Is Wegovy more effective when diet and exercise are included compared to drugs like Saxenda and Trulicity?

Yes, trial evidence shows that Wegovy works best when combined with healthy eating and physical activity, leading to average weight losses of around 15%. Saxenda and Trulicity also perform better when paired with lifestyle support, but semaglutide at the doses used in Wegovy generally results in greater overall reductions.

Why lifestyle support matters

No weight-loss medicine is intended to work on its own. NICE guidance makes clear that drugs such as Wegovy, Saxenda, and Trulicity must always be prescribed alongside a reduced-calorie diet and increased physical activity. Medicines change how the body regulates appetite, digestion, or metabolism, but lifestyle support provides the foundation that makes these changes sustainable.

Wegovy in the STEP trials

The strongest evidence comes from the STEP programme. In STEP-1, people using Wegovy (semaglutide 2.4 mg weekly) alongside lifestyle advice lost an average of 15% of their body weight over 68 weeks. STEP-5 confirmed that much of this loss could be maintained at two years with ongoing treatment and lifestyle support. These results show that semaglutide is highly effective, but only when combined with structured diet and activity changes.

Saxenda’s results

Saxenda (liraglutide 3 mg daily) is another GLP-1 receptor agonist. In the SCALE trials, it produced average weight losses of around 6–8% after one year, again in combination with lifestyle measures. Participants receiving Saxenda alone without dietary guidance would not have achieved these results. This underlines that the medicine enhances, rather than replaces, lifestyle changes.

Trulicity’s role

Trulicity (dulaglutide) is licensed primarily for type 2 diabetes but can also contribute to modest weight loss. In the REWIND trial, participants taking dulaglutide saw small but consistent weight reductions, typically a few kilograms, along with improvements in blood sugar and cardiovascular outcomes. As with Wegovy and Saxenda, these benefits were seen on top of lifestyle support, not in isolation.

Why Wegovy stands out

What sets Wegovy apart is the scale of its results. While Saxenda and Trulicity provide improvements, semaglutide at the higher Wegovy dose consistently produces greater and more sustained reductions in body weight. Its impact on appetite and satiety is stronger, making it easier for people to maintain a calorie deficit when paired with diet and exercise. This explains why NICE prioritised Wegovy in NHS weight-management services.

NHS perspective

In England, Wegovy is prescribed only through specialist NHS services, where patients also receive structured support from dietitians, psychologists, and exercise specialists. This mirrors the conditions of the clinical trials, ensuring that people benefit not just from the medicine but also from the behavioural changes needed to maintain results. Saxenda and Trulicity are available in narrower contexts, but they too are framed within the need for lifestyle support.

Putting it all together

Yes, Wegovy is more effective when combined with diet and exercise, and it outperforms Saxenda and Trulicity in clinical trials when used under the same conditions. All three medicines rely on lifestyle changes to work properly, but semaglutide at the doses used in Wegovy consistently delivers the strongest overall weight loss. The message is clear: medicine and lifestyle go hand in hand, and Wegovy offers the most powerful results when the two are combined.