Semaglutide: Benefits, Side Effects, Before and After Pictures

What is Semaglutide?

Semaglutide is a glucagon-like peptide-1 (GLP-1) agonist that has been approved by the US Food and Drug Administration (FDA) for the treatment of obesity and type 2 diabetes. The brand names for semaglutide are:

• Wegovy
• Ozempic
• Rybelsus

What Are the Benefits of Semaglutide?

• Weight loss
• Blood sugar control
• Anti-inflammatory
• Cardioprotective
• Nephroprotective

Weight Loss

Semaglutide induces lipolysis by reducing blood sugar levels and thus enhancing fatty acid oxidation. This shifts the body from burning glucose as a main energy source to adipose tissue, otherwise known as fat stores.

Semaglutide increases satiety and thus acts as an appetite suppressant. This effect occurs due to semaglutide delaying the process of gastric emptying, slowing the release of food into the intestine. As a result, semaglutide users may be more inclined to adhere to a calorie-deficit diet.

Can Semaglutide Cause Muscle Loss?

• Research has shown that those who adopt a large calorie deficit are more susceptible to muscle atrophy in conjunction with fat loss (1, 2).
• In contrast, individuals who eat in a smaller calorie deficit typically experience less muscle loss. This dynamic may explain why a study found that up to 40% of total weight loss from semaglutide was attributed to lean mass (3), while other users did not experience any notable muscle tissue loss.
• Thus, it appears that semaglutide does not directly cause muscle wasting, but it remains a potential side effect indirectly caused by semaglutide’s potent appetite-suppressant attributes.

We have had bodybuilders at our clinic utilize semaglutide effectively to reduce their body fat percentage while retaining muscle hypertrophy. However, such patients reported being vigilant in avoiding their calories dropping excessively low to avoid muscle loss.

How Much Weight Loss Can Users Experience From Semaglutide?

The amount of weight loss caused by semaglutide in a study on individuals who experienced post-bariatric treatment failure can be viewed below (4). In this study, prior to taking semaglutide, obese men and women underwent bariatric surgery and either failed to lose enough weight or gained it back after the procedure, known as weight recidivism.

This is how much weight they lost following 12 months of semaglutide treatment:

• >5% in 90% of patients
• >10% in 62% of patients
• >15% in 35% of patients
• >20% in 24% of patients
• >25% in 17% of patients

In our experience, the total weight loss range of semaglutide, based on our patients results, can be viewed below:

Duration	Weight loss range	Median weight loss
1–4 weeks	5–20 pounds	12.5 pounds
1–8 weeks	8–30 pounds	19 pounds
1–12 weeks	11–40 pounds	25.5 pounds

Are Weight Loss Results From Semaglutide Sustainable?

A long-term data study found that semaglutide users on average lost 10% of their total weight and maintained these results for 4 years (5).

In our experience, the majority of our patients maintain their weight loss results several months or years following semaglutide discontinuation. However, a few of our patients have regained the weight they initially lost.

We have found that tapering off semaglutide by gradually decreasing the dosage can be efficacious in reducing large spikes in appetite following cycle cessation, increasing the likelihood of long-term results.

Blood Sugar Control

• Clinical trials have shown that semaglutide works as an antihyperglycemic and can significantly reduce blood sugar levels, as it stimulates the pancreas to secrete more insulin.
• A study found that glycated hemoglobin (HbA1c) levels decreased by 2.8% following a semaglutide dosage of 1 mg/week (6).

We recently treated a bodybuilder with diabetes mellitus, successfully reducing his HbA1c levels with semaglutide to a clinically normal range, decreasing from 6.5% to 5.3%.

Research has shown that the risk of semaglutide causing hypoglycemia may be low due to its insulinogenic effects being glucose-dependent. Therefore, this reductive effect is less likely to occur when blood sugar levels are stable, known as normoglycemia (7).

Anti-Inflammatory

• Semaglutide has been found to reduce inflammation in animal research by lowering the levels of tumor necrosis factor-alpha (TNF-α) and interleukin 6 (IL-6) cytokines (8).
• This effect is caused by semaglutide reprogramming immune cells and macrophages via the GLP-1R/PPARG/ACSL1 pathway, also causing anticancerous effects in rodents (9).

We have observed significant reductions in C-reactive protein (CRP) levels of patients administering semaglutide, potentially benefiting individuals with autoimmune disease.

Cardioprotective

A study found that semaglutide reduced the risk of cardiovascular-related death by 29% (10).

Japanese research also found semaglutide to significantly decrease low-density lipoprotein (LDL) cholesterol levels, lowering the risk of dyslipidemia in type 2 diabetes patients (11).

Several of our patients have utilized semaglutide in conjunction with SARMs or anabolic steroids and consequently have improved their diastolic and systolic blood pressure readings, reducing the risk of hypertension.

There are several mechanisms by which semaglutide can reduce blood pressure, including:

• Reduced body fat
• Improved insulin sensitivity
• The excretion of sodium in urine, known as natriuresis
• Vasodilation

Nephroprotective

• Clinical studies indicate that semaglutide may have renal protective effects, with chronic kidney disease patients experiencing significantly improved outcomes following a dosage of 1 mg/week.
• After a 3-year follow-up, their urinary albumin-to-creatinine ratios and estimated glomerular filtration rates remained improved, contributing to a 20% lower risk of death (12).

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Is Semaglutide Safe?

A PubMed study involving 3,962 overweight individuals receiving 2.4 mg/week concluded that semaglutide appeared to be “safe” and “well-tolerated.” (13). However, gastrointestinal-related side effects were reported in several users. The researchers stated that these adverse reactions were “transient” and “mild to moderate in nature.”

Despite semaglutide being FDA approved, the federal agency has warned the public of non-prescription purchases of this drug due to potential counterfeiting.

• The public can report adulterated semaglutide products here: https://www.accessdata.fda.gov/scripts/medwatch/

Dr. James Stirrett, a specialist in regenerative medicine, warns that how semaglutide is administered can dictate its safety. Dr. Stirrett states that if a provider administers large dosages of semaglutide and only provides annual health checkups, this could lead to issues.

Dr. Stirrett adds that when semaglutide is utilized diligently, it can be an efficacious tool for increasing a patient’s motivation.

Semaglutide Contraindications

Dr. Stirrett says that a questionnaire is crucial to understand a patient’s medical history and existing health, as semaglutide may be a high-risk medication for those with medullary thyroid carcinoma and multiple endocrine neoplasia syndrome.

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What Are the Side Effects of Semaglutide?

The National Institute of Diabetes and Digestive and Kidney Diseases states that semaglutide is generally “well tolerated”; however, adverse effects can be more prevalent at higher doses.

The following side effects are possible from semaglutide, based on data from ten randomized controlled trials involving 14,550 participants, in conjunction with several additional studies (14):

• Nausea or vomiting
• Fetus complications
• Abdominal cramping or pain
• Hyposalivation
• Diarrhea
• Hair loss
• Headaches
• Constipation

Thus, the majority of semaglutide side effects appear to be gastrointestinal-related. Gastrointestinal disturbances may be attributed to semaglutide delaying gastric emptying, in conjunction with affecting gastric inhibitory polypeptide levels.

Vomiting

In one PubMed report, a female was diagnosed with hyperemesis gravidarum, experiencing several days of severe vomiting and abdominal cramping (15). The user administered 2 mg of semaglutide on the day of her symptoms transpiring. Such side effects resolved after 6 days of semaglutide discontinuation. The risk of gastrointestinal side effects may increase in pregnant females. Consequently, the FDA warns against such use during pregnancy.

Fetus Complications

Animal studies have also shown that GLP-1 agonists can negatively influence fetal weight (16); however, existing human research regarding semaglutide’s full effects on fetuses is limited.

Abdominal Cramping or Pain

Semaglutide use has been associated with abdominal pain and dyspepsia in research, with a report of a 61-year-old male being diagnosed with gastric pneumatosis following a dosage of 4 mg/week (17).

• A 53-year-old female was also diagnosed with gastroparesis following semaglutide use, with symptoms significantly improving one month after supplement cessation (18). She received a dosage of 0.5 mg/week of semaglutide for 4 months, resulting in weight loss of 40 pounds.
• Chaudhry et al. noted that although gastrointestinal issues have been related to GLP-1 antagonist use, they consider a diagnosis of gastroparesis to be “unusual.”

Hyposalivation

Research has found that semaglutide can cause secondary xerostomia, otherwise known as dry mouth (19). Thus, it appears that the peptide can affect the salivary glands. There have also been instances of semaglutide causing temporary dysgeusia in a 2025 study, and thus it has the potential to affect taste (20).

Diarrhea

One study found 29.7% of semaglutide users experience diarrhea following dosages of 2.4 mg/week (21). This data is based on 803 participants utilizing semaglutide for 68 weeks. In our experience, diarrhea is a less common side effect when administering lower dosages and shorter cycles.

Hair Loss

Semaglutide has been associated with alopecia in medical research, following data collected by the FDA’s adverse event reporting system (22). Significant weight loss can cause hormonal fluctuations, inducing telogen effluvium; hence, this is potentially the mechanism causing some users to experience hair loss on semaglutide.

Headaches

Akhil Shenoy, M.D., states that 15% of Ozempic users experience headaches based on existing studies (23). Dr. Shenoy adds that sulfonylureas stimulating insulin secretion is likely to be the mechanism causing this side effect in some individuals.

Additional research has also shown that GLP-1 agonists can cause hemiplegic migraines (24).

• William P. Shutze, M.D., a specialized vascular surgeon, states that ibuprofen can relieve headache symptoms from semaglutide. However, he advises that individuals inform their physician prior to taking the nonsteroidal anti-inflammatory drug to avoid any potential contraindications.
• Dr. Patricia Weiser, a licensed pharmacist, says that staying hydrated may resolve headache symptoms. She also states that headaches occurring in over 15% of users in New England Journal of Medicine research were only a little more frequent compared to the placebo group (12%).

Constipation

In a randomized controlled trial, participants were over two times more likely to experience constipation compared to the placebo group. Constipation affected 24% of users from a 2.4 mg/week dosage (21).

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Semaglutide Before and After Pictures

• This male Reddit user lost approximately 100 pounds after taking semaglutide for 9 months.
• The user stated that losing the first 60 pounds was “easy,” while the last 40 pounds were notably more difficult.
• The user started at a dosage of 0.5 mg/week, increasing it gradually until reaching a maximum dose of 2.5 mg, which they sustained for the last 6 months of their cycle.

In our experience, these results can be considered above average, which may be attributed to the user’s diligent dieting to lose the last 40 pounds, where they report eliminating sugar and cheese from their diet.

In terms of side effects, the user experienced mild nausea following several injections, which was exacerbated if consuming a large meal near the injection time.

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Semaglutide Results After 10 Months

This female Reddit user lost 63 pounds following 10 months of semaglutide use. They report combining semaglutide injections with a consistent calorie deficit and regular exercise to maximize fat loss. Thus, similar results are unlikely to be attained with a sedentary lifestyle and excess calorie consumption.

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One Month Before and After Photos

This female Reddit user lost 10 pounds after 1 month of semaglutide injections. The user’s dosage during this transformation was 0.25 mg/week, which they plan on increasing for additional results.

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Semaglutide Dosage

In our experience, healthcare providers commonly start patients on a dosage of 0.25 mg/week, increasing as necessary based on how the user responds to the peptide.

The maximum dosage of semaglutide is 2.4 mg/week; however, research indicates that gastrointestinal issues may be more frequent at higher dosages (25).

Based on the before and after pictures previously illustrated in this article, significant weight loss may be experienced even on lower semaglutide dosages if utilized in conjunction with a caloric-deficit diet.

In one study, users lost 29.45% more weight following a 1 mg/week dosage compared to 0.5 mg/week (26). Thus, there is evidence that higher dosages may be more efficacious for inducing lipolysis.

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Semaglutide Reviews

This journey has helped me so much. I started Wegovy in November, and I’ve lost over 40 lbs. Today, I’m finally under 300 lbs. I haven’t seen those numbers in more than 10 years. Yes, I have some of the side effects, but I’m managing. I’ve learned what a proper portion size is. I’ve learned the value of protein. I’m finally comfortable enough to go to the gym, and I’m actually enjoying it!

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Good news: my A1C results are now under control for pre-diabetes!

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I took my first 0.25 mg shot 7 weeks ago, and I have lost 18 pounds since. I am pretty happy with the results; it could go faster, but it’s okay. I have had no major side effects, but sometimes bad breath. I count calories every day; I stay between 1200 and 1400, and I exercise every other day on the treadmill for 15 minutes. Then I lift 3 lb weights for 10 minutes to tone my arms, and I’m trying to drink 100 oz of water a day. I just thought I would share. Good luck to you all.

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1 mg/week felt bad in the beginning. I never had any side effects until then. I mean it subsided after a few weeks, but I had extreme heartburn, nausea, and headaches. I’d randomly feel like I was going to be sick. I only was once, though. But it’s also the first dose that worked for me. I would think it would be worse if I didn’t initially start on lower dosages. Personally, I wouldn’t start on anything over 0.50 mg/week as a beginner. It’s just my opinion; everyone is different.

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I just increased my dose to 1 mg/week after taking 0.5 mg for 3 months. The sick feeling is a lot worse. I took my second shot this week, and it wasn’t as bad as last week. Hoping next week is even better. But yes, you probably shouldn’t start right off the bat on 1 mg.

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Semaglutide Reviews on Social Media

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How to Take Semaglutide

Semaglutide is injected subcutaneously, with the most common sites being the:

• Abdomen
• Thigh
• Back of the upper arm

We advise users to:

1. Clean the injection site with an alcohol swab to reduce the likelihood of infection.
2. Pinch a fatty area in the chosen region.
3. Inject slowly at a 90-degree angle.
4. Ensure the full dose is delivered and gently withdraw the needle.

In our experience, the majority of our patients prefer injecting in the abdomen, due to greater levels of subcutaneous fat being located within 2 inches of the umbilicus, otherwise known as the belly button.

In contrast, we have found that thigh injections may be susceptible to bruising in some individuals due to this being a thicker muscle region with a greater density of blood vessels. Consequently, capillaries are more likely to be damaged at this injection site.

Injection sites also may be rotated to reduce the risk of irritation or lipodystrophy.

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Semaglutide vs. Tirzepatide

Tirzepatide is a dual agonist that targets both the glucose-dependent insulinotropic polypeptide (GIP) and the GLP-1 receptor. Thus, as with semaglutide, tirzepatide causes weight loss by reducing blood sugar levels and increasing satiety. Tirzepatide is FDA-approved for the treatment of:

• Weight management
• Type 2 diabetes
• Obstructive sleep apnea

The brand names for tirzepatide are:

• Mounjaro
• Zepbound

In a clinical study, tirzepatide demonstrated a weight loss advantage of 2.4% after three months compared to the semaglutide group (27). Furthermore, after six and twelve months of treatment, tirzepatide resulted in weight loss differences of 4.3% and 6.9%, respectively.

• In research, tirzepatide and semaglutide are both associated with an increased risk of gastrointestinal side effects, with tirzepatide causing more frequent disturbances (28).
• Semaglutide has been shown to produce more frequent incidences of gallbladder issues compared to tirzepatide, with it being 2.6 times more likely to cause cholelithiasis, demonstrating an increased biliary risk.

Christopher McGowan, M.D., an obesity medicine specialist, states that tirzepatide may be more effective for weight loss due to it having synergistic effects, targeting GLP-1 and GIP receptors.

He adds that during the Surmount-1 trial, 50% of patients lost over 20% of their total weight, compared to 32% of patients losing the same amount of weight from semaglutide in the Step 1 trial.

However, Dr. McGowan warns that comparing the lipolytic effects of each medication based on the results of different studies can cause validity issues due to differing patient populations. Dr. McGowan says he has observed hundreds of successful patient transformations from each medication.

• Both medications cost approximately $1,000 per month in the United States via prescription.
• For individuals purchasing online for research purposes, we find that semaglutide appears to be more widely available, making it a potentially more accessible peptide.

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Semaglutide Alternatives

Berberine

Berberine is a natural isoquinoline alkaloid supplement that can be taken over-the-counter.

Berberine is extracted from plants such as:

• Berberis
• Turmeric
• Golden seal
• Oregon grape

Berberine works via mitochondrial biogenesis regulation and AMP-activated protein kinase (AMP) activation. Consequently, berberine improves insulin sensitivity and enhances fatty acid oxidation similar to semaglutide. Consequently, it has been nicknamed by some as “nature’s Ozempic.”

Research has shown berberine can cause “significant” weight loss in humans (29). However, other studies suggest the results of berberine may be notably less than semaglutide, with participants losing 3.6% of body fat following 12 weeks of berberine supplementation (30). In comparison, semaglutide users lost approximately 6% of body weight for the same duration in a double-blind trial (31).

Diarrhea and constipation have been documented as berberine side effects in a study (32). However, these adverse effects have been described as mild, with PubMed researchers concluding berberine to be a “safe medicinal plant.” Furthermore, “no serious side effects” were reported from berberine use in a study involving 2,569 patients (33).

High-Protein Diet

• One alternative to taking semaglutide could be to adopt a high-protein diet.
• A study conducted in 2005 found that when protein constitutes 30% of total caloric intake, it can lead to a reduction in overall calorie consumption by 441 calories (34).

This increase in satiety mimics the appetite suppressant effects of semaglutide, while a decrease in carbohydrate intake can also lower blood sugar levels.

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Frequently Asked Questions

Is Semaglutide Legal?

Semaglutide is legal in the United States, Canada, Australia, the United Kingdom, and various other countries when accompanied by a physician’s prescription for the treatment of type 2 diabetes or weight management.

Semaglutide also may be purchased or sold for research purposes. However, cosmetic use by the general public without a prescription is prohibited.

What is the Price of Semaglutide?

• In the UK, semaglutide is available via prescription with the National Health Service (NHS), which can cost approximately £120 per month. However, in our experience, most users self-fund their semaglutide use privately due to strict prescription criteria and lengthy waiting lists. Semaglutide can be purchased online for research purposes, costing approximately £100 for a month’s supply.
• In the US, the price of semaglutide can vary based on insurance plans. However, without such coverage, individuals can pay $800–$1,200 per month through a health clinic. Alternatively, semaglutide can be purchased privately from online US companies for research purposes, with a 5 mg bottle costing approximately $175.

Can Semaglutide Cause Pancreatitis ?

A meta-analysis of over 55,000 patients found that GLP-1 agonist medications, such as semaglutide, did not significantly increase the risk of acute pancreatitis (35).

Can Semaglutide Cause Cancer?

Ozempic contains a boxed warning stating that the medication may cause thyroid cancer after rodents developed tumors in clinical research.

However, a PubMed systematic literature review found an incidence of thyroid cancer associated with semaglutide use to be less than 1% (36). The study was based on 7,830 participants. In conclusion, the researchers found no significant risk for thyroid carcinogenesis in humans.

A systematic review involving data on over 45,000 patients was not associated with an increased risk of any cancer from semaglutide when compared to a placebo group (37).

Animal studies have shown semaglutide to possess cytotoxic effects specifically in relation to CD8⁺ T cells, decelerating tumor progression in various cancers, including hepatocellular and breast carcinoma (38).

Additional research has also shown that GLP-1 therapy can increase natural killer (NK) cells. This is a direct effect independent of weight loss and occurs due to enhancements in the CD98-mTOR-glycolysis metabolic axis, a critical signaling pathway for cell survival (39).

What is the Half-Life of Semaglutide?

The half-life of semaglutide is approximately 7 days.

Can Semaglutide Cause Tiredness?

A PubMed study reported a 74-year-old male with progressive fatigue and sarcopenia following semaglutide use (40). Consequently, individuals may experience muscle atrophy, tiredness, and/or fatigue if caloric intake decreases excessively while taking semaglutide.

What Happens if Users Miss a Dose?

Concentrations of the peptide will approximately halve after missing a week of administration. We have not found this to be problematic for the objective of weight management, although results may reduce as semaglutide levels decrease.

If users have type 2 diabetes, they are advised to contact their physician if they miss a dose.

Several of our patients utilizing semaglutide for weight loss purposes have benefited from missing a dose strategically to increase their appetite for special occasions, such as a holiday or birthday meal.

Why Do Some People Not Lose Weight From Semaglutide?

In our experience, semaglutide’s appetite suppressant effects may not cause weight loss in users who are prone to emotional eating and have a tendency to binge-eat when they are not physically hungry.

How Can Individuals Qualify for a Semaglutide Prescription?

• Clinically obese adults with a body mass index (BMI) of 30 or higher
• Overweight adults with a BMI of 27 or higher who also have been diagnosed with hypertension, hyperlipidemia, or type 2 diabetes.
• For children, they must be at least 12 years old with a BMI at or above the 95th percentile for their age and sex.

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Semaglutide Pros and Cons

Pros:

• Can produce significant long-term weight loss outcomes
• Stabilizes blood sugar levels
• Can be purchased online without a prescription for research purposes
• Generally well tolerated in research

Cons:

• Gastrointestinal side effects are commonly reported.
• Has been described as “not economically attractive” by the Canadian Journal of Cardiology (41)
• Only approved for type 2 diabetic and obese patients

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