Semaglutide
Metabolic Health · GLP-1 agonist
Tier B
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.
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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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.