision.