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Semaglutide

78
evidence score
fat loss
Prescription Only
495 studies
OzempicWegovyRybelsus+2 more

Semaglutide is a GLP-1 receptor agonist approved for type 2 diabetes (Ozempic, 0.5–2mg weekly SC; Rybelsus, 7–14mg oral daily) and chronic weight management (Wegovy, up to 2.4mg weekly SC). In the STEP trials, semaglutide 2.4mg produced ~15% average weight loss vs. 2.4% placebo over 68 weeks. Cardiovascular outcomes trials (SUSTAIN-6) show significant MACE reduction. Robust evidence base across type 2 diabetes, obesity, MASH, and cardiovascular risk reduction. One of the most impactful drugs of the 2020s.

Evidence

Strong evidence

Safety

Unknown safety profile

Clinical Status

Approved

Last Sync

Feb 19, 2026

Last Reviewed

Not reviewed yet

Physician Notes

Start low (0.25mg), titrate slowly. Nausea = too fast. Pair with resistance training and high protein (1g/lb target) to protect lean mass.

FDA Status:FDA-approved as Ozempic (diabetes) and Wegovy (obesity).

Monitoring

  • HbA1c/fasting glucose q3mo
  • Weight + body composition q3mo
  • Lipid panel q6mo
  • Renal function baseline
  • GI symptom assessment

Contraindications

  • Personal/family history of medullary thyroid carcinoma
  • MEN2 syndrome
  • Pancreatitis history (relative)
  • Pregnancy
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Dosing

Typical
1 mg
0.25 mgRange2.4 mg
FrequencyOnce weekly (injection); once daily (oral Rybelsus)

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Pharmacology

Half-life~7 days (injection); ~1 week
OnsetAppetite suppression within days; full weight loss effect over months
DurationOngoing; effects reverse within ~8 weeks of discontinuation
Routes
subcutaneous
oral

Evidence Score

78
Level A — Strong
495 studies indexed · 46 meta-analyses
Scoring Factors
Volume(24%)~54/100
Quality(24%)~58/100
Sample Size(12%)~98/100
Consistency(14%)~98/100
Replication(8%)~98/100
Recency(18%)~98/100

Scores estimated from study counts. Exact breakdown computed after research sync.

Evidence Levels
AScore ≥75 with at least 1 meta-analysis and 3+ RCTs
BScore ≥50 with at least 1 RCT or meta-analysis
CScore ≥25 — observational or animal evidence only
DScore <25 — very limited or preclinical data

Plain-English Snapshot

Semaglutide is currently categorized as a fat loss compound.

Evidence is strong (78/100) with a relatively mature body of research (495 indexed studies).

Safety scoring is incomplete. Start conservatively and monitor carefully.

Core mechanism

GLP-1 receptor agonist: delays gastric emptying, suppresses appetite via hypothalamic signaling, stimulates glucose-dependent insulin secretion

Practical Context

Strongest current signals

  • Level B: Comparative Efficacy of Semaglutide versus Liraglutide on Weight Loss and Glycaemic Control.
  • Level C: Efficacy and safety of once-weekly insulins in type 2 diabetes: A systematic review and meta-analysis.
  • Level C: Semaglutide and tirzepatide in prediabetes: Evidence for diabetes prevention and cardiovascular protection.

Elevated caution signals

2 severe/high side effect flags

Compound Profile