What Is Semaglutide?
Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist - a synthetic peptide that mimics the action of the naturally occurring hormone GLP-1 in the body. It was originally developed for the treatment of type 2 diabetes and has since been studied for weight management.
The compounded form of semaglutide is available through state-licensed pharmacies, including 503A compounding pharmacies, under U.S.-licensed physician prescription. Compounded medications are not FDA-approved. The FDA does not review compounded drugs for safety, effectiveness or quality before they reach patients. A compounded preparation is not a generic version of, and is not the same as, any FDA-approved medication. It is prescribed only when a licensed provider decides it is appropriate for you.
Obesity is a chronic metabolic disease that affects over 40% of American adults. Where semaglutide is prescribed for weight management, it is meant to be used alongside changes to diet and physical activity, never as a standalone solution.
How Semaglutide Works
Semaglutide belongs to the GLP-1 receptor agonist drug class. In published clinical trials, GLP-1 receptor agonists were studied for how they act on GLP-1 receptors in the body: on appetite regulation centers in the brain, particularly the hypothalamus; on gastric emptying, meaning how long food stays in the stomach; and on glucose-dependent insulin secretion and glucagon release in the pancreas. Those trials studied the manufacturers' products, which are FDA-approved. The compounded preparations were not studied in these trials, and results are not guaranteed.
Semaglutide carries a fatty acid chain that binds to albumin in the blood, extending its half-life to approximately one week, which is why it is dosed once a week.
What the Published Research Studied
Research note
Semaglutide has been studied for weight management in the STEP (Semaglutide Treatment Effect in People with Obesity) clinical trial program, a series of large randomized, double-blind, placebo-controlled trials published in peer-reviewed journals, including the New England Journal of Medicine. Those trials studied the manufacturers' products, which are FDA-approved. The compounded preparations were not studied in these trials, and results are not guaranteed.
Because of that, this page does not quote trial weight-loss figures as something you can expect. Results vary from person to person. Your physician discusses realistic expectations with you at consultation, based on your starting point, medical history and treatment plan.
Other Areas of Research
Published research on GLP-1 receptor agonists has also looked at blood pressure, cholesterol, inflammatory markers and blood-sugar control, and the SELECT trial looked at cardiovascular events in adults with overweight or obesity. Those trials studied the manufacturers' products, which are FDA-approved. The compounded preparations were not studied in these trials, and results are not guaranteed.
Patient-reported outcomes during treatment often include changes in energy, sleep quality, and self-reported well-being. These reports are subjective and individual; outcomes cannot be guaranteed.
Emerging research is exploring potential applications of GLP-1 receptor agonists across additional metabolic and non-metabolic indications. These applications are under investigation.
Side Effects and Considerations
Safety note
The most common side effects of semaglutide are gastrointestinal in nature. Nausea is reported by approximately 40-45% of patients in clinical trials, though it is typically mild to moderate and tends to improve after the first few weeks of treatment. Other GI side effects include diarrhea, constipation, vomiting, and abdominal discomfort. The gradual dose escalation protocol is specifically designed to minimize these effects.
Less common side effects include headache, fatigue, dizziness, and injection site reactions. Rare but serious potential risks include pancreatitis, gallbladder disease (including gallstones), and potential thyroid effects. In animal studies, semaglutide was associated with thyroid C-cell tumors, leading to a boxed warning against use in patients with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2.
Semaglutide is contraindicated in patients with a history of medullary thyroid carcinoma, MEN2 syndrome, known hypersensitivity to semaglutide, and during pregnancy. Patients with a history of pancreatitis, gallbladder disease, or severe gastrointestinal conditions should discuss risks with their physician. Discuss your medical history and the risks of semaglutide with your physician.
Who Should Consider Semaglutide?
Semaglutide for weight management is appropriate for adults with a BMI of 30 or greater (obesity) or a BMI of 27 or greater (overweight) with at least one weight-related comorbidity such as type 2 diabetes, high blood pressure, high cholesterol, or obstructive sleep apnea. It is intended for use in conjunction with a reduced-calorie diet and increased physical activity - not as a standalone solution.
Ideal candidates are individuals who have attempted to lose weight through lifestyle modifications alone without achieving adequate results. Semaglutide is not intended for cosmetic weight loss in individuals at a healthy weight. It is a medical treatment for a chronic metabolic condition, and appropriate patient selection is essential for both safety and efficacy.
At The Pep Club, your physician will evaluate your BMI, medical history, current medications, and weight management goals during your consultation. If semaglutide is appropriate, you will receive a prescription, comprehensive dosing instructions, and dietary guidance.
Frequently asked
How much weight can I expect to lose with semaglutide?
Results vary from person to person, and results are not guaranteed. Your clinician discusses realistic expectations with you at consultation, based on your starting point, medical history and treatment plan. Published clinical trials were conducted on FDA-approved products, not on compounded preparations.
How is compounded semaglutide regulated?
Compounded medications are not FDA-approved. The FDA does not review compounded drugs for safety, effectiveness or quality before they reach patients. A compounded preparation is not a generic version of, and is not the same as, any FDA-approved medication. It is prescribed only when a licensed provider decides it is appropriate for you. Compounded semaglutide is prepared for an individual prescription by state-licensed pharmacies, including 503A compounding pharmacies.
Will I gain the weight back if I stop semaglutide?
Published clinical trials have reported that weight regain is common after stopping GLP-1 therapy, because obesity is a chronic metabolic condition, not a temporary problem. Those trials studied the manufacturers' products, which are FDA-approved. The compounded preparations were not studied in these trials, and results are not guaranteed. Continued treatment, gradual dose reduction and transition strategies are options a clinician may consider.
Can I take semaglutide if I have type 2 diabetes?
Semaglutide was originally developed for type 2 diabetes, and your physician decides whether it is appropriate for you. Dosing and monitoring protocols may differ. Tell the clinician reviewing your request about every diabetes medication you take, and keep your endocrinologist or primary care doctor informed.