Can you take Wegovy with multiple sclerosis (MS)?

Jump to: What is multiple sclerosis? | The obesity-MS connection | Emerging research on semaglutide and MS | How does Wegovy work? | Drug interactions with MS medications | Practical considerations for MS patients | Exercise on Wegovy with MS | Frequently asked questions | Take home message

Yes, you can take Wegovy (semaglutide) if you have multiple sclerosis. There are no direct drug interactions between Wegovy and common MS disease-modifying therapies, and emerging research suggests semaglutide may offer benefits beyond weight loss for people with MS.¹

Over 150,000 people in the UK live with MS, and many also struggle with weight management.² Emerging evidence suggests that GLP-1 medications may be beneficial for people living with MS. A 2025 study of more than 7,000 MS patients found that those taking GLP-1 medications, including semaglutide, showed significantly less disease progression over five years than matched controls.¹

Additionally, preclinical research has shown that semaglutide specifically may have neuroprotective effects, reducing demyelination and promoting nerve repair in MS models.³

What we do know for certain is that obesity worsens MS outcomes. A Swedish study following over 3,000 MS patients for more than a decade found obesity was associated with a 43% higher risk of reaching significant disability milestones.⁴ This makes weight management particularly important for people living with MS.

What is multiple sclerosis?

Multiple sclerosis is a chronic autoimmune condition affecting the central nervous system. The immune system mistakenly attacks the protective myelin sheath surrounding nerve fibres in the brain and spinal cord, causing inflammation and damage.

This damage disrupts the normal flow of electrical signals between the brain and body, leading to a wide range of symptoms, including fatigue, mobility problems, vision issues, numbness, and cognitive changes.

Relapsing-remitting MS is the most common form, affecting about 85% of people initially diagnosed.⁵ Most people with MS are diagnosed between ages 20 and 50, and women are approximately 2.5 times more likely to develop the condition than men.²

Weight management matters for MS patients because excess weight can worsen symptoms, reduce mobility, and accelerate disease progression.

The obesity-MS connection: why weight loss matters

The relationship between obesity and MS is well-established. Research consistently shows that carrying excess weight worsens MS outcomes in several ways.

A 2024 Swedish study followed 3,249 MS patients for an average of 10.6 years and found that obesity was associated with:⁴

• 43% higher risk of reaching EDSS 3 (moderate disability)
• 40% higher risk of reaching EDSS 4 (significant walking impairment)
• More rapid cognitive decline
• Higher MRI activity showing new brain lesions

A German study of 1,066 MS patients found that obese patients reached disability milestones more quickly than those with normal weight.⁶ Specifically, obese MS patients reached EDSS 3 in an average of 0.99 years compared to 1.46 years for non-obese patients.

The mechanisms linking obesity and MS progression involve chronic inflammation. Fat tissue, particularly visceral fat around internal organs, releases inflammatory proteins that may worsen the neuroinflammation already present in MS.

Weight loss is now considered a modifiable risk factor for MS progression. Unlike genetic factors or environmental exposures that are difficult to change, weight is something that can be addressed with proper support.

Emerging research on semaglutide and MS

Perhaps the most exciting development for MS patients considering Wegovy is emerging evidence that semaglutide may have neuroprotective benefits beyond weight loss.

Semaglutide-specific research

A 2023 preclinical study tested semaglutide specifically in an experimental mice model of MS.³ The findings were significant:

• Semaglutide improved both cognitive and motor function in mice with MS-like disease
• Reduced demyelination (the nerve damage that characterises MS)
• Promoted remyelination (nerve repair)
• Reduced neuroinflammation by lowering inflammatory markers
• Protected against oxidative stress damage

This was the first study to examine semaglutide specifically in an MS model, and the results suggest that the medication may have direct neuroprotective effects beyond its weight-loss benefits.

Clinical evidence in MS patients

A 2025 conference abstract presented at the American Academy of Neurology analysed data from 7,046 MS patients taking GLP-1 agonists (including semaglutide) compared to matched controls over five years.¹ The findings showed:

• Those not taking GLP-1 medications showed significantly more MS disease progression
• Higher risk of brainstem dysfunction (4.36% risk difference)
• Higher risk of cerebellar dysfunction (4.54% risk difference)
• Higher risk of bowel and bladder dysfunction (4.98% risk difference)

As a retrospective analysis, this study has limitations including potential confounding factors, and definitive randomised controlled trials are needed to confirm any disease-modifying effects of GLP-1 medications in MS.

Real-world safety data is also reassuring. A Massachusetts General Hospital study of 49 MS patients taking GLP-1 medications found similar tolerability to the general population, with an average weight loss of 0.47 kg per month.⁷

A Beth Israel study of 60 MS patients showed a 3.7% mean reduction in BMI, increased vitamin D levels (which is beneficial for MS), and no negative change in disability scores.⁸

It’s important to note that this research is still emerging. A clinical trial at Northwestern University (NCT07207148) is currently investigating GLP-1 agonists specifically in MS patients, and results from randomised trials will be needed to establish whether these medications have genuine disease-modifying effects.⁹

Still, the early evidence suggests semaglutide may be particularly beneficial for people with MS.

How does Wegovy work?

Wegovy (semaglutide) is a GLP-1 receptor agonist that mimics a hormone naturally produced in the gut. This hormone communicates with the hypothalamus, the brain’s appetite control centre, to reduce hunger and food-seeking behaviour.

By lowering hunger and our desire to eat, Wegovy helps create a calorie deficit, which is when we consume fewer calories than our body needs. This prompts the body to use stored fat for energy, resulting in weight loss.

Wegovy also slows gastric emptying, meaning food stays in the stomach longer. This helps you feel full faster and stay satisfied for longer after eating.

The STEP 1 clinical trial showed Wegovy leads to an average weight loss of around 15% after 68 weeks, making it one of the most effective weight-loss medications available.¹⁰

In patients with MS, the anti-inflammatory and potentially neuroprotective effects of semaglutide may confer benefits beyond weight loss, as demonstrated in preclinical research.³

Drug interactions with MS medications

No direct pharmacokinetic interactions have been identified between semaglutide (Wegovy) and common MS disease-modifying therapies (DMTs).¹¹

Semaglutide is metabolised through proteolytic cleavage rather than hepatic cytochrome P450 pathways. This means it doesn’t compete with the liver enzymes that metabolise many other medications, reducing the likelihood of drug interactions.

Common MS medications that have been checked for interactions include:

Injectable DMTs: Interferons (Avonex, Rebif, Betaferon), glatiramer acetate (Copaxone)

Oral DMTs: Fingolimod (Gilenya), dimethyl fumarate (Tecfidera), teriflunomide (Aubagio), siponimod (Mayzent), cladribine (Mavenclad)

Infusion DMTs: Natalizumab (Tysabri), ocrelizumab (Ocrevus), alemtuzumab (Lemtrada)

While there are no direct interactions, some practical considerations apply:

• Immunosuppressive DMTs: Maintaining adequate nutrition and hydration is important when taking immunosuppressive medications. If Wegovy causes significant nausea or reduced appetite, work with your healthcare team to ensure you’re still getting adequate nutrition.
• Corticosteroid pulses: If you need high-dose steroids for an MS relapse, these may temporarily offset Wegovy’s glucose-lowering effects. Your blood sugar may be higher than usual during steroid treatment.
• Oral medications: Wegovy slows gastric emptying, which may affect absorption timing of oral medications including some oral DMTs. Taking oral medications at a consistent time relative to meals can help maintain predictable absorption.

Always inform your neurologist that you’re taking or planning to take Wegovy. While drug interactions aren’t a concern, coordinated care between your MS team and prescriber ensures the best outcomes.

Practical considerations for MS patients

Taking Wegovy with MS requires some additional planning compared to the general population. Here’s what to consider:

Coordinate with your MS team

Before starting Wegovy, consult your neurologist. While they may not be the prescribing clinician, they should be aware of all medications you’re taking. Your MS nurse can also be a valuable resource for monitoring how you’re responding.

Managing overlapping symptoms

Some Wegovy side effects can overlap with MS symptoms, which may make it harder to tell what’s causing what:

• Fatigue: Both MS and Wegovy can cause tiredness. If fatigue worsens significantly after starting Wegovy, it may be worth reducing the dose or adjusting the titration schedule.
• GI issues: Nausea and constipation are common on Wegovy. Some MS medications also affect the gut. Keep a symptom diary to help identify patterns.
• Dizziness: This can occur with both Wegovy (especially if eating too little) and MS. Stay well-hydrated and eat regular meals.

Nutrition considerations

Eating enough protein is crucial when taking Wegovy, and this is even more important for MS patients:

• Diet: Eat a diet based on whole foods that minimises ultra-processed foods
• Protein: Aim for 30-40g of protein at each meal to preserve muscle mass. Muscle strength is particularly important for mobility in MS.
• Vitamin D: Many MS patients supplement vitamin D. Studies show vitamin D levels may actually improve on GLP-1 medications.⁸ Continue your vitamin D supplementation as directed by your neurologist.
• Hydration: Staying well-hydrated helps with both Wegovy side effects and bladder health in MS. Aim for 2 litres of water daily unless advised otherwise.

Monitoring your progress

Keep track of both your weight loss and any changes in MS symptoms. While weight loss generally improves MS outcomes, rapid weight loss should be monitored. Aim for steady, sustainable weight loss of 0.5-1kg per week rather than dramatic drops.

Exercise on Wegovy with MS

Exercise is now strongly encouraged for people with MS, representing a significant shift from earlier guidance recommending rest.

Current guidelines suggest at least 150 minutes of moderate aerobic activity per week plus strength training twice weekly.¹²

When combining Wegovy with MS, exercise becomes even more important for preserving muscle mass during weight loss. However, some adaptations may be needed:

Heat sensitivity

About 80% of MS patients experience heat sensitivity, where symptoms temporarily worsen when body temperature rises.¹³ To manage this:

• Exercise in air-conditioned spaces or cooler times of day
• Use cooling vests or cold packs
• Keep cold water available during workouts
• Consider swimming or water-based exercise

Fatigue

MS fatigue is different from normal tiredness and affects about 80% of patients.¹³ Shorter, more frequent exercise sessions often work better than long workouts:

• Try 10-15 minute sessions multiple times per day
• Exercise during your peak energy times
• Rest as needed between exercises
• Don’t push through extreme fatigue

Adapted exercises

Depending on your mobility level, you may need to adapt exercises:

• Seated exercises if balance is affected
• Resistance bands instead of free weights
• Recumbent bikes instead of upright cycles
• Chair yoga or gentle stretching

A physiotherapy evaluation before starting a new exercise programme is highly recommended. A physio can assess your current abilities and design a programme that’s safe and effective for your specific situation.

Strength training

Strength training is particularly important when taking Wegovy because it helps preserve muscle mass during weight loss.

For patients with MS, maintaining muscle strength also supports mobility and independence. Aim for at least two strength-training sessions per week, targeting major muscle groups.

Comparison: MS patients vs general population on Wegovy

Frequently asked questions

Can Wegovy interact with my MS medications?

No direct drug interactions have been identified between semaglutide (Wegovy) and common MS disease-modifying therapies.

Wegovy is metabolised differently from most medications, reducing the risk of interactions. However, always inform your neurologist about all medications you’re taking.

Should I tell my neurologist I’m taking Wegovy?

Yes, definitely. While your neurologist may not be prescribing Wegovy, they should know about all medications and supplements you’re taking. This ensures coordinated care and helps them monitor for any changes in your MS. Your MS nurse can also be informed.

Will weight loss help my MS symptoms?

Research suggests yes. Studies show obesity is associated with faster MS progression, more disability, and increased brain lesion activity.

Losing weight reduces inflammation and may slow disease progression. The Swedish study found obese MS patients had a 43% higher risk of reaching significant disability compared to those with normal weight.⁴

Can Wegovy make my MS worse?

Current evidence suggests the opposite. Preclinical research shows semaglutide may actually protect nerve cells and reduce MS-related damage.³

The 2025 AAN conference abstract found that MS patients on GLP-1 medications had less disease progression than matched controls, though this preliminary finding needs confirmation in randomised trials.¹ There’s no evidence that Wegovy worsens MS.

What if I experience fatigue? Is it MS or Wegovy?

This can be tricky to distinguish. Wegovy-related fatigue typically occurs in the early weeks and improves as your body adjusts.

MS fatigue tends to be more persistent and may worsen with heat or activity. Keep a symptom diary noting when fatigue occurs and any patterns.

If fatigue significantly worsens after starting Wegovy and doesn’t improve after 4-6 weeks, discuss with your prescriber.

Can I exercise while on Wegovy with MS?

Absolutely, and you should. Exercise is strongly recommended for MS and helps preserve muscle during weight loss on Wegovy.

Adaptations may be needed for heat sensitivity, fatigue, and mobility limitations. A physiotherapy assessment can help design a safe, effective programme for your situation.

What about vitamin D levels?

Many MS patients already supplement vitamin D, which is important for immune function. Studies show GLP-1 medications may actually improve vitamin D levels.⁸ Continue your vitamin D supplementation as directed by your neurologist and have levels monitored regularly.

How much weight can I expect to lose?

The STEP 1 clinical trial showed Wegovy leads to average weight loss of around 15% after 68 weeks.¹⁰ Individual results vary based on starting weight, dose, diet, and activity level. Studies in MS patients specifically show safe weight loss with no negative impact on disability scores.^7,8

Should I come off Wegovy before steroid treatment for a relapse?

No, you don’t need to stop Wegovy for steroid pulses. However, be aware that high-dose corticosteroids temporarily raise blood sugar levels, which may offset some of Wegovy’s glucose-lowering effects.

Your blood sugar may be higher than usual during steroid treatment. This is temporary and will return to normal after the steroids finish.

Is there any research specifically on semaglutide and MS?

Yes. A 2023 preclinical study tested semaglutide specifically in an MS model and found it improved cognitive and motor function, reduced nerve damage, and promoted nerve repair.³

Clinical studies have also examined MS patients taking GLP-1 medications, including semaglutide, showing good tolerability and potential benefits.^1,7,8 A clinical trial specifically examining GLP-1 agonists in MS patients is currently underway, and results from randomised trials will help establish whether these medications have genuine disease-modifying effects.⁹

Take home message

You can safely take Wegovy if you have multiple sclerosis. There are no direct drug interactions with MS medications, and emerging research suggests semaglutide may offer neuroprotective benefits beyond weight loss.

Given that obesity worsens MS outcomes and accelerates disease progression, weight management is particularly important for people living with MS. The evidence linking obesity to faster disability progression is strong and consistent across multiple studies.

What makes semaglutide particularly interesting for MS patients is preclinical research indicating it may directly protect nerve cells and promote repair, alongside preliminary clinical evidence that MS patients on GLP-1 medications experience less disease progression. Randomised controlled trials are needed to confirm these disease-modifying effects.

For MS patients with obesity, Wegovy offers a way to address a modifiable risk factor that may genuinely improve long-term outcomes.

References

1. Ali K, Ali A, Manoj A, Morrison-Banks EH. (2025). Exploring the Effect of GLP-1 Agonists on Multiple Sclerosis Disease Progression (P11-1.007). Neurology. Conference abstract presented at AAN 2025 Annual Meeting.
2. MS Society UK. (2024). MS Facts and Figures.
3. Sadek MA, Kandil EA, El Sayed NS, Sayed HM, Rabie MA. (2023). Semaglutide, a novel glucagon-like peptide-1 agonist, amends experimental autoimmune encephalomyelitis-induced multiple sclerosis in mice: Involvement of the PI3K/Akt/GSK-3β pathway. International Immunopharmacology, 115, 109647.
4. Hedström AK, et al. (2024). Obesity and multiple sclerosis progression: A Swedish cohort study. Multiple Sclerosis Journal.
5. National Institute for Health and Care Excellence. (2022). Multiple sclerosis in adults: management (NG220).
6. Lutfullin I, et al. (2023). Body mass index and disability progression in multiple sclerosis. Journal of Neurology.
7. Udawatta M, Fidalgo N, Mateen FJ. (2025). Multiple sclerosis patients taking glucagon-like peptide-1 receptor (GLP-1) agonists: a single-institution retrospective cohort study of tolerability and weight loss. Neurological Sciences, 46(1):343-349.
8. Balshi A, et al. (2024). Glucagon-like peptide-1 agonist safety and efficacy in a multiple sclerosis cohort. Multiple Sclerosis and Related Disorders, 93, 106229.
9. ClinicalTrials.gov. (2024). GLP-1 Agonists in Ocrelizumab-Treated Multiple Sclerosis Patients (NCT07207148).
10. Wilding JPH, et al. (2021). Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine, 384(11), 989-1002.
11. Novo Nordisk. (2024). Wegovy Summary of Product Characteristics. Electronic Medicines Compendium.
12. Motl RW, et al. (2017). Exercise in patients with multiple sclerosis. Lancet Neurology.
13. National Multiple Sclerosis Society. (2024). MS Symptoms.