Semaglutide
Also known as Wegovy, Ozempic
What it is
Semaglutide is a glucagon-like peptide-1 receptor agonist. It acts on receptors involved in appetite regulation and gastric emptying. It is available as an FDA-approved branded product for chronic weight management in eligible patients.
How it is used
Administered as a once-weekly subcutaneous injection, started at a low dose and titrated upward over several weeks to reduce gastrointestinal side effects. Titration schedule is set by the prescribing provider and adjusted to tolerance.
What a provider evaluates first
- BMI and weight history, plus any weight-related comorbidities
- Personal or family history of medullary thyroid carcinoma or MEN2 — a contraindication
- History of pancreatitis, gallbladder disease or severe gastrointestinal disorders
- Current medications, particularly insulin or sulfonylureas
- Baseline metabolic panel, HbA1c and thyroid function
Considerations and monitoring
- Gastrointestinal effects are the most commonly reported, particularly during titration
- Carries a boxed warning regarding thyroid C-cell tumours based on rodent studies
- Requires ongoing clinical review rather than an open-ended prescription
- Discontinuation is commonly followed by weight regain; this should be part of the plan from the outset
Questions about semaglutide
How does semaglutide work?
Semaglutide is a GLP-1 receptor agonist. It acts on receptors involved in appetite regulation and slows gastric emptying, which affects how full you feel and for how long. It is given as a once-weekly injection, started low and titrated upward over several weeks to manage tolerability. Whether it is appropriate depends on eligibility criteria and your medical history.
What side effects does semaglutide have?
Gastrointestinal effects are the most commonly reported — nausea, constipation, diarrhoea and reflux — and are most pronounced during dose escalation. This is why titration is gradual. The class carries a boxed warning regarding thyroid C-cell tumours based on rodent studies. Pancreatitis and gallbladder disease are less common but require prompt attention. Report anything unexpected to your provider rather than waiting for a scheduled review.
What happens if I stop GLP-1 therapy?
Appetite regulation generally returns toward its previous state once the medication is cleared, and weight regain is commonly observed. This is a recognised feature of the therapy rather than a failure, and it is why providers discuss the longer-term plan at the outset rather than treating it as a short course. Any decision to stop should be made with your provider.
Part of Weight Management.