Wegovy for men vs women: does the response differ?

Yes, on average. In the trials behind the Wegovy (semaglutide) licence, women lost more weight than men. In STEP 1, the main trial, the difference between Wegovy and placebo was 14.0 percentage points of body weight in women and 8.0 in men. [1]

Both figures are differences against placebo, so men on Wegovy lost more than men on placebo. The licence covers men and women on the same terms. [2] Results also varied widely within each sex, so an average does not tell you where you will land. [2]

This article sets out what the trials show by sex and the explanations researchers have offered. It also covers the heart evidence, and what the average can and cannot tell one man. For the results at each dose, see our companion article on Wegovy results for men at each dose stage.

Do men and women respond differently to Wegovy?

Yes. The licence document for Wegovy states that efficacy was shown regardless of age, sex, race, ethnicity, starting weight, BMI, type 2 diabetes and kidney function. It adds that relatively greater weight loss was observed in women. [2]

BMI is body mass index, your weight relative to your height. Placebo is an inactive dummy treatment given to a comparison group.

What the main trial found

STEP 1 enrolled 1,961 adults with obesity, or overweight with a weight-related condition, and none with type 2 diabetes. They took Wegovy 2.4 mg or placebo once a week for 68 weeks, alongside advice on eating less and moving more. [2] [3]

Across everyone, body weight fell by 14.9% on Wegovy and 2.4% on placebo. [2]

The medicines regulator's assessment report splits that result by sex. The estimated difference between Wegovy and placebo was 14.0 percentage points in women and 8.0 percentage points in men. [1] The 95% confidence intervals were 15.1 to 12.9 for women and 9.8 to 6.3 for men. [1]

A percentage point is the gap between two percentages. A confidence interval is the range within which the true figure is likely to sit. Trial figures are averages from groups of people. They are not a prediction for any one person.

What did the trials show, by sex?

Women lost more than men in STEP 1, STEP 2 and the heart-failure trials, and the same as men in STEP 3. [1] [4] A 2025 review that pooled 14 trials of GLP-1 medicines found the same direction. [5]

GLP-1 medicines act like the gut hormone GLP-1, which is how Wegovy works. The STEP trials are the semaglutide weight-management trial programme.

Trial by trial

Weight loss by sex in the semaglutide trials

Trial	Women	Men	What it shows
STEP 1 (68 weeks, 1,961 adults without type 2 diabetes)	14.0 points more than placebo	8.0 points more than placebo	Women lost more [1]
STEP 2 (68 weeks, adults with type 2 diabetes)	7.48 points more than placebo	4.63 points more than placebo	Women lost more [1]
STEP 3 (68 weeks, with an intensive behavioural programme)	10.12 points more than placebo	11.07 points more than placebo	No sex difference; a small trial with wide uncertainty [1]
STEP-HFpEF trials pooled (52 weeks, 1,145 adults with heart failure and obesity)	9.6% of body weight lost on semaglutide	7.2% of body weight lost on semaglutide	Women lost more; heart-failure symptoms improved equally [4]
Meta-analysis of 14 GLP-1 trials (2025)	Women lost 1.04 kg more than men, or 1.69% of body weight; for semaglutide alone, 1.04 kg		The gap grew as total weight loss grew [5]

How to read the figures

The STEP 1 to 3 figures are differences against placebo, not the total weight lost. The heart-failure figures are the weight change on semaglutide itself. [1] [4] HFpEF is heart failure with preserved ejection fraction, a form in which the heart pumps normally but fills stiffly.

In the heart-failure trials, women lost more weight than men. The improvement in symptom scores was the same in both sexes: 7.6 points in women and 7.5 in men. [4]

Why might women lose more weight than men?

No single cause is established. [1] [6] The regulator's assessors and independent researchers point to four factors.

• Dose relative to body weight. Body weight is the main factor that sets how much semaglutide circulates in the blood. Lighter people get a higher exposure from the same dose, and the women in the trials weighed less on average. [1] The assessors found this explained part of the gap but not all of it. [1]
• The dose may not reach a plateau in men. One analysis suggests the drug concentration did not fully level off in men at the doses licensed for weight management. [6]
• Hormones and appetite. Sex hormones may shape eating behaviour differently in men and women. The stomach also empties more slowly in women before the menopause. [6]
• Side effects. Digestive side effects were more frequent in women at every level of exposure. Researchers suggest these effects may be linked to the larger weight loss seen in women. [6]

Claims that men burn fat faster, or that the gap is explained by muscle mass, do not appear in the trial reports. Treat them as opinion.

How many men were in the Wegovy trials?

A minority in every trial. Women made up 74.1% of STEP 1, 51.2% of STEP 2, 81.0% of STEP 3 and 79.0% of STEP 4. Across the four trials, 71.6% of participants were women. [1]

Men were 26.9% of the people given semaglutide in STEP 1. [6] Fewer men means more uncertainty around the male figure, which is why the confidence interval for men is wider. [1]

The assessors drew a cautious conclusion. Because women responded more and made up most of the participants, the headline trial figure could overstate the effect of semaglutide in general. [1] The authors of the 2023 review asked for trials that address men separately. [6]

Does the average gap tell you anything about your own result?

Very little. The licence document notes that efficacy varied within every subgroup. [2] Sex was one of two factors the assessors linked to the size of the response. Starting weight was the other. [1]

In STEP 1, people who started under 90 kg lost 14.0 points more than placebo. People who started over 115 kg lost 9.6 points more. [1] In STEP 3, where everyone also followed an intensive behavioural programme, men and women lost the same. [1]

Most people in STEP 1 responded. 83.5% of those on Wegovy lost at least 5% of their body weight, against 31.1% on placebo. The report does not split that figure by sex. [1] An average describes a group. It does not say where you will land.

Do the benefits beyond weight differ for men?

The evidence here comes mostly from men. SELECT, the largest trial of Wegovy and heart disease, enrolled 17,604 adults with established cardiovascular disease and a BMI of 27 or more, without diabetes. 72.3% of them were men. [2]

Over a median of 41.8 months, a first major cardiovascular event occurred in 6.5% of people on Wegovy and 8.0% on placebo. A major cardiovascular event here means death from a cardiovascular cause, a non-fatal heart attack or a non-fatal stroke. [2]

That is a hazard ratio of 0.80, a 20% relative reduction in risk. A hazard ratio compares how often an event happened in one group against the other over the trial. [2]

Was the heart result the same in men?

Yes. The licence document states that the reduction in events was not affected by age, sex, race, ethnicity, BMI or kidney function. [2] In the trial’s pre-planned subgroups the hazard ratio was 0.79 in men and 0.84 in women. [8]

Weight loss in SELECT averaged 9.4% on Wegovy against 0.9% on placebo at 104 weeks, less than in STEP 1. [8] The heart result was therefore seen in a mostly male group that lost less weight, on average, than STEP 1’s mostly female group.

The heart-failure trials point the same way. Men and women improved by the same amount on the symptom score, even though women lost more weight. [4] These are population results from trials in people who already had heart disease. They are not a prediction for any one person.

Does the licence or eligibility differ by sex?

No. Wegovy is licensed for adults with a BMI of 30 or more, or 27 or more with at least one weight-related condition. It is used alongside a reduced-calorie diet and more physical activity. The criteria are the same for men and women. [2]

On the NHS, NICE recommends semaglutide within specialist weight management services under its guidance TA875. NICE is the body that advises the NHS on which treatments to provide. [7] NICE recommends identifying the health conditions linked to weight at the start and reviewing regularly during treatment. [7]

Whether treatment is right for you is a clinical decision. The questions a clinician asks are about your health, your history and your blood test, not your sex.

How does HeMed fit in?

HeMed starts with a blood test. We measure 10 metabolic markers across four systems from a needle-free blood test at home.

A clinician reviews your blood test first. If they approve treatment, we deliver it the next working day, discreetly packaged, with delivery included in your plan.

Your dose moves on how you are doing, not on a calendar. If side effects are still settling on a lower dose, your clinician can hold that dose before any increase, as the licence allows. [2] No step comes sooner than the licence minimum of 4 weeks. [2]

A weekly in-app check-in, reviewed by clinicians, so your plan can be adjusted when it needs to be. A retest every 6 months shows what’s actually changing.

Wegovy is a prescription medicine for weight management. Whether it’s right for you is a clinical decision, made from your health information and your baseline blood test.

Frequently asked questions

Does Wegovy work for men?

Yes. In STEP 1, men on Wegovy lost 8.0 percentage points more body weight than men on placebo over 68 weeks. That is a smaller average than in women. Trial figures are averages, not a prediction for one person.

Why do women lose more weight than men on Wegovy?

No single reason is established. Women in the trials weighed less, so the same dose gave a higher exposure to the medicine. The regulator's assessors found this explained part of the gap, not all of it.

Researchers also point to sex hormones, slower stomach emptying in women and more frequent digestive side effects in women.

What does the trial evidence show for men?

Men lost more than men on placebo in STEP 1 and STEP 2, and the same as women in STEP 3. In the pooled heart-failure trials, men on semaglutide lost 7.2% of their body weight over 52 weeks. These are group averages from separate trials.

Is the sex difference clinically important?

The gap is consistent across trials. A 2025 meta-analysis puts it at about 1 kg, or 1.69% of body weight. Whether it matters for one man depends on his starting weight and his health. A clinician assesses that before prescribing.

Is the sex difference a reason for men not to seek assessment?

No. The licence criteria are the same for men and women, and men lost more than men on placebo in the trials. Whether treatment is suitable is a clinical decision made from your health information, your history and your blood test.

Does the heart evidence for Wegovy include men?

Yes. 72.3% of the 17,604 people in the SELECT cardiovascular trial were men. Major cardiovascular events occurred in 6.5% of people on Wegovy and 8.0% on placebo. The licence document states the reduction was not affected by sex. These are results from people who already had heart disease.

How does HeMed approach treatment for men?

HeMed starts with a blood test. We measure 10 metabolic markers across four systems from a needle-free blood test at home. A clinician reviews your blood test first.

A weekly in-app check-in, reviewed by clinicians, so your plan can be adjusted when it needs to be. A retest every 6 months shows what’s actually changing.

HeMed provides clinician-led weight management. Treatment is prescription-only and is prescribed only where a clinician decides it is suitable. This page is general health information, not medical advice. If you are worried about symptoms, speak to your GP, or use NHS 111.

Next step: see what the HeMed blood test measures.

Sources (8)

1. European Medicines Agency, Wegovy assessment report EMA/112307/2022 (CHMP, 2021 to 2022), section 2.6.5.3 "Clinical studies in special populations" (subgroup analyses by sex and baseline weight, pages 123 to 124) and the benefit-risk discussion: STEP 1 estimated treatment difference versus placebo in body weight (%) at week 68, female -14.0 (95% CI -15.1 to -12.9), male -8.0 (-9.8 to -6.3); STEP 2 female -7.48, male -4.63; STEP 3 female -10.12, male -11.07; baseline weight under 90 kg -14.0, over 115 kg -9.6; 5% responders 83.5% versus 31.1%; female share by trial 74.1%, 51.2%, 81.0% and 79.0%, pooled 71.6%; "Higher exposure may contribute to the larger weight loss seen in female subjects"; "exposure differences cannot explain all differences between genders"; the inclusion of relatively more females "could lead to an overestimation of the effect of semaglutide on weight loss in general". ema.europa.eu, Wegovy EPAR public assessment report (PDF). Accessed 19 October 2026.
2. European Medicines Agency, Wegovy product information (Summary of Product Characteristics), sections 4.1, 4.2 and 5.1: the indication by BMI and weight-related comorbidity; the 4-week dose steps; STEP 1 (1,961 patients) change in body weight at week 68 -14.9% versus -2.4%; "Efficacy was demonstrated regardless of age, gender, race, ethnicity, baseline body weight, BMI, presence of type 2 diabetes and level of renal function. Variations in efficacy existed within all subgroups. Relatively greater weight loss was observed in women". ema.europa.eu, Wegovy product information (PDF). The UK SmPC is published by the electronic medicines compendium at medicines.org.uk/emc/product/13800/smpc. Accessed 19 October 2026.
3. Wilding JPH, Batterham RL, Calanna S, et al. "Once-weekly semaglutide in adults with overweight or obesity" (STEP 1). New England Journal of Medicine 2021;384:989-1002. doi.org/10.1056/NEJMoa2032183. Headline results read from the product information table (source 2); the journal full text is paywalled. Accessed 19 October 2026.
4. Verma S, Butler J, Borlaug BA, et al. "Efficacy of semaglutide by sex in obesity-related heart failure with preserved ejection fraction: STEP-HFpEF trials." Journal of the American College of Cardiology 2024 (prespecified pooled analysis of STEP-HFpEF and STEP-HFpEF DM, 1,145 patients, 52 weeks): body weight change -9.6% in women versus -7.2% in men (P for interaction 0.006); KCCQ clinical summary score change +7.6 versus +7.5 points. doi.org/10.1016/j.jacc.2024.06.001. Read via the abstract and the American College of Cardiology summary. Accessed 19 October 2026.
5. Yang Y, He L, Han S, et al. "Sex differences in the efficacy of glucagon-like peptide-1 receptor agonists for weight reduction: a systematic review and meta-analysis." Journal of Diabetes 2025;17(3):e70063 (14 randomised trials; women lost more than men, mean difference 1.04 kg, 95% CI 0.70 to 1.38, and 1.69%, 95% CI 0.78 to 2.61; semaglutide 1.04 kg, 95% CI 0.45 to 1.63; larger total weight loss associated with a larger sex difference). doi.org/10.1111/1753-0407.70063; open access at europepmc.org (PMC11880690). Accessed 19 October 2026.
6. Jensterle M, Rizzo M, Janez A. "Semaglutide in obesity: unmet needs in men." Diabetes Therapy 2023;14(3):461-465: men were 26.9% of the STEP 1 semaglutide group; STEP 1 treatment differences -14.0% in women versus -8.0% in men; proposed explanations of lower female body weight and higher exposure, drug concentration not fully plateauing in men at the licensed doses, sex hormones and feeding behaviour, slower gastric emptying in pre-menopausal women, and more frequent gastrointestinal adverse events in women across exposure levels; the call for research that addresses men separately. doi.org/10.1007/s13300-022-01360-7; open access at europepmc.org (PMC9981825). Accessed 19 October 2026.
7. NICE, "Semaglutide for managing overweight and obesity", technology appraisal guidance TA875, recommendations 1.1 to 1.3 (8 March 2023, updated 4 September 2023). nice.org.uk/guidance/ta875. Accessed 19 October 2026.
8. Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. "Semaglutide and cardiovascular outcomes in obesity without diabetes" (SELECT). New England Journal of Medicine 2023;389:2221-2232 (17,604 adults; first major adverse cardiovascular event 6.5% versus 8.0%, hazard ratio 0.80, 95% CI 0.72 to 0.90; mean follow-up 39.8 months). doi.org/10.1056/NEJMoa2307563. The prespecified sex subgroups (men HR 0.79, 95% CI 0.70 to 0.90; women HR 0.84, 95% CI 0.66 to 1.07) and the 104-week weight change (-9.4% versus -0.9%) are taken from the American College of Cardiology trial summary, acc.org, SELECT; the journal full text is paywalled. Accessed 19 October 2026.

Numbered markers in the page text link to these entries. Statistics describe populations, not any one person’s results.