Semaglutide (Wegovy/Ozempic) for Weight Loss & Metabolic Health — Weight & Metabolism
FDA-approved GLP-1 receptor agonist for significant weight reduction, metabolic health, and cardiovascular risk reduction.
Overview
Semaglutide is a GLP-1 receptor agonist approved by the FDA for chronic weight management (Wegovy 2.4mg) and type 2 diabetes (Ozempic up to 2mg). The STEP clinical trial program demonstrated average weight loss of 14.9% (up to 17.4% in some trials) with improvements in cardiovascular risk factors and metabolic parameters. The SELECT trial (n=17,604) demonstrated 20% reduction in major adverse cardiovascular events in patients with obesity and established CVD.
Indications
- Obesity (BMI ≥30) or overweight (BMI ≥27) with weight-related conditions
- Type 2 diabetes management and glycemic control
- Cardiovascular risk reduction in patients with heart disease
- Metabolic syndrome optimization
Mechanism of Action
Excess weight impairs insulin signaling, increases appetite dysregulation, and promotes metabolic dysfunction
Dosing
| Compound | Dose | Frequency | Notes |
|---|---|---|---|
| Semaglutide | 0.25 mg | Once weekly | Initiation dose for GI tolerance, minimal weight loss |
| Semaglutide | 0.5 mg | Once weekly | First increase, weight loss begins, improved satiety |
| Semaglutide | 1 mg | Once weekly | Therapeutic dose for diabetes (Ozempic), moderate weight loss |
| Semaglutide | 1.7 mg | Once weekly | Enhanced weight loss (10-12% body weight) |
| Semaglutide | 2.4 mg | Once weekly | FDA-approved Wegovy dose for obesity (14.9% average weight loss) |
| Semaglutide Oral | 7-14 mg | Once daily (30 min before first meal) | Oral formulation for diabetes, lower bioavailability than injection |
Evidence Grade
GRADE A
Safety & Contraindications
- FDA-approved medication with extensive safety data from STEP and SELECT trials
- Common side effects: nausea, vomiting, diarrhea, constipation (usually transient during titration)
- Contraindicated in personal/family history of medullary thyroid carcinoma or MEN2
- May increase risk of gallbladder disease - monitor for symptoms
- Use with caution in patients with diabetic retinopathy
- Requires healthcare provider supervision and prescription