What are the main differences between Wegovy and Trulicity?

Wegovy contains semaglutide at a higher dose and is licensed for weight management, while Trulicity (dulaglutide) is prescribed for type 2 diabetes. Weight changes with dulaglutide are usually modest compared with the significant reductions seen in trials of semaglutide for obesity.

Two GLP-1 medicines, two purposes

Both Wegovy and Trulicity belong to the same broad group of medicines known as GLP-1 receptor agonists. They mimic a natural hormone in the body that helps reduce appetite, slows stomach emptying, and boosts insulin release after meals. Despite working through the same pathway, their licensed uses are different: Trulicity is designed for people with type 2 diabetes, while Wegovy is approved in the UK for weight management in adults with a high BMI and weight-related conditions.

Doses and schedules

The differences start with how they are prescribed. Trulicity (dulaglutide) is given once a week at doses of 0.75 mg, 1.5 mg, and sometimes higher for blood sugar control. Wegovy (semaglutide) is taken at a weekly dose of 2.4 mg after a gradual 16-week increase. This higher dose is what drives the stronger weight-loss effect seen in clinical studies. NICE has highlighted this point in its guidance, making clear that semaglutide at weight-management doses is not the same as the lower-dose diabetes medicines.

Effectiveness in trials

The STEP-1 trial, published in The New England Journal of Medicine, showed that people taking Wegovy lost on average about 15% of their body weight over 68 weeks alongside diet and exercise. By comparison, dulaglutide trials such as AWARD-11 focused on blood sugar control and showed only modest weight reductions, usually around 2–3%. This reflects the different design goals: dulaglutide is first and foremost a diabetes treatment, while semaglutide at the higher Wegovy dose is specifically for obesity care.

NHS positioning

In the UK, Trulicity is offered on the NHS for people with type 2 diabetes when first-line treatments are not enough to control blood sugar. It is valued for its cardiovascular protection as well as its effect on glucose levels. Wegovy, in contrast, has been recommended by NICE for people with obesity who meet eligibility criteria, and is now being rolled out through NHS specialist weight-management services. Each drug therefore has a defined place within NHS care pathways.

Side effects and tolerability

Because they are both GLP-1 receptor agonists, side effects overlap. The most common are nausea, diarrhoea, or constipation, especially at the start of treatment. People generally find these ease with time or with dose adjustments. The higher doses used in Wegovy can lead to stronger appetite suppression, but also sometimes stronger gastrointestinal side effects compared with dulaglutide.

Why the distinction matters

Although both medicines belong to the same family, it would be misleading to treat them as interchangeable. Trulicity remains a diabetes medicine, and Wegovy is the semaglutide brand for weight loss. Their trial evidence, licensed doses, and NHS pathways make them separate tools for different clinical problems.

The wider context

The key difference between Wegovy and Trulicity is not just the name, but their purpose. Trulicity helps people manage type 2 diabetes, with weight loss as a secondary benefit. Wegovy is the higher-dose semaglutide product that has been proven to deliver significant, sustained weight reduction in people living with obesity. Both matter in modern medicine, but they serve different roles and should be understood on their own terms.