Researchers tested a stronger version of a popular weight loss injection called semaglutide to see if it could help people lose more weight. Over 1,400 adults with obesity tried either the new higher dose, the standard dose, or a fake injection for 72 weeks while also making lifestyle changes. People using the higher dose lost about 19% of their body weight on average—significantly more than those on the standard dose or placebo. While the higher dose caused more stomach problems, doctors say the benefits outweigh the risks for most people seeking serious weight loss.

The Quick Take

  • What they studied: Does a stronger dose of semaglutide (a weekly injection) help people with obesity lose more weight than the standard dose?
  • Who participated: 1,407 adults with obesity (average age 47, mostly women) from hospitals and clinics in 11 countries. All participants had a BMI of 30 or higher and didn’t have diabetes.
  • Key finding: People getting the higher dose (7.2 mg) lost an average of 18.7% of their body weight compared to 15.6% for the standard dose and only 3.9% for those getting a fake injection. The higher dose was about 3 times more likely to help people lose 25% or more of their weight.
  • What it means for you: If you’re struggling with obesity and the standard weight loss injection isn’t working well enough, a higher dose may help you lose significantly more weight. However, expect more stomach-related side effects, and this should only be done under doctor supervision.

The Research Details

This was a rigorous randomized controlled trial, which is one of the best ways to test if a treatment works. Researchers randomly divided 1,407 people into three groups: some received the higher dose of semaglutide (7.2 mg), others got the standard dose (2.4 mg), and a third group received a placebo (fake injection). Nobody knew which group they were in—not even the doctors giving the injections—to prevent bias. Everyone also received guidance on healthy eating and exercise. The study lasted 72 weeks (about 18 months), and researchers carefully tracked how much weight people lost and what side effects they experienced.

The study was conducted across 95 different hospitals, clinics, and medical centers in 11 countries, which makes the results more reliable because they weren’t limited to one location or population. The large number of participants (1,407) also strengthens the findings because bigger studies are generally more trustworthy than smaller ones.

This research design is important because it allows scientists to clearly see whether the higher dose actually causes the weight loss, rather than other factors like diet changes or placebo effect. By comparing the higher dose to both the standard dose and placebo, researchers could determine exactly how much better the new dose performs. The long study period (18 months) also shows whether benefits last over time.

This study has several strengths: it’s large (over 1,400 people), it’s randomized (reducing bias), it’s double-blind (neither participants nor doctors knew who got what), and it was conducted across multiple countries and medical centers. The study was completed recently (2024) and published in a highly respected medical journal. One limitation is that most participants were women (74%), so results might not apply equally to men. Also, participants were generally healthier (no diabetes), so results may differ for people with other health conditions.

What the Results Show

The higher dose of semaglutide (7.2 mg) significantly outperformed both the standard dose and placebo. People receiving the higher dose lost an average of 18.7% of their body weight over 18 months, compared to 15.6% for the standard dose and only 3.9% for placebo. This means the higher dose helped people lose about 3% more body weight than the standard dose.

When looking at specific weight loss milestones, the results were even more dramatic. About 71% of people on the higher dose lost at least 5% of their body weight, compared to only 6% on placebo. For more significant weight loss (20% or more), 35% of people on the higher dose achieved this goal versus just 1% on placebo. For very substantial weight loss (25% or more), 20% on the higher dose succeeded compared to less than 1% on placebo.

The higher dose also reduced waist circumference (belly fat) by about 11.7 cm more than placebo, which is important because belly fat is linked to serious health problems. These improvements were consistent across different groups of people in the study.

Beyond weight loss, the study measured other important health markers. Waist circumference decreased significantly more with the higher dose, suggesting better reduction of dangerous belly fat. The study also found that the higher dose was more effective than the standard dose at helping people achieve major weight loss goals (20% or 25% reduction), though the standard dose still worked better than placebo.

The standard dose of semaglutide (2.4 mg) was already approved and known to be effective for weight loss. This study shows that going to a higher dose (7.2 mg) provides additional benefits—about 3% more weight loss on average. This builds on previous research showing that semaglutide works for weight management, and now we know that more of the medication produces more weight loss, at least up to this higher dose.

The study had several limitations worth noting. About 74% of participants were women, so we’re less certain how well this works for men. All participants were relatively healthy (none had diabetes), so results might differ for people with other medical conditions. Some people dropped out of the study, which could affect results. Additionally, the study only lasted 18 months, so we don’t know if the weight loss continues or if people regain weight after stopping the medication. Finally, this was funded by the medication’s manufacturer, which could introduce some bias, though the study design helps minimize this.

The Bottom Line

If you have obesity and the standard dose of semaglutide isn’t helping you reach your weight loss goals, the higher dose (7.2 mg) appears to be significantly more effective. However, this should only be considered under close medical supervision. The higher dose causes more stomach-related side effects, so discuss with your doctor whether the extra weight loss benefit is worth the increased side effects. This medication works best when combined with healthy eating and exercise habits. (Confidence level: High—this is based on a large, well-designed study.)

This research is most relevant for adults with obesity who have already tried the standard dose and want better results. It’s also important for doctors deciding which dose to prescribe. People without obesity, those with diabetes, or those with certain medical conditions should not assume these results apply to them without consulting their doctor. Pregnant women and people with a personal or family history of thyroid cancer should not use this medication.

Based on this study, people can expect to see meaningful weight loss within the first few months, with continued progress over 18 months. However, this medication requires ongoing use—weight typically returns if you stop taking it. Most people should see noticeable changes within 3-6 months if the medication is working for them.

Want to Apply This Research?

  • Track weekly body weight and waist circumference measurements. Set milestone goals (5%, 10%, 15%, 20%, 25% weight loss) and log progress toward each. Also track gastrointestinal symptoms daily (nausea, vomiting, constipation) to monitor side effects and discuss patterns with your doctor.
  • Use the app to log daily meals and exercise to complement the medication’s effects. Set reminders for your weekly injection day. Track hunger levels before and after meals to understand how the medication affects appetite. Log any side effects immediately so you have a record to discuss with your healthcare provider.
  • Create a dashboard showing weekly weight trends, monthly waist circumference changes, and progress toward major milestones (5%, 10%, 20%, 25% weight loss). Include a symptom tracker for side effects. Set up monthly check-in reminders to review progress and adjust diet/exercise as needed. Share reports with your doctor at regular appointments to ensure the medication is working safely and effectively.

This research describes a prescription medication that requires medical supervision. Do not start, stop, or change semaglutide doses without consulting your doctor. This medication is not suitable for everyone—people with a personal or family history of thyroid cancer, pregnant women, and those with certain medical conditions should not use it. The side effects described (nausea, vomiting, constipation, nerve pain) can be serious for some people. This summary is for educational purposes only and should not replace professional medical advice. Always discuss any new treatment with your healthcare provider to determine if it’s appropriate for your individual situation.