Metabolic · GLP-1 receptor agonist
Semaglutide
- Drug class
- GLP-1 receptor agonist
- Status
- FDA-approved
- Also known as
- Ozempic, Wegovy, Rybelsus
- Reviewed
- 2026-06-01 · Dr. Ana Lisa Carr, MD
What Semaglutide is studied for
- Chronic weight management (adults with obesity / overweight + a comorbidity)
- Type 2 diabetes glycemic control
- Cardiovascular risk reduction in adults with established CVD
- Appetite regulation and food-noise reduction
Mechanism of action
GLP-1 receptor agonist. Activates GLP-1 receptors in the pancreas, brain, and gut — slowing gastric emptying, suppressing glucagon, increasing glucose-dependent insulin secretion, and signaling satiety in the hypothalamus.
Frequently asked questions
Is semaglutide the same as Ozempic and Wegovy?
Yes — semaglutide is the active molecule. Ozempic is the brand for type 2 diabetes; Wegovy is the brand for chronic weight management; Rybelsus is the oral form. Compounded semaglutide is the same molecule prepared by a 503A pharmacy.
How is semaglutide typically dosed?
Once-weekly subcutaneous injection, titrated from 0.25 mg upward over several months to a maintenance dose (commonly 1.7–2.4 mg/wk for weight management). Titration reduces nausea and other GI side effects.
What are the most common side effects?
Nausea, constipation, diarrhea, reflux, fatigue, and injection-site reactions. Most resolve within weeks. Rare but serious risks include pancreatitis, gallbladder disease, and (in animals) thyroid C-cell tumors.
Who should not use semaglutide?
Personal or family history of medullary thyroid carcinoma or MEN-2, prior pancreatitis, active gallbladder disease, pregnancy, or severe gastroparesis. A clinician should review every case before prescribing.
How fast does weight loss happen?
In STEP-1, average loss was ~6% at 12 weeks and 14.9% at 68 weeks. Most people see clinically meaningful loss within 8–12 weeks of reaching their maintenance dose.