Semaglutide—more commonly known by its brand names Ozempic and Wegovy—is a peptide that was originally designed as an anti-diabetic medication, “Ozempic,” but was later discovered to be highly effective as a weight-loss drug; after some time, Semaglutide was approved as a weight loss drug under the brand name “Wegovy.”
Semaglutide is a member of the GLP-1 receptor agonist class, alongside peptides like Tirzepatide. This class of peptides has proven to be effective in both controlling diabetes, as well as greatly aiding in weight loss.
Like any peptide or medication, there are some risks associated with the use of Semaglutide. That said, in most cases, the benefits far outweigh the risks. We’ll walk through the semaglutide’s safety profile a little later.
Semaglutide dosages range from 0.25mg per week to 1mg per week. This peptide is typically injected subcutaneously (in the abdominal area), but an oral option also exists. It is important to remember that Semaglutide has a long half-life, which means that starting off with too much can lead to a very rough week for you. Unless instructed differently by a physician, start off at the minimum dosage.
The journey of semaglutide began in the 1970s with groundbreaking research on incretin hormones by scientists Jens Juul Holst, Joel Habener, and Svetlana Mojsov. Holst discovered that gut hormones affected insulin secretion, while Habener and Mojsov used emerging recombinant DNA technology to identify and characterize GLP-1 (glucagon-like peptide-1). Their research revealed that GLP-1 stimulated insulin secretion but had an extremely short half-life of only 1-2 minutes in the bloodstream, limiting its therapeutic potential. These discoveries established the scientific foundation for developing GLP-1-based medications that would eventually transform diabetes and obesity treatment.
Building on this foundation, scientists at Novo Nordisk, led by Lotte Bjerre Knudsen, began developing modified versions of GLP-1 with extended half-lives. They first created liraglutide in 1998, then pursued the development of semaglutide as a once-weekly alternative. Semaglutide's design incorporated several critical modifications: an amino acid substitution to prevent enzymatic degradation and a C18 fatty diacid attachment that enhanced albumin binding and reduced renal clearance, extending its half-life to approximately seven days. After extensive testing of roughly 4,000 molecular variations, researchers finalized semaglutide's structure, achieving the optimal balance between potency and extended duration.
Clinical trials for semaglutide began with a Phase II study in 2008, followed by the comprehensive SUSTAIN clinical trial program across multiple countries. The FDA approved injectable semaglutide (Ozempic) for type 2 diabetes in December 2017 based on seven clinical trials involving over 4,000 patients. Further research demonstrated semaglutide's effectiveness for weight management, leading to the approval of a higher-dose formulation (Wegovy) in June 2021—the first new drug approved for chronic weight management since 2014. Subsequent trials showed cardiovascular benefits, resulting in additional FDA approval for reducing cardiovascular risks. Novo Nordisk also developed an oral formulation (Rybelsus), expanding treatment options and making semaglutide one of the most significant therapeutic advances in metabolic health in recent decades.
Semaglutide offers substantial benefits for patients with type 2 diabetes, providing superior glycemic control through its action as a GLP-1 receptor agonist. Clinical trials have demonstrated that it significantly reduces HbA1c levels, with many patients achieving target levels below 7%. Beyond improving blood sugar control, semaglutide promotes significant weight loss, with patients typically losing 5-15% of their body weight depending on the dosage and formulation. This dual action addresses two critical aspects of metabolic health simultaneously. Additionally, semaglutide has shown cardiovascular benefits, reducing the risk of major adverse cardiovascular events like heart attack, stroke, and cardiovascular death in people with established cardiovascular disease. Its once-weekly dosing (for injectable forms) represents a significant convenience advantage over medications requiring daily administration, potentially improving treatment adherence.
The benefits of semaglutide extend beyond glycemic control and weight management. The medication has been shown to reduce blood pressure and improve lipid profiles, contributing to overall cardiometabolic health improvement. For patients with obesity, the substantial weight loss achieved with semaglutide treatment is associated with improvements in obesity-related complications, including sleep apnea, joint pain, and mobility limitations. Research suggests semaglutide may have beneficial effects on non-alcoholic fatty liver disease (NASH), which frequently co-occurs with obesity and diabetes. While gastrointestinal side effects can occur, particularly during initial treatment and dose escalation, these typically diminish over time for most patients. The development of both injectable and oral formulations has expanded treatment options, allowing healthcare providers to tailor therapy to individual patient preferences and needs. For many patients, the comprehensive health benefits and convenience of semaglutide make it a valuable treatment option for managing complex metabolic disorders.
As with any medication, Semaglutide does come with certain risks and potential side effects. Some of these include injection site reactions such as redness, swelling, or itching at the site where the medication is administered. Additionally, there have been rare reports of pancreatitis and medullary thyroid carcinoma (MTC) associated with the use of GLP-1 receptor agonists like Semaglutide.
In clinical trials, patients treated with Semaglutide reported a relatively low rate of adverse events compared to placebo. In most cases, the benefits of using this medication for diabetes management or weight loss outweigh the risks when used under medical supervision and in accordance with prescribed guidelines. However, it is important for individuals considering the use of Semaglutide to discuss their options with healthcare professionals and weigh the potential risks and benefits based on their personal state of health.
Semaglutide—more commonly known by its brand names Ozempic and Wegovy—is a peptide that was originally designed as an anti-diabetic medication, “Ozempic,” but was later discovered to be highly effective as a weight-loss drug; after some time, Semaglutide was approved as a weight loss drug under the brand name “Wegovy.”
Semaglutide is a member of the GLP-1 receptor agonist class, alongside peptides like Tirzepatide. This class of peptides has proven to be effective in both controlling diabetes, as well as greatly aiding in weight loss.
Like any peptide or medication, there are some risks associated with the use of Semaglutide. That said, in most cases, the benefits far outweigh the risks. We’ll walk through the semaglutide’s safety profile a little later.