----|------| | 1-4 | 0.25mg | | 5-8 | 0.5mg | | 9-12 | 1.0mg | | 13-16 | 1.7mg | | 17+ | 2.4mg (maintenance) |
Why the slow titration? Jumping to high doses causes severe GI side effects and dropouts. The gradual increase lets your body adapt.
Can you stay at lower doses? Yes. Some men find 1.7mg sufficient. Discuss with your provider.
Results for Men
STEP trials data: - Average weight loss: 14.9% at 68 weeks - With intensive lifestyle intervention: 16.0% - Some participants lost 20%+
Real-world expectations: - Most men lose 12-18% of body weight - Significant loss begins month 2-3 - Maximum loss typically at 9-15 months - Maintenance required to keep weight off
Beyond weight: - A1C reduction: 1.5-2 points - Blood pressure improvement - Cholesterol improvement - 20% cardiovascular event reduction (SELECT trial)
Male-Specific Benefits
Testosterone Restoration
The ENDO 2025 data applies to Wegovy users: - 77% of obese men normalized testosterone - Average increase: 312 → 368 ng/dL - No TRT required
Wegovy produces the visceral fat loss that restores natural testosterone production.
Sleep Apnea Improvement
Men are 2-3x more likely to have OSA. Weight loss significantly improves apnea severity. While Zepbound has the specific OSA approval, Wegovy produces substantial improvement through weight loss.
Erectile Function
Studies show improved IIEF scores (erectile function measure) in men with obesity/diabetes on semaglutide. Mechanisms: improved vascular health, testosterone recovery, weight loss.
Cardiovascular Protection
SELECT trial: 20% reduction in heart attacks, strokes, and cardiovascular death. This is Wegovy-specific data — the trial used 2.4mg semaglutide in people with obesity but without diabetes.
For men, who have higher baseline cardiovascular risk than women at every age, this protection is particularly valuable.
Side Effects
Same GLP-1 class effects:
Common: - Nausea (44%) - Diarrhea (30%) - Vomiting (25%) - Constipation (24%)
Management: - Smaller meals - Avoid fatty foods initially - Ginger for nausea - Hydration - Time (symptoms usually fade)
Serious (rare): - Pancreatitis - Gallbladder disease - Thyroid C-cell tumors (rodent studies, not confirmed in humans)
Wegovy vs. Zepbound
The main competitor comparison:
| Factor | Wegovy | Zepbound |
|---|---|---|
| Active ingredient | Semaglutide | Tirzepatide |
| Mechanism | GLP-1 | GLP-1 + GIP |
| Weight loss | 15-17% | 20-22% |
| CV outcome data | Yes (SELECT) | Pending |
| Sleep apnea approved | No | Yes |
| Oral option | Yes (Wegovy Pill) | No |
Choose Wegovy if: Cardiovascular protection is priority, you want oral option, proven long-term data matters.
Choose Zepbound if: Maximum weight loss is priority, you have sleep apnea, tirzepatide side effects may be milder.
Cost and Coverage
Retail: $1,300-1,400/month
With insurance: Varies widely. Many commercial plans cover with prior authorization. Copays with savings card: as low as $25/month.
Coverage challenges: - Many insurers require prior authorization - Documented weight-related conditions help - Failed diet attempts may be required - Some plans specifically exclude weight loss drugs
Manufacturer program: NovoCare savings card reduces copays significantly for those with commercial insurance.
Coming 2027: Medicare Part D coverage through BALANCE Model. Negotiated price ~$245/month.
Wegovy Pill (Oral Semaglutide)
Launched December 2025. Same medication, oral formulation.
Dosing: Daily pill, up to 25mg Weight loss: 16.6% in trials (slightly less than injectable) Cost: $149-299/month (promotional pricing) Requirement: 30-minute morning fasting protocol
For men who won't inject, the pill is a major breakthrough. It's also currently cheaper than injectable through promotional pricing.
Getting Wegovy
Through healthcare provider: - Primary care can prescribe - Endocrinologist or obesity specialist - Prior authorization usually required
Through telehealth: - Faster process (days vs. weeks) - May or may not involve insurance - Some telehealth providers offer self-pay options
Requirements: - BMI ≥30, or ≥27 with comorbidity - Medical screening - No contraindications
What to Expect: Month by Month
Month 1: Adjustment. Mild effects. Learning the injection process.
Month 2-3: Appetite significantly reduced. Weight loss accelerating.
Month 4-6: Substantial weight loss visible. Energy improving. Dose reaching maintenance level.
Month 6-12: Peak weight loss phase. Metabolic improvements measurable. Testosterone likely improving.
Year 1+: Maintenance. Weight stabilizes. Ongoing medication required to maintain.
The Bottom Line
Wegovy is the FDA-approved semaglutide product for weight loss. For men, it offers: - 15-17% average weight loss - Proven 20% cardiovascular risk reduction - Testosterone normalization through fat loss - Fertility preservation - Now available in oral form
The main tradeoff: tirzepatide (Zepbound) produces more weight loss, but Wegovy has better cardiovascular outcome data and an oral option.
For most men, either works well. Wegovy is the choice when cardiovascular protection is paramount or oral administration is preferred.
Related Articles: - Semaglutide vs Tirzepatide: Which Is Better for Men? - Oral Wegovy Just Launched: The Injection-Free Era Begins - GLP-1 Medications for Men: The Complete 2026 Guide
Last updated: January 2026
Medical disclaimer: This content is for informational purposes only and does not constitute medical advice.