Semaglutide
GLP-1 receptor agonist (peptide)
Also known as: Ozempic, Wegovy, Rybelsus
A GLP-1 receptor agonist peptide approved for type 2 diabetes and chronic weight management, backed by large, high-quality clinical trials.
Validated by multiple large double-blind RCTs (STEP, SUSTAIN, SELECT) and regulatory approval in major markets.
Supported by meta-analyses or multiple double-blind RCTs.
Intended use
Blood-glucose control in type 2 diabetes and long-term weight management in obesity/overweight with comorbidity.
Mechanism of action
Mimics the incretin hormone GLP-1: enhances glucose-dependent insulin secretion, suppresses glucagon, slows gastric emptying, and reduces appetite via central pathways.
Reported benefits
Significant weight loss
STEP trials showed ~15% average body-weight reduction over 68 weeks.
Glycemic control
Large HbA1c reductions in type 2 diabetes patients.
Cardiovascular risk reduction
SELECT trial showed reduced major cardiovascular events in overweight patients without diabetes.
Risks & side effects
GI side effects
moderate riskNausea, vomiting, and diarrhea are common, especially during dose escalation.
Pancreatitis
high riskRare reports of acute pancreatitis.
Thyroid C-cell tumors
high riskBoxed warning based on rodent data; contraindicated in MEN 2 / medullary thyroid cancer history.
Research & citations
Studies are ordered by design strength. Dots indicate the rigor of each study type — meta-analyses and double-blind RCTs rank highest, case reports and in vitro work lowest.
- STEP 1: Once-weekly semaglutide in adults with overweight or obesity
Mean 14.9% weight loss vs 2.4% placebo.
New England Journal of Medicine · 2021 · n = 1,961
Double-blind RCT - SELECT: Semaglutide and cardiovascular outcomes
20% reduction in major adverse cardiovascular events.
New England Journal of Medicine · 2023 · n = 17,604
Double-blind RCT - SUSTAIN-6 cardiovascular outcomes in type 2 diabetes
Reduced cardiovascular events in high-risk diabetics.
New England Journal of Medicine · 2016 · n = 3,297
Double-blind RCT
Legal status by region
Regulatory status varies widely and changes often. Verify against current local law before acting.
| Region | Status | Notes |
|---|---|---|
| United States | Prescription | FDA-approved (Ozempic, Wegovy, Rybelsus). |
| European Union | Prescription | EMA-approved for diabetes and weight management. |
| United Kingdom | Prescription | MHRA-approved; available via NHS with criteria. |
| Australia | Prescription | TGA-approved (Ozempic); supply subject to shortages. |
Sourcing & prescribing
Where a compound can legally be obtained, and who is able to prescribe it.
- Legal
Licensed pharmacy (prescription)
Standard route via GP, endocrinologist, or weight-management clinic.
- Legal
Telehealth weight-loss clinics
Many licensed telehealth providers prescribe after assessment.
- Gray area
Compounded 'semaglutide' from gray vendors
FDA has warned about unapproved/compounded and counterfeit versions.
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