Semaglutide
Metabolic Health · GLP-1 agonist
Also known as: Ozempic ·Wegovy ·Rybelsus
Tier B
Bottom line
Read Off Label grades Semaglutide as B (6.8/10) based on strong evidence, high benefit magnitude, and a med-risk safety profile.
STEP 1: ~15% body weight loss over 68 weeks.
Typical use: Wegovy (obesity): titrate to 2. — Rx.
What this is
STEP 1: ~15% body weight loss over 68 weeks. SELECT 2023: 20% reduction in MACE in obese patients with CVD but no diabetes. FDA approved Wegovy HD 7.2 mg on March 19, 2026 after data showed additional average weight reduction vs lower approved doses with a broadly consistent GLP-1 safety profile; altered skin sensation (sensitivity, pain, burning) was more common at the higher dose and is under further FDA investigation. GI side effects common; rare pancreatitis/gallbladder. Weight regain on cessation. Delayed gastric emptying raises peri-operative aspiration risk — anesthesia guidance now recommends holding GLP-1 agonists before elective surgery. Oral Wegovy (semaglutide tablets) is FDA-approved for chronic weight management; Phase 3 OASIS-4 (n=307, 64 wk): ~13.6% weight loss vs 2.4% placebo (treatment-policy estimand).
Mechanism
GLP-1 receptor agonist: slows gastric emptying; suppresses glucagon; enhances glucose-dependent insulin secretion; central appetite suppression via hypothalamic GLP-1R
Dose & route
Wegovy (obesity): titrate to 2.4 mg SC weekly; Wegovy HD: 7.2 mg SC weekly in selected adults; Ozempic (T2DM): 0.25-2 mg SC weekly
Citations
- https://www.nejm.org/doi/full/10.1056/NEJMoa2032183
- https://www.nejm.org/doi/full/10.1056/NEJMoa2307563
- https://www.nejm.org/doi/full/10.1056/NEJMoa1607141
- https://clinicaltrials.gov/study/NCT07462663
- https://doi.org/10.5281/zenodo.20112888
- https://www.fda.gov/news-events/press-announcements/fda-approves-fourth-product-under-national-priority-voucher-program-higher-dose-semaglutide
- https://doi.org/10.1001/jama.2026.1030
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Common questions
- Does Semaglutide work?
- Read Off Label rates the evidence for Semaglutide as Strong and the benefit magnitude as high, producing an overall grade of B (6.8/10). STEP 1: ~15% body weight loss over 68 weeks.
- Is Semaglutide safe?
- Semaglutide has a med risk profile in published human data. Legal status: Rx. This is not medical advice — see the disclaimer.
- What is the typical dose for Semaglutide?
- Wegovy (obesity): titrate to 2.4 mg SC weekly; Wegovy HD: 7.2 mg SC weekly in selected adults; Ozempic (T2DM): 0.25-2 mg SC weekly
- How does Semaglutide work?
- GLP-1 receptor agonist: slows gastric emptying; suppresses glucagon; enhances glucose-dependent insulin secretion; central appetite suppression via hypothalamic GLP-1R
This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.