Highlights
- Semaglutide is prescribed on a dosage escalation basis, meaning your dose for weight loss in units will change over the course of weeks and months as you lose weight.
- It’s typical to increase your dosage every four weeks, but together with your healthcare provider, you will find the best dosage escalation plan for you.
- Most people start at 0.25 milligrams per week and move up, with the highest dose being 2.4 milligrams.
- Side effects are usually related to your gastrointestinal system; they can be managed by either lowering your dosage or escalating it at a slower pace.
It’s not a secret that when you try to lose weight, it can be a very challenging journey. The good news is that semaglutide, the medication more commonly known by its brand names Wegovy and Ozempic, can be a useful tool on your path to a healthy weight. But one thing you’ll want to know is how your dosage may be altered along the way and how the different dosage amounts can affect you. If you take too much, you may experience unpleasant side effects, but too little may stall your weight loss.
Even though you’ll receive a detailed dosage chart from your medical provider, it can be helpful to learn more about the process in advance. Read on to learn how semaglutide works, how it can be part of your weight loss treatment, what kind of dosage you can expect to help you with your goals, and anything else you should be on the lookout for.
Semaglutide Dosage for Weight Loss
Semaglutide is a unique medication in that your dosage will change over the first few weeks and months while you are taking it. Everyone begins with a small starting dose, and then your healthcare provider will guide you through a dose escalation over a time period of up to 20 weeks until you reach your maximum recommended dosage. This is a typical dosing schedule:
- Starting dose: When you first start taking semaglutide, you’ll begin with 0.25 milligrams once per week. This beginning dose is to initiate treatment and let your body get used to the medication, so you
may not see results right away [2*] . - Gradual increments: After four weeks, it’s typical to experience a dose escalation. Oftentimes, you will double your dose to 0.5 milligrams as your weekly dosage.
- Maintenance dose: If you tolerate the medication and are seeing good results, you may have hit a good therapeutic dose for you. Depending on what your doctor says, you may continue at 0.5 milligrams as your weekly dosage.
- Maximum dose: If you are not seeing the results you want with your semaglutide treatment, your healthcare provider may increase your dose to 1 milligram once per week, but this is the maximum recommended dosage for maintenance of lost weight.
- Highest dose: Some people may not achieve the results they are looking for with 1 mg of semaglutide per week. Your doctor may recommend the highest dose of up to 2.4 mg per week, but this will come as a gradual increase over four to five months. Not everyone needs this highest dose. Increasing your injection dosage in a shorter period of time may result in unpleasant side effects in your gastrointestinal system.
Your dosing schedule for weight loss may differ from others. Together with your medical provider, you can determine the most suitable plan for you.
The semaglutide dosage chart below can help guide you through your weight loss management journey:
- Weeks 1-4: 0.25 mg, weekly injection dosage
- Weeks 4-8: 0.5 mg, weekly injection dosage
- Weeks 8-12: 1 mg, weekly injection dosage
- Weeks 13+: Up to 2.4 mg, weekly injection dosage
While this is the average plan for many people, your individual path may be different. You should work with your medical provider to determine the most suitable plan as well as make changes to your weekly dosage depending on your weight loss results and any side effects you may experience along the way.
How Does Semaglutide Work for Weight Loss?
Semaglutide was originally approved by the Food and Drug Administration (FDA) to treat type 2 diabetes by lowering glucose levels in the body. As the trials went on though, it became clear that semaglutide is also an effective weight loss aid; in June 2021, it was approved by the FDA for this use as well. This has opened the door to many people who struggled with unsuccessful weight loss attempts. But how does semaglutide work and what exactly does it do in your body? We have the answers.
It Mimics a GLP-1 Hormone
Semaglutide is a once-weekly injection that mimics a hormone in your body called glucagon-like peptide-1, or GLP-1 for short. This medication is 94% similar to the natural GLP-1 hormone and, just like the natural version, it binds to GLP-1 receptors in your pancreas and other organs. When this happens, it stimulates insulin and lowers glucagon, both of which have the effect of lowering your blood sugar.
Semaglutide also slows down the rate at which food leaves your stomach. All together, these actions can reduce your appetite, make you feel fuller for longer, reduce cravings, and help you eat less. This ultimately leads to
It Is Injected Beneath the Skin
Semaglutide comes in a pre-filled injection pen (similar to insulin) that contains a thin needle to inject the education into the fat tissue under your skin. Semaglutide pens come in different doses, from 0.25 mg to 2.4 mg, and which one you get will depend on what dosage your healthcare provider prescribes for you. It is common to get different injection pens with higher doses as you move along your weight loss journey.
It is recommended that you inject the medication into your thigh, abdomen, or upper arm and to use different injection sites each time. You should inject semaglutide on the same day each week. If you miss a dose, then take it as soon as you can. But if it’s been more than 5 days since your missed dose, skip the missed dose and go back to your regular dosing schedule. Remember to discuss these and other details of your weight loss plan with your healthcare provider.
It’s Meant to Be Used in Addition to Diet and Exercise
One thing to remember is that using semaglutide alone is not typical. While it can still be effective, it is prescribed along with changes to diet and exercise to improve your overall health. Together, a healthy lifestyle and semaglutide may reduce your risk of heart attack, stroke, kidney failure, and may slow the worsening of kidney disease. Also, these lifestyle changes help maintain your weight loss results after stopping the medication.
Potential Risks of Using Semaglutide
Just like any medication, there are possible adverse effects to watch for. Semaglutide has many positive benefits, such as weight loss and better blood sugar control, but there are a few common side effects and other things to keep in mind.
Side Effects
The following is a list of common side effects. These symptoms often begin at the start of treatment and may worsen anytime there is a dose escalation. Not everyone experiences every symptom, but common ones
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain
- Constipation
- Headache
- Fatigue
- Dyspepsia (indigestion)
- Dizziness
- Bloating
- Belching
- Flatulance
- Gastroesophageal reflux disease (GERD)
Type 2 Diabetes-Related Side Effects
If you have type 2 diabetes, it’s possible that you may experience other side effects in addition to the common reactions listed above. Since semaglutide encourages your pancreas to release insulin, the hormone that lowers blood sugar, it can leave you at risk of hypoglycemia. With hypoglycemia, your blood sugar drops to an uncomfortable or even dangerous level. Symptoms of hypoglycemia may
- Feeling shaky
- Sweating
- Feeling anxious or nervous
- Sudden irritability
- Confusion
- Feeling dizzy or lightheaded
- Feeling hungry
You may be at higher risk of experiencing a drop in blood sugar if you are taking semaglutide along with other medications for type 2 diabetes. These medications include insulin injections and sulfonylurea drugs, such as Glucotrol (glipizide), DiaBeta (glyburide), Amaryl (glimepiride), and others. If you are struggling with hypoglycemia after starting semaglutide, talk with your doctor. Options they may suggest include adjusting your semaglutide dose for weight loss in units, adjusting your type 2 diabetes medications, or possibly making changes to your diet until your blood sugar becomes more stable.
Who Shouldn’t Use Semaglutide?
Just like any medication, semaglutide may not be a good choice for everyone. There are some people who should not use semaglutide for weight loss. These groups
- Women who are pregnant or breastfeeding: There is little information about how semaglutide can affect your baby while you’re pregnant or breastfeeding, but animal studies show that the risk of birth defects is considerable. It’s unknown whether semaglutide makes it into human breastmilk, but it is known that it was present during animal studies. Doctors recommend stopping semaglutide at least two months before you plan to get pregnant and not using it again until after you are finished breastfeeding.
- Children under age 18: Semaglutide has not been studied in children so it is unknown whether it is effective and safe in young people.
- People with a personal or family history of thyroid cancer: In animal studies, semaglutide caused tumors in the thyroid gland. It’s unknown whether the same will be seen in humans, but semaglutide is not recommended for anyone with a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2).
- Allergies: If you are allergic to semaglutide or any of its ingredients, you should not take the medication.
Finding Your Ideal Semaglutide Dose
How much semaglutide works for you for weight loss management will depend on many factors. While the FDA approves certain doses, that is based on the average results of clinical trials, but you as an individual are unique. This means that your dosing schedule for weight loss might be different from others, so you will work with your healthcare provider to find the right therapeutic dose for you.
In addition, there are many factors beyond your control that can affect your semaglutide treatment dose, which your healthcare provider will take into account. These can include any of the following:
- Age: It is more common for people over age 65 to have kidney or liver issues, and this can affect how the medication is metabolized or processed in the body and how much of it becomes available to use. This will affect your injection dosage.
- Weight: Depending on your weight, the medication may be absorbed differently.
- Kidney health: If your kidneys are not functioning at their peak, either due to injury, illness, or a medication that affects kidney function, this may influence your therapeutic dose. Your kidneys filter everything that goes into your body and is the organ that does most of the processing of semaglutide, so the health of your kidneys may affect whether and how much semaglutide you can take.
- Genetics: Some genetic factors can affect how medication is absorbed and processed within your body.
- Other diagnoses and medications: Depending on what other diseases or conditions you have been diagnosed with, and what medications you are taking, your dose may need to be adjusted. Other diseases may change how your body absorbs and processes semaglutide.
Other things to think about when it comes to the most suitable dose for you is how well your body tolerates the side effects. At MEDvidi, you can have an online weight loss consultation and discuss all these questions with a licensed medical professional. You will learn whether semaglutide is the right medication for you and receive a plan where you have tolerable or no side effects and are satisfied with your weight loss results.
Expected Results and Timeframes
Semaglutide can be a powerful tool to help you reduce excess weight. Studies show weight reduction of up to
It can be tempting to discuss an earlier increase in your semaglutide dose for faster weight loss results, but that can lead to negative consequences, such as side effects (nausea, vomiting, other undesirable gastrointestinal symptoms, etc.). The best path is to consult with your healthcare provider, monitor side effects, and together, find a good dosing schedule for weight loss.
Conclusion
Semaglutide offers hope to those who have been struggling with weight loss. The best path forward with semaglutide is to work with a knowledgeable healthcare provider who can help you find the right dosage where you can see results but also minimize side effects. At MEDvidi, we have licensed medical providers who can prescribe semaglutide if appropriate. It’s easy to find a convenient time for your online appointment, and it’s an affordable way to get professional recommendations on weight loss.
