Semaglutide for Weight Loss
A once-weekly GLP-1 injection that reduces appetite and stabilizes blood sugar, prescribed and monitored by a physician — with on-site labs, a structured dose schedule, and honest expectations about what it can and cannot do.
Book Your Free ConsultationMedically reviewed by Dr. Jamie Lynn Jaqua, MD
How Semaglutide Works
GLP-1 (glucagon-like peptide-1) is a hormone released by cells in your small intestine when food arrives. It has a short natural half-life — a matter of minutes — because enzymes break it down almost immediately. Semaglutide is a modified version of that hormone, engineered to resist those enzymes and bind to albumin in the blood, which is why a single injection lasts about a week rather than a few minutes.
That sustained signal does four things that make weight loss meaningfully easier than willpower alone:
- Signals fullness — acts on receptors in the hypothalamus and brainstem that regulate satiety, so you feel satisfied on less food
- Slows gastric emptying — food stays in the stomach longer, which extends fullness between meals and is also the source of most nausea
- Stabilizes blood sugar — enhances insulin release only when glucose is elevated and suppresses glucagon, flattening the spike-and-crash pattern that drives cravings
- Reduces food noise — patients consistently describe the intrusive, constant mental chatter about food quieting down, which is often the change they value most
Two things follow from this mechanism. First, semaglutide reduces how much you want to eat — it does not change what happens to the food you do eat. Second, because the effect is a hormonal signal rather than a permanent change to your physiology, the appetite suppression fades when the drug is stopped.
Compounded Semaglutide Is Not a Generic of Ozempic or Wegovy
Vitality prescribes compounded semaglutide— a preparation made for an individual named patient by a licensed 503A compounding pharmacy, on a physician's prescription. This is a different regulatory category from Ozempic and Wegovy, which are FDA-approved products manufactured by Novo Nordisk and reviewed by the FDA for safety and efficacy.
Compounded semaglutide has not been through that review and is not FDA-approved. It is not a generic — a generic is an approved copy of an approved drug, and no generic semaglutide exists. Compounded preparations are permitted under a different part of federal law, which allows a licensed pharmacy to prepare a medication for a specific patient where a physician judges it clinically appropriate. The FDA does not review, approve, or verify individual compounded preparations.
We say this plainly because a lot of marketing does not. If a clinic describes compounded semaglutide as “generic Ozempic” or “FDA-approved,” that is inaccurate. What you can reasonably ask any prescriber is which pharmacy prepares it, whether that pharmacy is state-licensed and in good standing, and whether the preparation is tested for potency and sterility. Dr. Jaqua will answer all three for the pharmacy partners Vitality uses.
Compounded semaglutide is prescribed at the physician's clinical discretion. It is a supervised medical treatment requiring evaluation, patient-specific labs, and ongoing monitoring — not a product you should obtain without a physician relationship.
Who Semaglutide Is For — and Who It Is Not For
The candidacy criteria used for branded GLP-1 weight management treatment are a BMI of 30 or above, or a BMI of 27 or above alongside a weight-related condition such as type 2 diabetes, hypertension, dyslipidemia, or obstructive sleep apnea. Dr. Jaqua applies the same clinical standard, and reviews your full history and labs rather than treating BMI as the only input.
Likely a good candidate
- BMI 30+, or 27+ with a weight-related condition
- Repeated attempts at diet and exercise that have not held
- Appetite and portion control are the main obstacle
- Prediabetes, type 2 diabetes, or metabolic syndrome
- Willing to attend follow-up and have labs monitored
Not a candidate
- Personal or family history of medullary thyroid carcinoma
- Multiple Endocrine Neoplasia syndrome type 2
- Pregnant, breastfeeding, or actively trying to conceive
- Prior pancreatitis or active gallbladder disease
- Severe gastroparesis or significant motility disorder
- An untreated eating disorder involving restriction or purging
- Already at a healthy weight and seeking cosmetic loss
Some of these are absolute — the thyroid and pregnancy contraindications are not negotiable. Others are judgment calls Dr. Jaqua makes case by case. If semaglutide is not appropriate for you, we will say so and discuss what is, rather than prescribing anyway.
Not sure where you sit? Work through our candidacy guide before you book.
How the Dose Is Escalated
Semaglutide is injected subcutaneously once a week — abdomen, thigh, or upper arm — on the same day each week, with or without food. Most patients self-inject at home after a short training session. The dose is stepped up gradually, and the schedule below is the standard starting point. Dr. Jaqua adjusts it based on how you tolerate each step and how your weight is actually tracking.
An adaptation dose, not a treatment dose. Its job is to let your gut adjust. Meaningful weight loss is not expected here, and that is normal.
Appetite suppression usually becomes noticeable. Many patients report the constant background thinking about food quieting down.
A therapeutic dose for many patients. Some stay here indefinitely if the rate of loss is steady and side effects are minimal.
Escalated only if progress has stalled and tolerance allows. 2.4 mg is the maintenance dose used in the STEP trials.
Two points patients ask about constantly. If you miss a dose and it has been fewer than five days, take it as soon as you remember and keep your usual schedule; if it has been longer, skip it and resume as normal — do not double up. And if you have missed several weeks, tell us before restarting, because tolerance to the GI effects fades and you may need to step back down.
Escalating faster than this schedule does not produce faster weight loss. It produces nausea, and nausea is the main reason patients abandon treatment before it has had a chance to work.
What to Expect, and What to Call Us About
Gastrointestinal side effects are common and mostly dose-related. In the STEP trials, nausea affected roughly 44% of participants on semaglutide, with diarrhea, vomiting, and constipation each affecting a meaningful minority. Symptoms are typically worst in the few days after a dose increase and improve as you adapt. Practical measures help more than people expect: smaller portions, stopping at the first sign of fullness, reducing fatty and fried food, keeping fluid intake up, and taking the dose on an evening when a quiet next day is possible.
Fatigue during the first weeks is usually a calorie deficit, not the drug. Constipation responds to fiber, fluid, and movement, and we would rather you tell us early than manage it alone.
Contact the clinic promptly for severe or persistent abdominal pain — particularly pain that radiates to the back, which can indicate pancreatitis — for vomiting that prevents you keeping fluids down, for right upper abdominal pain with nausea after eating, which can indicate gallbladder disease, or for a lump or swelling in the neck, hoarseness, or difficulty swallowing. Semaglutide carries a boxed warning for thyroid C-cell tumors based on rodent studies; the relevance to humans is not established, but it is the reason for the thyroid contraindications.
Tell every clinician treating you that you are on a GLP-1, particularly before any procedure requiring sedation — delayed gastric emptying changes anesthesia planning.
What Semaglutide Will Not Do
It will not keep the weight off by itself. In the STEP 4 withdrawal study, patients who stopped semaglutide regained roughly two thirds of the weight they had lost within a year. Planning for what happens after is part of treatment, not an afterthought.
It will not build muscle, and it can cost you some. Rapid weight loss on any protocol includes lean mass. Resistance training two to three times a week and protein intake of at least 1.2 g per kg of body weight materially reduce that loss. Without them, you can end up lighter and weaker.
It will not target a specific area. There is no such thing as spot reduction, from this drug or any other.
It will not fix an underlying driver. Untreated hypothyroidism, low testosterone, obstructive sleep apnea, certain psychiatric medications, and chronic sleep deprivation all promote weight gain. Semaglutide works around them rather than correcting them, which is why we run labs first.
It does not work for everyone. Around 10–15% of trial participants lost less than 5% of body weight. If you are in that group, continuing to escalate the dose is not the answer, and we will reassess rather than keep you on a medication that is not doing anything.
It is not a substitute for care. If disordered eating is part of the picture, suppressing appetite can make it worse rather than better. That needs addressing directly.
What's Included at Vitality
Semaglutide is most effective as part of a supervised program — not a standalone prescription. At Vitality, your weight loss plan includes:
- On-site metabolic labs with results the following day
- Physician-managed dosing — adjusted based on your response
- Nutritional guidance and lifestyle coaching
- Access to lipotropic injections and B12 for metabolic support
- Regular in-person check-ins with Dr. Jaqua
- Optional combination with TRT or peptide therapy
Clinical Trial Results
Figures below are from trials of branded semaglutide 2.4 mg. They are averages across trial populations, not a prediction of your result.
Mean body weight lost at 68 weeks (STEP 1)
Participants losing 20% or more
Relative reduction in major cardiovascular events (SELECT)
Semaglutide Questions & Answers
Common questions about semaglutide weight loss therapy.
References
- Wilding JPH, Batterham RL, Calanna S, et al. “Once-Weekly Semaglutide in Adults with Overweight or Obesity.” N Engl J Med. 2021;384(11):989–1002. DOI: 10.1056/NEJMoa2032183
- Rubino D, Abrahamsson N, Davies M, et al. “Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance.” JAMA. 2021;325(14):1414–1425. DOI: 10.1001/jama.2021.3224
- Ryan DH, Lingvay I, Deanfield J, et al. “Long-Term Weight Loss Effects of Semaglutide in Obesity without Diabetes in the SELECT Trial.” Nat Med. 2024;30(7):2049–2057. DOI: 10.1038/s41591-024-03027-3
This page is for general information and does not constitute medical advice. Compounded semaglutide is not FDA-approved and is prescribed at the physician's discretion following individual evaluation.
Ready to Start Losing Weight?
Physician-supervised semaglutide therapy starts with labs and a consultation. Book your free appointment with Dr. Jaqua today.
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