Healthcare provider talking with patient about how much weight you can lose on semaglutide

How Much Weight Can You Lose On Semaglutide?

Written on August 21, 2023 by Sendra Yang, PharmD, MBA. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

Nearly 50% of American adults try to lose weight every year.[1] If you are one of them, one of the most important things to consider is setting realistic weight loss goals. Knowing your weight loss expectations can help make the journey more enjoyable by having sensible and achievable weight targets.

Recently, a medication called semaglutide has been featured in many news outlets after the manufacturer reported an impressive percentage of weight loss from clinical trials.[2] The weight loss reported with semaglutide is higher than what is typically seen with other weight loss drugs.[3] So, how much weight can you potentially lose on semaglutide? Continue reading to find out.

Semaglutide Basics

Semaglutide belongs to a class of medications known as GLP-1s, or glucagon-like peptide 1 drugs.[4] It is the first GLP-1 drug that is U.S. Food and Drug Administration (FDA) approved for long-term use in people who are obese and overweight. The semaglutide dose used in weight loss is higher than that used to treat type 2 diabetes.[4,5]

Semaglutide is indicated with diet and exercise in adults with obesity or overweight adults with at least one weight-related condition such as hypertension, type 2 diabetes, or dyslipidemia.[5] Semaglutide is also used in adolescents 12 years and older who are obese. The brand name of semaglutide for use in weight loss is Wegovy®, and it is only available as a subcutaneous injection.[5]

How Semaglutide Works

Semaglutide is a manufactured form of the naturally occurring GLP1 in the human body.[4,5] GLP1s are incretin hormones produced in the gastrointestinal tract after food intake to help regulate insulin release.[4] It mimics the functions of the human GLP1 by binding to and activating the GLP-1 receptor.[5] GLP1 helps to regulate appetite and food intake, including highly complex pathways in the brain.

The mechanism of how GLP-1 works is not fully understood, though it is thought that GLP-1 also improves beta-cell function to produce insulin, delays gastric emptying, and improves insulin sensitivity.[4,6] Semaglutide is also highly bound to a protein in the bloodstream called plasma albumin, resulting in reduced renal clearance and degradation.[4,5]

Everlywell Weight Loss Support

Average Weight Loss With Semaglutide

The average weight loss with medications previously approved by the FDA for long-term weight management is around 5% to 10%.[3] Though how much weight you can lose may vary, the percentage of weight loss reported with semaglutide in the STEP clinical trials is closer to 15%.[2,7-11] In the large STEP 1 study, of 1,961 adults with obesity or overweight were randomly assigned to receive semaglutide or placebo for 68 weeks.[7] The group using semaglutide had an average weight loss of 14.9% from baseline weight compared to 2.4% in the placebo group.[7] The average baseline weight at the start of the study was approximately 231 lbs. The study also reported a weight reduction of about 33 lbs in the semaglutide group, compared with about 6 lbs in the placebo group.[7]

In another study (STEP 2) with obese and overweight adults with type 2 diabetes, semaglutide with lifestyle changes had an average weight loss from baseline to 68 weeks of 9.6% compared with 3.4% in placebo. [9] The STEP 5 long-term study in adults with obesity or overweight with at least one weight-related condition, without diabetes, found a 15.2% change in the average weight from baseline to week 104 (almost 2 years and 2 months) compared with 2.6% in placebo. [10]

Common And Serious Side Effects Of Semaglutide

Semaglutide has significant efficacy on weight loss but also has some side effects.[5,7-10] The most frequent side effects of semaglutide are gastrointestinal-related.[4,5,10,11] These include nausea, diarrhea, vomiting, constipation, upset stomach, and abdominal pain or distension.[4,5] Additional common side effects are headache, fatigue, dizziness, belching, hypoglycemia in type 2 diabetes, flatulence, gastroenteritis, gastroesophageal reflux disease, and nasopharyngitis.[5]

Sometimes, more severe side effects may occur. Semaglutide has a serious FDA safety warning for the risk of thyroid C-cell tumors.[5] Other serious side effects can include pancreatitis, gall bladder disease, kidney damage, increased heart rate, as well as low blood glucose levels and eye disorder in type 2 diabetics. You should avoid semaglutide if you have a personal or family history of certain types of thyroid cancers. Additionally, you should not use semaglutide if you have a hypersensitivity reaction to the medication.

Weight Loss With Everlywell

It’s important to discuss your weight loss goals and expectations with your healthcare provider. You can choose to schedule a virtual care visit through a comprehensive GLP-1 weight loss program accessed via Everlywell's telehealth option. You can get access to regular one-to-one virtual visits with a licensed clinician. During the first visit, the healthcare provider will review and evaluate your medical history and order any appropriate lab testing that may be needed to see whether GLP-1 weight loss medication may be right for you. Follow-up visits will include discussing personal health and weight-related goals to develop a personalized care plan for you.

Schedule online weight loss visit

When Does Semaglutide Start Working For Weight Loss?

How to Keep the Weight Off After Semaglutide

Semaglutide for Weight Loss in Non-Diabetics: What You Need to Know

References

  1. Data briefs - number 313 - July 2018. Attempts to lose weight among adults in the U.S., 2013-2016. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/products/databriefs/db313.htm. July 12, 2018. Accessed August 14, 2023.
  2. Novo Nordisk A/S. Novo Nordisk files for US FDA regulatory approval of once-weekly semaglutide 2.4 mg for weight management. GlobeNewswire News Room. https://www.globenewswire.com/news-release/2020/12/04/2139776/0/en/Novo-Nordisk-files-for-US-FDA-regulatory-approval-of-once-weekly-semaglutide-2-4-mg-for-weight-management.html. December 4, 2020. Accessed August 16, 2023.
  3. Jin J. Medications for weight loss: Indications and usage. JAMA. 2015;313(21):2196. doi:10.1001/jama.2015.5575
  4. Alorfi NM, Algarni AS. Clinical impact of semaglutide, a glucagon-like peptide-1 receptor agonist, on obesity management: A review. Clin Pharmacol. 2022;14:61-67. doi: 10.2147/CPAA.S374741
  5. DailyMed - Wegovy®- semaglutide injection, solution. U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b. Accessed August 14, 2023.
  6. Mahapatra MK, Karuppasamy M, Sahoo BM. Semaglutide, a glucagon-like peptide-1 receptor agonist with cardiovascular benefits for management of type 2 diabetes. Rev Endocr Metab Disord. 2022;23(3):521-539. doi: 10.1007/s11154-021-09699-1
  7. Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, McGowan BM, Rosenstock J, Tran MTD, Wadden TA, Wharton S, Yokote K, Zeuthen N, Kushner RF; STEP 1 Study Group. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989-1002. doi: 10.1056/NEJMoa2032183
  8. Kosiborod MN, Bhatta M, Davies M, Deanfield JE, Garvey WT, Khalid U, Kushner R, Rubino DM, Zeuthen N, Verma S. Semaglutide improves cardiometabolic risk factors in adults with overweight or obesity: STEP 1 and 4 exploratory analyses. Diabetes Obes Metab. 2023;25(2):468-478. doi: 10.1111/dom.14890
  9. Davies M, Færch L, Jeppesen OK, Pakseresht A, Pedersen SD, Perreault L, Rosenstock J, Shimomura I, Viljoen A, Wadden TA, Lingvay I; STEP 2 Study Group. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet. 2021;397(10278):971-984. doi: 10.1016/S0140-6736(21)00213-0
  10. Garvey WT, Batterham RL, Bhatta M, Buscemi S, Christensen LN, Frias JP, Jódar E, Kandler K, Rigas G, Wadden TA, Wharton S; STEP 5 Study Group. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial. Nat Med. 2022;28(10):2083-2091. doi: 10.1038/s41591-022-02026-4
  11. Ghusn W, De la Rosa A, Sacoto D, Cifuentes L, Campos A, Feris F, Hurtado MD, Acosta A. Weight loss outcomes associated with semaglutide treatment for patients with overweight or obesity. JAMA Netw Open. 2022;5(9):e2231982. doi: 10.1001/jamanetworkopen.2022.31982
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