What Is Semaglutide?

Semaglutide is a GLP-1 receptor agonist—a type of medication that mimics a hormone your body naturally produces to regulate blood sugar and appetite. It's FDA-approved for two main uses:

• Type 2 diabetes management (marketed as Ozempic)
• Chronic weight management (marketed as Wegovy)

The same active ingredient is used in both formulations, but Wegovy is prescribed at a higher dose specifically for weight loss in adults with obesity or overweight with at least one weight-related health condition.

How Semaglutide Works

Semaglutide works by mimicking GLP-1 (glucagon-like peptide-1), a hormone that plays several important roles in metabolism and appetite regulation:

Blood Sugar Regulation

When you eat, GLP-1 signals your pancreas to release insulin, which helps move glucose from your bloodstream into your cells. Semaglutide enhances this natural process, improving blood sugar control in people with type 2 diabetes.

Appetite Suppression

GLP-1 acts on areas of the brain that regulate hunger and satiety. Semaglutide slows gastric emptying (how quickly food leaves your stomach) and reduces appetite, which leads many people to feel full longer and eat less overall.

Long-Lasting Effect

Natural GLP-1 breaks down quickly in the body. Semaglutide is designed to last much longer, allowing for once-weekly injections rather than multiple daily doses.

Clinical Trial Results: What the Research Shows

The most comprehensive data on semaglutide for weight loss comes from the STEP (Semaglutide Treatment Effect in People with obesity) clinical trial program.

STEP 1 Trial (68 Weeks)

This randomized, double-blind study included 1,961 adults with obesity or overweight with at least one weight-related condition. Participants received either semaglutide 2.4 mg weekly or a placebo, along with lifestyle interventions (diet and exercise counseling).

Key findings:

• Semaglutide group lost an average of 14.9% of their body weight
• Placebo group lost an average of 2.4% of their body weight
• 86.4% of semaglutide participants lost at least 5% of their body weight
• 69.1% lost at least 10%
• 50.5% lost at least 15%

Source: Wilding et al., "Once-Weekly Semaglutide in Adults with Overweight or Obesity," New England Journal of Medicine, 2021.

Common Side Effects

Like all medications, semaglutide comes with potential side effects. Most are gastrointestinal and tend to improve over time as your body adjusts.

Gastrointestinal Effects (Most Common)

• Nausea: Reported by 20–40% of users, typically worse in the first few weeks
• Diarrhea or constipation: Affects roughly 15–25% of users
• Vomiting: Less common (5–10%), usually related to dosing increases
• Abdominal discomfort: Mild cramping or bloating, often temporary

Most people find that these symptoms improve after 4–6 weeks. Your healthcare provider may adjust your dose to minimize side effects.

Less Common but Serious

• Pancreatitis: Rare but serious. Seek medical attention if you experience severe, persistent abdominal pain.
• Gallbladder issues: Rapid weight loss can increase gallstone risk. Report symptoms like severe upper abdominal pain or yellowing of the skin.
• Thyroid tumors: Seen in animal studies; unclear if risk applies to humans. Avoid if you have a personal or family history of medullary thyroid cancer or Multiple Endocrine Neoplasia syndrome type 2.

Who Can Use Semaglutide?

Semaglutide (Wegovy) is FDA-approved for chronic weight management in:

• Adults with a BMI of 30 or greater (obesity)
• Adults with a BMI of 27 or greater (overweight) plus at least one weight-related condition like high blood pressure, type 2 diabetes, or high cholesterol

Who Should Not Use Semaglutide

Semaglutide may not be appropriate if you have:

• Personal or family history of medullary thyroid carcinoma
• Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
• History of severe allergic reactions to semaglutide
• Pregnancy or plans to become pregnant (semaglutide should be stopped at least 2 months before conception)

Your healthcare provider will evaluate your full medical history to determine if semaglutide is safe for you.

How to Access Semaglutide

Semaglutide requires a prescription from a licensed healthcare provider. There are several ways to obtain it:

Traditional Healthcare

Your primary care doctor or an endocrinologist can prescribe semaglutide if you meet the criteria. You'll need an in-person evaluation and ongoing monitoring.

Telehealth Platforms

Several telehealth companies offer GLP-1 prescriptions through virtual consultations. These platforms typically include:

• Online health questionnaires
• Virtual provider consultations
• Prescription fulfillment (brand-name or compounded semaglutide)
• Ongoing support and monitoring

See our provider reviews for detailed comparisons of telehealth platforms.

Insurance Coverage

Many insurance plans cover semaglutide (Ozempic) for type 2 diabetes but not for weight loss alone. Some plans cover Wegovy if you meet specific criteria. Check with your insurance provider to understand your coverage. If insurance doesn't cover it, out-of-pocket costs for brand-name Wegovy can range from $1,000–$1,500 per month. Compounded semaglutide may be more affordable ($200–$500/month), though it's not FDA-approved.

What to Expect: Timeline & Results

Weeks 1–4: Titration Phase

Most people start with a low dose (0.25 mg weekly) and gradually increase to minimize side effects. You may notice reduced appetite, but weight loss is typically modest in the first month (1–2% of body weight).

Months 2–6: Active Weight Loss

This is when most people see the most significant weight loss. You'll likely reach the maintenance dose (2.4 mg for Wegovy) during this period. Average weight loss during this phase is 1–2 pounds per week, though it varies.

Months 6–12: Plateau & Maintenance

Weight loss often slows or plateaus after 6–12 months. Some people continue losing weight, while others maintain their new weight. Clinical trials show that most weight loss occurs within the first 60–68 weeks.

After Stopping

Research shows that many people regain weight after discontinuing semaglutide. Long-term weight maintenance may require continuing the medication, making sustainable lifestyle changes, or both. Discuss a long-term plan with your healthcare provider.

Frequently Asked Questions