Is Wegovy better suited for patients with specific conditions compared to other weight loss drugs?

Yes, Wegovy has strong evidence in people with type 2 diabetes, cardiovascular disease, and sleep apnoea, where weight loss can improve outcomes. Other drugs may be chosen if semaglutide is unsuitable, but few have shown the same range of benefits across multiple health conditions.

Why certain conditions matter

Weight-related health problems often go beyond the number on the scales. People with obesity are more likely to develop type 2 diabetes, cardiovascular disease, and sleep disorders such as obstructive sleep apnoea. For this reason, medicines that not only help with weight but also improve these linked conditions are particularly valuable in clinical practice.

Wegovy in type 2 diabetes

Semaglutide, the active ingredient in Wegovy, has been widely studied in people with type 2 diabetes. At the weight-management dose of 2.4 mg, it reduces calorie intake and helps bring blood sugar under control. The STEP-2 trial specifically examined adults with both obesity and type 2 diabetes, showing average weight loss of about 9.6% at 68 weeks, alongside significant improvements in HbA1c (a key blood sugar measure). NICE recognises this dual benefit, which explains why Wegovy is often considered in people with diabetes who struggle with both weight and glucose control.

Cardiovascular protection

Wegovy also has strong evidence in people with established cardiovascular disease. The SELECT trial demonstrated that semaglutide 2.4 mg reduced the risk of major cardiovascular events — including heart attack and stroke — by about 20% in adults with overweight or obesity and heart disease. No other weight-loss medicine has yet shown benefits of this scale on cardiovascular outcomes, making Wegovy particularly well suited for this group.

Sleep apnoea and other conditions

Excess weight is one of the strongest risk factors for obstructive sleep apnoea, a condition where breathing repeatedly stops and starts during sleep. Studies have shown that semaglutide-driven weight loss can lead to meaningful improvements in sleep apnoea severity, often reducing the need for CPAP machines or other treatments. Smaller studies and observational data also suggest benefits for conditions such as fatty liver disease, although Wegovy is not formally licensed for these.

Comparisons with other medicines

Other weight-loss drugs can be helpful but usually have narrower effects. Saxenda (liraglutide) supports weight loss and modestly improves metabolic markers, but the average reductions are smaller than with Wegovy. Mysimba (naltrexone/bupropion) can help with cravings, but its role in diabetes or cardiovascular disease is limited. Orlistat reduces fat absorption and may modestly improve cholesterol but has little impact on blood sugar or heart outcomes. In this sense, Wegovy stands out for the breadth of its evidence across multiple health conditions.

NHS considerations

NICE guidance recommends Wegovy specifically for adults with a BMI over 35 who also have weight-related health problems, or in some cases above 30 if criteria are met. This reflects the recognition that Wegovy is particularly valuable when used in people with co-existing conditions where weight reduction improves outcomes. For other medicines, NHS use is more restricted, and they are less likely to be prioritised for people with complex health needs.

What the evidence shows overall

Wegovy is better suited than most other weight-loss drugs for people with conditions like type 2 diabetes, cardiovascular disease, and sleep apnoea, because it has strong evidence of benefits across all three. Other medicines may be chosen where semaglutide is not appropriate, but few offer the same combination of weight reduction and improvements in broader health outcomes.