Semaglutide – Your Complete Review

What is Semaglutide?

Semaglutide is a type of medication used to help manage blood sugar in people with type 2 diabetes and to support weight loss in individuals living with obesity. It belongs to a class of drugs called GLP-1 receptor agonists, which mimic a natural hormone involved in appetite and glucose regulation.

How Semaglutide Works

Semaglutide activates the GLP-1 receptor, a key player in glucose metabolism and appetite control. When this receptor is stimulated, the body releases more insulin, reduces glucagon (a hormone that raises blood sugar), and slows digestion. Together, these actions help lower blood sugar and promote a feeling of fullness, which can lead to weight loss. It also impacts appetite centers in the brain, reducing cravings and spontaneous food intake.

Who Might Use It

Doctors may prescribe Semaglutide to adults with:

• Type 2 diabetes who need better blood sugar control
• Obesity or overweight individuals with weight-related health conditions (such as high blood pressure or sleep apnea)

This drug is not typically used for type 1 diabetes or for general weight loss without medical supervision.

Available Brands and Formulations

Semaglutide is available under several brand names:

• Ozempic® – for type 2 diabetes (once-weekly injection)
• Wegovy® – for weight management (once-weekly injection, different dosing)
• Rybelsus® – an oral tablet version used for type 2 diabetes

Each brand has its own dosing and indication. Ozempic and Wegovy are injected subcutaneously once a week using a pre-filled pen.

Clinical Trial Evidence

SUSTAIN Trials

Showed significant reductions in HbA1c and weight in people with type 2 diabetes using Ozempic.

STEP Trials

Focused on weight management. In STEP 1, patients using Wegovy lost an average of 14.9% of their body weight over 68 weeks.

SELECT Trial

Demonstrated reduced cardiovascular risk in adults with obesity and no prior diabetes diagnosis.

Side Effects and Safety

Common Side Effects

• Nausea
• Vomiting
• Diarrhea
• Constipation

These are often mild and improve over time.

Serious Risks

• Pancreatitis
• Gallbladder issues
• Kidney problems
• Risk of thyroid C-cell tumors (observed in animal studies)

People with a personal or family history of medullary thyroid cancer or MEN 2 syndrome are typically advised not to take Semaglutide.

Dosing and Administration

Semaglutide is usually started at a low dose and increased gradually to improve tolerance:

• Injections are taken once a week on the same day, with or without food.
• Rybelsus (tablet) is taken once daily on an empty stomach, with water only.

Dosing schedules differ by indication (diabetes vs weight loss), and dose escalation is done over several weeks under medical supervision.

Cost and Insurance Coverage

Cost varies by brand and country:

• In Australia, Ozempic is subsidised on the PBS for type 2 diabetes, but Wegovy is not currently listed.
• In the U.S., the monthly out-of-pocket cost can exceed $1,000 without insurance.
• Some private insurance plans may cover it, especially for diabetes indications.

Pricing continues to be a barrier to access in many regions.

Where It’s Available

Semaglutide has been approved for use in:

• Type 2 diabetes: Australia, United States, United Kingdom, Canada, EU, and many other countries
• Weight management: United States, United Kingdom, EU, Canada

Wegovy was launched later than Ozempic and is still rolling out in some regions.
Supply shortages have been reported due to high global demand.

Before and After: What the Research Shows

In weight management trials:

• Participants lost an average of 15% of their body weight over 68 weeks on Wegovy.
• Weight loss typically begins within the first few weeks and continues gradually.

In diabetes studies:

• HbA1c reductions of around 1.5% have been observed in patients using Semaglutide.

These results reflect controlled trials. Real-world outcomes may vary.

Alternatives to Semaglutide

Other medications in the same class include:

• Tirzepatide (dual GLP-1/GIP agonist, e.g. Mounjaro)
• Liraglutide (daily injection, e.g. Saxenda, Victoza)
• Dulaglutide (weekly injection, e.g. Trulicity)
• Exenatide (e.g. Byetta, Bydureon)

Tirzepatide is often compared directly to Semaglutide due to its stronger weight loss outcomes in trials.

Common Questions About Semaglutide

Is Ozempic the same as Semaglutide?
Yes. Ozempic is a brand name for Semaglutide used for treating type 2 diabetes.

How much weight can you lose on Semaglutide?
In clinical trials, weight loss of up to 15% of body weight has been observed with Wegovy over about 16 months.

How long do you need to take it?
There is no defined “treatment window.” It is often used long-term as weight and blood sugar tend to return to baseline after stopping.

Can you take Semaglutide if you don’t have diabetes?
Yes—for weight management, but only under medical supervision and in countries where it’s approved for this purpose.

Is it safe long-term?
Studies of up to 2 years have shown consistent safety, but long-term outcomes are still being monitored.

Can it be taken with other medications?
Yes, but it depends on your situation. Doctors often combine Semaglutide with other diabetes or blood pressure medications.