Semaglutide (Ozempic®), administered as a weekly subcutaneous injection up to 1.0 mg, holds a privileged place in the international guidelines for the management of type 2 diabetes. Commercialized under the trade name Wegovy®, semaglutide is also indicated at a weekly dose up to 2.4 mg for the management of obesity or over-weight with at least one weight-related comorbidity, after failure and in combination with life-style interventions. Its efficacy and tolerance were investigated in the STEP clinical research programme. Gastrointestinal adverse events after initiation of therapy, as with all glucagon-like peptide-1 receptor agonists, requires a progressive titration every 4 weeks from 0.25 mg to 2.4 mg/week. It is the first anti-obesity medication that has shown a significant reduction of major cardiovascular events and all-cause mortality in the large placebo-controlled SELECT trial. Wegovy® is commercialized in Belgium (currently not reimbursed) according to the indications supported by the European Medicines Agency (EMA) both in adults and adolescents suffering from obesity or overweight with at least one weight-related complication, ideally within a holistic multidisciplinary approach.