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Semaglutide: GLP-1 receptor agonist

A GLP-1 receptor agonist and the most-studied modern weight-loss and diabetes drug — FDA-approved by prescription, though the 'research peptide' versions sold online are not the approved product.

What is Semaglutide?

Semaglutide is a GLP-1 receptor agonist. In branded, FDA-approved forms it is prescribed for type 2 diabetes (Ozempic) and chronic weight management (Wegovy), and it has the strongest clinical evidence in its drug class. Note that the semaglutide sold by peptide vendors as a 'research' compound is not the FDA-approved product and is not quality-assured; approved semaglutide is a prescription medicine used under medical supervision.

Published-literature summary: GLP-1 receptor agonist with the most robust clinical evidence in the class. STEP 1 trial (NEJM, 2021) demonstrated ~15% mean body weight reduction over 68 weeks. SUSTAIN-6 showed significant cardiovascular risk reduction in T2D patients. Widely studied for obesity, T2D management, and metabolic syndrome. (Wilding et al. (2021) STEP 1 — N Engl J Med; Marso et al. (2016) SUSTAIN-6 — N Engl J Med)

How Semaglutide works (mechanism)

Semaglutide mimics the gut hormone GLP-1. It enhances glucose-dependent insulin secretion, slows gastric emptying, and acts on appetite centres in the brain to reduce food intake — which together drive weight loss and improved blood-sugar control. In the STEP 1 obesity trial, once-weekly semaglutide produced a mean weight reduction of about 14.9% over 68 weeks versus 2.4% for placebo [1].

Why it's studied / reported uses

Chronic weight management

The STEP programme established substantial, sustained weight loss with once-weekly semaglutide plus lifestyle support in adults with overweight/obesity [1][2]. This is an FDA-approved indication (Wegovy).

Type 2 diabetes & cardiovascular risk

As Ozempic, semaglutide is approved for glycemic control in type 2 diabetes, and trials in that population have shown cardiovascular-risk reduction. These are prescription uses under medical supervision.

Dosing reported in studies

⚠ Not a recommended dose. The figures below are what studies or protocols reported, for educational reference only.
Clinical / trial data
STEP obesity trial titration
Start 0.25 mg/week → 0.5 → 1.0 → 1.7 → 2.4 mg/week
Frequency: once weekly, escalated every 4 weeks
Route: subcutaneous
Slow titration is used specifically to reduce nausea/GI effects.
Reported maintenance
2.4 mg per week
Frequency: once weekly
Route: subcutaneous
Maintenance dose in the STEP-1 obesity trial.

Sources: Wilding et al. (2021) STEP 1 — N Engl J Med · Marso et al. (2016) SUSTAIN-6 — N Engl J Med

A GLP-1 agonist. FDA-approved forms exist under prescription; the peptide itself is prescription-only. These figures reflect what studies or protocols reported — not a recommendation and not tailored to you.

Calculate a dose in the reconstitution calculator →

Common combinations & stacks

Combinations

In investigational work semaglutide has been combined with the amylin analog cagrilintide (the 'CagriSema' combination). This is trial-stage; semaglutide itself should only be used as prescribed.

Safety & side effects

Gastrointestinal effects — nausea, vomiting, diarrhoea, constipation — are the most common and are dose-related, which is why approved dosing titrates up slowly. Approved labels carry a boxed warning regarding thyroid C-cell tumours seen in rodents (contraindicated with a personal/family history of medullary thyroid carcinoma or MEN 2), and note risks including pancreatitis and gallbladder disease. Semaglutide is prescription-only for good reason and should be used under a clinician's care.

Studies & references

  1. Once-weekly semaglutide in adults with overweight or obesity (STEP 1) — PubMed 33567185 (Wilding et al., NEJM 2021)
  2. STEP 1 trial registration — semaglutide for overweight/obesity — ClinicalTrials.gov NCT03548987

Frequently asked questions

Is semaglutide FDA-approved?

Yes — in branded prescription forms (Wegovy for weight management, Ozempic/Rybelsus for type 2 diabetes). The unbranded 'research' semaglutide sold by peptide vendors is not the approved product.

How is semaglutide dosed?

Approved use titrates slowly — for weight management, roughly 0.25 → 0.5 → 1.0 → 1.7 → 2.4 mg once weekly, stepping up about every 4 weeks (see the dosing section). Titration limits nausea. This is not a recommendation; dosing should be set by a prescriber.

What are the side effects?

Mostly gastrointestinal (nausea, vomiting, diarrhoea), usually dose-related and easing over time. Serious risks and contraindications are on the approved label — discuss with a doctor.

How much weight loss does semaglutide cause?

In the STEP 1 trial, mean weight loss was about 14.9% at 68 weeks versus 2.4% on placebo. Individual results vary.

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