GLP-1 & Metabolic Peptides
Semaglutide
Commonly used for
Weight LossDiabetesMetabolic Health
What is it?
Semaglutide is a long-acting glucagon-like peptide-1 (GLP-1) receptor agonist that improves glycemic control, reduces appetite, slows gastric emptying, and promotes significant weight loss.
Brand names: Ozempic®, Wegovy®, Rybelsus® (oral)
Mechanism of action: GLP-1 receptor agonist; Increases glucose-dependent insulin secretion; Suppresses glucagon secretion; Delays gastric emptying; Acts on hypothalamic appetite centers to reduce hunger
What do people use it for?
Approved indications: Type 2 diabetes mellitus; Chronic weight management (obesity or overweight with comorbidity); Reduction of major adverse cardiovascular events in eligible patients with obesity and cardiovascular disease (Wegovy); Noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH) with moderate-to-advanced (F2–F3) fibrosis (Wegovy, accelerated approval, 2025); Reduction of the risk of kidney function decline, kidney failure, and cardiovascular death in adults with type 2 diabetes and chronic kidney disease (Ozempic, based on the FLOW trial)
Proposed indications: Metabolic syndrome; Polycystic ovary syndrome; Binge eating disorder; Alcohol use disorder; Addiction reduction (nicotine/cocaine); Alzheimer's disease
How is it used? / Dosing
Administration: Subcutaneous injection — Weekly
How does it compare?
Compare with:
How well does it work? / Evidence
✓ Well-established
Evidence rating: ⭐⭐⭐⭐⭐ (Approved) — Large cardiovascular outcome trials involving tens of thousands of patients.
Landmark trials: STEP 1 Trial (2021) — Mean weight loss ≈15%; SELECT Trial (2023) — 20% reduction in major cardiovascular events; SUSTAIN Program — Significant HbA1c reduction; FLOW Trial (2024) — Reduced risk of kidney disease progression, kidney failure, and cardiovascular death in type 2 diabetes with chronic kidney disease
Safety & side effects
Common side effects: Nausea, Vomiting, Constipation, Diarrhea, Abdominal pain, Reduced appetite
Serious risks: Pancreatitis; Gallbladder disease; Acute kidney injury (usually secondary to dehydration); Diabetic retinopathy worsening (rapid glucose improvement); Possible thyroid C-cell tumors in rodents (human significance uncertain)
Drug interactions: May delay absorption of oral medications; Increased hypoglycemia risk when combined with insulin or sulfonylureas
Monitoring: Weight, HbA1c, Renal function, Gastrointestinal tolerance, Blood pressure
Legal & regulatory status
Legal status: Prescription required. This is an FDA-approved medication available only through a licensed prescriber — dosing and titration are determined by your prescriber based on your medical history and are not provided here.
Regulatory status: FDA Approved • EMA Approved
Who should avoid it?
Contraindications: Personal/family history of medullary thyroid carcinoma; MEN2 syndrome; Serious hypersensitivity
Pregnancy & breastfeeding: Not recommended during pregnancy. Discontinue before planned conception per prescribing information. Insufficient data for breastfeeding.
Research & references
Wilding JPH, et al. (2021). Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine, 384, 989-1002. https://doi.org/10.1056/NEJMoa2032183 Lincoff AM, et al. (2023). Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. New England Journal of Medicine. https://doi.org/10.1056/NEJMoa2307563 Rubino D, et al. (2021). STEP Program.