Imcivree® vs. Wegovy®

Updated on March 5, 2026 by Lori Mulligan, MPH. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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Table of contents

• Imcivree®
• Wegovy®
• Imcivree vs. Wegovy Comparison
• Exploring Weight Management Options
• Related Content

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One of the main differences between Imcivree® (setmelanotide) and Wegovy® (semaglutide) is that Imcivree® is designed specifically for individuals with certain rare genetic conditions that cause obesity. Wegovy®, on the other hand, is a GLP-1 medication approved for chronic weight management in adults with obesity or overweight with related health conditions. Below, we take a closer look at each medication and how they compare.

Imcivree®

Setmelanotide (brand name Imcivree®) injection is used to help people lose weight and maintain weight loss in patients with obesity caused by specific genetic conditions, including proopiomelanocortin (POMC), proprotein convertase subtilisin/kexin type 1 (PCSK1), leptin receptor (LEPR) deficiency, or Bardet-Biedl syndrome (BBS). Before prescribing this medication, healthcare providers typically perform genetic testing to confirm the presence of one of these conditions.[1]

Individuals with obesity related to POMC, PCSK1, or LEPR deficiency often develop severe obesity beginning in childhood. While patients are usually born at a normal weight, genetic differences affecting hunger regulation, satiety, and metabolism can lead to rapid weight gain. These conditions are extremely rare, with only around 150 documented cases across all three genetic disorders in the medical literature.

How Does Imcivree® Work?

Imcivree® activates specific pathways in the brain that regulate appetite and fullness. By targeting these pathways, the medication helps people with these genetic conditions feel fuller and eat less. It may also increase resting metabolism, meaning the body burns more calories at rest. While Imcivree® can support weight loss in eligible patients, it does not cure the underlying genetic condition or address other symptoms associated with these disorders.

Imcivree® was evaluated in two one-year clinical studies. The first enrolled patients with obesity and confirmed or suspected POMC or PCSK1 deficiency, while the second enrolled patients with confirmed or suspected LEPR deficiency. All participants were at least six years old. Researchers evaluated effectiveness based on the percentage of patients who lost at least 10% of their body weight after one year of treatment.

Across the studies, 21 patients were evaluated. In the first study, 80% of patients with POMC or PCSK1 deficiency lost at least 10% of their body weight. In the second study, 46% of patients with LEPR deficiency achieved similar weight loss.

The studies also evaluated changes in hunger levels using an 11-point scale among patients aged 12 and older. While many participants reported meaningful reductions in hunger, responses varied considerably between individuals.

What Are Common Side Effects Of Imcivree®?

The most common side effects of Imcivree® include injection-site reactions, skin hyperpigmentation (darkened patches of skin), headache, and gastrointestinal symptoms such as nausea, diarrhea, and abdominal pain. Some patients have also reported spontaneous penile erections in males and adverse sexual reactions in females. Depression and suicidal ideation have also been reported during treatment with Imcivree®.[2]

Wegovy®

Wegovy® is the brand name for a higher-dose injectable form of semaglutide. Semaglutide was previously approved under the brand names Rybelsus® (oral) and Ozempic® (lower-dose injection) for the treatment of type 2 diabetes. Wegovy® uses a higher dose of semaglutide and is specifically approved for chronic weight management.

Semaglutide belongs to a class of medications called glucagon-like peptide-1 receptor agonists (GLP-1 RAs). GLP-1 is a hormone naturally released in the digestive tract in response to food intake. It helps regulate blood sugar levels, slows stomach emptying, and signals fullness to the brain. These combined effects can reduce appetite and help individuals consume fewer calories.

What Are The Risks And Benefits Of Wegovy®?

Phase 3 clinical trials of Wegovy®, known as the STEP (Semaglutide Treatment Effect in People with Obesity) trials, evaluated the medication across multiple patient populations. In the widely cited STEP 1 trial published in the New England Journal of Medicine, participants receiving Wegovy® lost an average of 14.9% of their body weight after 68 weeks, compared to 2.4% weight loss in the placebo group. For comparison, many older anti-obesity medications typically result in weight loss of around 5% to 9%, while lifestyle interventions alone often lead to 3% to 5% weight loss.

The most common side effects of Wegovy® include nausea, diarrhea, vomiting, and constipation. The medication also carries a warning for potential risk of thyroid tumors. As a result, it is not recommended for individuals with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia type 2 (MEN2). It is important to note that tumors were observed in animal studies but not in human clinical trials.[3]

Imcivree® vs. Wegovy®: At a Glance

Feature	Imcivree®	Wegovy®
Active ingredient	Setmelanotide	Semaglutide
Drug class	MC4 receptor agonist	GLP-1 receptor agonist
Primary use	Treats obesity caused by rare genetic conditions (POMC, PCSK1, LEPR deficiency, or Bardet-Biedl syndrome)	Chronic weight management in adults with obesity or overweight with related health conditions
How it works	Activates brain pathways that regulate hunger and energy balance	Mimics GLP-1 hormone to reduce appetite, slow stomach emptying, and regulate blood sugar
Administration	Injection	Once-weekly injection
Who it’s for	People with specific genetic obesity disorders confirmed through testing	Adults with obesity or overweight with at least one weight-related condition
Average weight loss in studies	Many patients lost ≥10% of body weight after one year	Average ~14.9% body weight reduction after 68 weeks (STEP-1 trial)
Common side effects	Injection site reactions, skin hyperpigmentation, nausea, diarrhea	Nausea, vomiting, diarrhea, constipation
Key limitation	Only used for rare genetic obesity conditions	Not recommended for those with certain thyroid cancer risks

Exploring Weight Management Options

Medications like Wegovy® and Imcivree® highlight how treatment approaches for obesity can vary depending on the underlying cause and an individual’s health history. Because eligibility, dosing, and potential risks differ between medications, it’s important to work with a licensed healthcare provider to determine which option may be appropriate for you.

Some individuals choose to explore telehealth weight management programs that connect patients with licensed providers who can evaluate eligibility for medications like GLP-1 therapies and develop personalized treatment plans.

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References

1. Setmelanotide. Mayo Clinic. https://www.mayoclinic.org/drugs-supplements/setmelanotide-subcutaneous-route/description/drg-20506354. Last Updated on 2/1/23. Accessed on 9/12/23.
2. FDA approves first treatment for weight management for people with certain rare genetic conditions. FDA. https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-first-treatment-weight-management-people-certain-rare-genetic-conditions. 11/27/2020. Accessed on 9/12/2023.
3. Anekwe C. A new treatment for obesity. Harvard Health Publishing. https://www.health.harvard.edu/blog/a-new-treatment-for-obesity-202109102589. 9/10/21. Accessed on 9/12/2023.