Semaglutide is the GLP-1 molecule behind Ozempic and Wegovy. It mimics a gut hormone your body already makes, which reduces appetite and slows how quickly the stomach empties. That is the whole mechanism, and understanding it explains most of what follows.
It does not burn fat and it does not raise your metabolism. It acts on appetite signalling and on gastric emptying, so you feel full sooner and stay full longer. Weight falls because intake falls.
That distinction matters practically. If you eat the same volume out of habit rather than hunger, the medication has less to work with, and you are more likely to get the digestive side effects. The eating advice is not an add-on.
The starting dose is not a treatment dose. It exists so your body adjusts to the medication before the dose that does the work.
Step up on schedule
Increases happen at set intervals, typically every four weeks, and only when the current dose is tolerated.
Hold when needed
If a step is not tolerated, holding or stepping back is standard. Almost everyone who has a miserable time went up too fast.
Maintenance
A dose that is effective and tolerable, held long term. Reaching it is the goal, not the highest number on the pen.
Who it suits
Who is a candidate for semaglutide
The thresholds are a BMI of 30 or above, or 27 and above with a documented weight-related condition. Meeting them makes you a candidate for assessment, not automatically for a prescription.
Personal or family history of medullary thyroid carcinoma or MEN2 rules it out, as does pregnancy. A history of pancreatitis or gallbladder disease needs a closer look before starting rather than after. Related reading: Who should not take it, BMI requirements and Serious side effects.
BMI 30, or 27 with conditionThreshold
MTC or MEN2 historyRules it out
PregnancyNot used in
Related
Related weight loss medication pages
The brands semaglutide is sold under, and the molecule it competes with.
How it works, how much weight it moves, and how long people stay on it.
Trial averages for weight-management dosing sit around the mid-teens as a percentage of body weight over roughly a year. An average conceals a wide spread, and your result depends on dose tolerated, adherence and what else changes.
Appetite usually changes within the first weeks, often before the scale does. Meaningful weight change generally takes a couple of months, because the early doses are about tolerance rather than effect.
Semaglutide is the molecule; Ozempic is one brand containing it, approved for type 2 diabetes. Wegovy is another brand containing the same molecule, approved for weight management at different doses.
Not necessarily. There is a daily oral tablet form. It has stricter instructions about timing and food than the weekly injection, which suits some people and not others.
Appetite returns and weight tends to follow. That is well documented and it is why stopping is planned rather than abrupt. The guide on stopping covers what is known.
Suitability turns on your conditions, your family history and what else you take. That is what the assessment establishes before anything is prescribed.
