During pregnancy, health decisions carry extra weight — not just for the parent, but also for the developing baby. The American College of Obstetricians and Gynecologists (ACOG) advises against intentional weight loss while expecting, since rapid or restrictive approaches can affect both maternal health and fetal growth. At the same time, obesity during pregnancy does raise the risk of complications such as gestational diabetes and preeclampsia, making weight management a nuanced and often challenging conversation.
One of the most talked-about weight-loss medications today is Wegovy (semaglutide), a GLP-1 receptor agonist approved by the FDA for long-term weight management in adults with obesity or overweight conditions. But while it has helped many achieve significant results outside of pregnancy, its use during pregnancy is a different story.
In this article, we’ll break down what’s known — and what’s not yet clear — about Wegovy and pregnancy. We’ll review its safety profile, summarize expert guidance, and discuss what patients should consider if they’re planning a pregnancy or already expecting while on treatment.
Key Takeaways
- Wegovy (semaglutide) is not recommended during pregnancy. FDA labeling advises discontinuing immediately if pregnancy occurs and stopping at least 2 months before planned conception due to its long half-life.
- Animal studies have shown reduced fetal weight, structural abnormalities, and pregnancy loss, often confounded by maternal weight loss and decreased food intake.
- Human data are limited to case reports and small observational studies with mixed outcomes. No consistent risk pattern or causal link has been established, though many reported exposures have resulted in healthy births.
- A sponsor-run pregnancy registry is collecting real-world data on maternal health, birth outcomes, and pregnancy complications to clarify safety over time.
- Non-drug alternatives — including nutrition counseling, physical activity, behavioral support, and close prenatal monitoring — remain the safest and most effective strategies for managing weight during pregnancy.
- A precautionary approach is currently recommended to protect both maternal and fetal health, with weight-loss medications resumed only after pregnancy if clinically appropriate.
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FDA and Registry Data on Wegovy Use in Pregnancy
The FDA advises against Wegovy (semaglutide) use during pregnancy due to limited human safety data and concerning findings from animal research. Current labeling recommends discontinuing Wegovy immediately if pregnancy occurs, and stopping the medication at least 2 months before a planned pregnancy because of its long half-life.
To better understand real-world outcomes, a dedicated pregnancy exposure registry is underway. This registry tracks maternal and fetal outcomes in patients exposed to Wegovy, with a focus on:
- Pregnancy complications such as gestational diabetes or hypertension
- Birth outcomes, including preterm delivery, birth weight, and congenital anomalies
- Maternal weight changes during and after pregnancy
While results are still limited, the registry represents a vital effort to capture data that clinical trials cannot ethically provide in pregnant patients. Until more evidence emerges, the FDA maintains a conservative, precautionary approach.
Animal Studies and Potential Risks with Wegovy During Pregnancy
Animal studies have been central to shaping current pregnancy warnings for Wegovy. At high doses, semaglutide exposure in animals has been linked to:
- Reduced fetal weight, suggesting impaired growth
- Structural abnormalities, including skeletal and organ malformations
- Increased pregnancy loss, particularly at higher exposure levels
However, researchers note that these fetal outcomes often occurred alongside maternal weight loss and decreased food intake, making it difficult to separate direct drug effects from secondary maternal factors. Despite these uncertainties, regulators advise against semaglutide use in pregnancy until clearer human data are available.
Known Outcomes from Semaglutide Exposure in Pregnancy
So far, human evidence remains sparse. Available reports include small observational studies, case reports, and early data from post-marketing surveillance. Outcomes are mixed, with some cases describing healthy births and others reporting complications. Importantly, no causal link or consistent risk pattern has been established.
Patients may see impressive Wegovy before and after photos that highlight weight loss transformations, but these stories rarely mention pregnancy-related risks. Given the current knowledge gap, professional societies and clinicians take a cautious stance. The FDA’s sponsor-run pregnancy registry continues to collect long-term data on maternal health, birth outcomes, and complications to improve future guidance.
Alternative Weight Management Options During Pregnancy vs Wegovy
Because most experts do not recommend Wegovy during pregnancy, healthcare providers guide patients toward non-pharmacological strategies that prioritize both maternal health and safety during the development of the fetus.
Recommended Alternatives
- Nutritional Counseling: Individualized meal planning to achieve appropriate weight gain targets while ensuring adequate micronutrient intake.
- Physical Activity Programs: Low-impact activities such as walking, swimming, or prenatal yoga to maintain cardiovascular health and support gradual, safe weight management.
- Behavioral Therapy: Counseling, coaching, or support groups to reinforce healthy habits and reduce stress.
- Medical Supervision: Regular prenatal care to monitor weight trends, screen for gestational diabetes or hypertension, and manage coexisting health conditions.
By focusing on lifestyle, nutrition, and careful monitoring, providers can help patients navigate pregnancy safely without exposing them to drug-related risks.
Conclusion
Based on current evidence, Wegovy is not recommended during pregnancy. Findings of fetal harm in animal studies and the lack of robust human safety data make discontinuation the safest course once pregnancy is recognized. Regulatory guidance also advises stopping Wegovy at least 2 months before conception planning.
Until registry data offers more clarity, the standard of care remains lifestyle-based weight management through nutrition, activity, and prenatal medical oversight. A precautionary approach protects both maternal and fetal health while keeping future treatment options open after pregnancy.
FAQs
1. Is Wegovy safe to use during pregnancy?
No. Experts do not recommend Wegovy during pregnancy due to insufficient human safety data and concerning animal findings. If pregnancy occurs, discontinue and consult your clinician.
2. What should I do if I become pregnant while on Wegovy?
Discontinue Wegovy immediately and speak with your healthcare provider for safer alternatives.
3. Are there any confirmed risks from semaglutide exposure in pregnancy?
No confirmed risk pattern has been identified. Human evidence is limited and inconclusive, and many reported exposures have resulted in healthy births.
4. What safer alternatives exist for weight management in pregnancy?
Nutritional counseling, low-impact physical activity, behavioral support, and close prenatal monitoring are the preferred strategies.
5. Why isn’t there enough data on using Wegovy during pregnancy?
Because randomized trials in pregnant populations are not ethically possible, evidence comes mainly from case reports and observational studies.
6. Does the pregnancy registry for Wegovy users help gather information?
Yes. The FDA-required, sponsor-run registry collects real-world data on pregnancy and birth outcomes to better understand reproductive safety.
7. Should I discuss reproductive safety considerations with my doctor?
Absolutely. Open discussion with a healthcare provider ensures personalized advice on medication safety, pregnancy planning, and long-term health.
References
Obesity in Pregnancy. www.acog.org. Published June 2021. https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2021/06/obesity-in-pregnancy
Managing your weight gain during pregnancy: MedlinePlus Medical Encyclopedia. medlineplus.gov. Published November 21, 2022. https://medlineplus.gov/ency/patientinstructions/000603.htm
Watson AR. Wegovy and pregnancy, breastfeeding, and birth control. Medicalnewstoday.com. Published September 26, 2023. Accessed August 29, 2025. https://www.medicalnewstoday.com/articles/drugs-wegovy-reproductive-health
