Semaglutide before and after 1 month
Curious about semaglutide's effectiveness and how fast you should see results? Witness the incredible weight loss changes possible in just one month!
Key highlights
- Semaglutide is a GLP-1 agonist that promotes weight loss by suppressing appetite and reducing food intake.
- In the first week of semaglutide treatment, you may experience reduced food noise, fewer cravings, improved blood sugar control, slight weight changes, and mild gastrointestinal side effects (nausea, constipation, diarrhea).
- Side effects can be managed by escalating the dose gradually and maintaining a healthy diet.
- Dosing starts at 0.25 mg once weekly for 4 weeks and gradually increases to 1.7 mg 2.4 mg once weekly.
- In weeks 2-3, you can expect weight loss of 1-2 lbs per week (2-4 lbs in the first month) and improved glycemic control.
- In week 4, you will notice significant appetite suppression, weight changes (due to loss of fat mass), less bloating, and elevated energy levels.
Semaglutide is a GLP-1 receptor agonist marketed with three brand names: Ozempic, Wegovy, and Rybelsus. Wegovy is FDA-approved for chronic weight management, and Ozempic and Rybelsus are approved for adults with type 2 diabetes. Recently, Ozempic was approved by the U.S. Food and Drug Administration (FDA) for reducing the risk of cardiovascular problems and worsening kidney disease in patients with chronic kidney disease and type 2 diabetes. Ozempic is also used off-label for weight management.
Semaglutide mimics the action of the natural hormone GLP-1 to suppress appetite which promotes weight loss and metabolic health. Keep in mind that semaglutide is not a quick fix for weight management. The medication works gradually and early changes are subtle but meaningful as the medication is working in your body even if you haven’t yet started to lose significant weight.
We’ll detail the week-by-week progress on semaglutide including expectations for weight loss in the first month so you can set realistic expectations and explain why some see faster results than others on their weight loss journey.
What is semaglutide and how does it work?
Manufactured by Novo Nordisk, semaglutide works as a GLP-1 receptor agonist, mimicking the effects of a natural hormone, glucagon-like peptide-1, that regulates appetite and blood sugar after food intake. The active ingredient semaglutide has 94% structural similarity to the naturally occurring GLP-1 hormone. Semaglutide occupies its receptors in the brain to suppress appetite and promote a feeling of fullness.
When combined with increased physical activity and a low-calorie diet, semaglutide (Wegovy) is indicated for weight management in patients with:
- Obesity (BMI of 30 kg/m² or higher)
- Overweight (BMI of 27 kg/m² or higher) with at least one weight-related health condition such as high cholesterol levels, hypertension (high blood pressure), heart disease, and type 2 diabetes
Mechanism of action
Semaglutide is a GLP-1 agonist that slows digestion, reduces appetite, and stabilizes blood sugar by working in the following ways:
- It mimics the action of glucagon-like peptide-1 in the lateral hypothalamus (hunger control centre), which suppresses appetite and gives you a feeling of satiety.
- The medication promotes insulin release from the beta cells of the pancreas, which promotes blood sugar control.
- Semaglutide decreases the production of glucagon from alpha cells of the pancreas. Glucagon increases blood sugar levels. Reduced glucagon production lowers blood glucose levels.
- It slows down the rate at which your stomach empties and food moves into the small intestine by relaxing stomach muscles. It gives you a feeling of fullness for a longer time. You feel full earlier than usual and experience fewer food cravings.
Typical dosage schedule
Semaglutide injection dosage starts at 0.25 mg once weekly administered subcutaneously (under the skin) of the stomach, thigh or upper arm for the first 4 weeks. If tolerated, the dosage is titrated every 4 weeks until you reach the maintenance dosage. The semaglutide injection dosage schedule is as follows:
Starting dose
- Weeks 1-4: 0.25 mg once weekly
Titration schedule
- Weeks 5-8: 0.5 mg once weekly
- Weeks 9-12: Your prescriber will escalate the dosage to 1 mg once weekly
- Weeks 13-16: If tolerated, your dosage will be increased to 1.7 mg once weekly
- Weeks 17-onwards: If the dosage needs to be escalated further, your prescriber will increase the dosage to 2.4 mg once weekly
- If you experience side effects, the dose escalation is delayed for another 4 weeks as your prescriber assesses your condition and adjusts the dosage accordingly
Maintenance dose
- 1.7 mg or 2.4 mg once weekly
Maximum dose
- 2.4 mg once weekly
Key benefits
- Weight loss: A clinical study demonstrates that 2.4 mg of semaglutide once weekly reduced 10-15 kg (or 10-15%) of body weight when combined with exercise and a reduced calorie diet over 68 weeks. In contrast, the placebo group lost only 3-4 kg (or 3-4%) of body weight. In addition, 70-80% of participants taking semaglutide lost 5% or more of their weight.
- Cardiovascular risk: The study also showed that semaglutide reduces the risk of cardiovascular events in obese and overweight patients by 20% compared to the placebo.
- Appetite suppression: Semaglutide suppresses appetite, reduces food cravings, and slows gastric emptying to promote weight loss. Moreover, the medication decreases the users’ inclination towards fatty, savoury, and palatable foods. They become less interested in high-calorie foods such as sugary snacks, carbonated drinks, sodas, and fried and processed foods.
- Blood sugar control: Clinical trials show that about 66% of patients taking semaglutide achieved significant blood sugar control (HbA1c below 7%) compared to a lower percentage in the placebo group, demonstrating its effectiveness in effectively managing blood sugar levels in people with type 2 diabetes.
Research studies show that semaglutide promotes adipose tissue browning (converts white adipose tissues into brown adipose tissues). White adipose tissues store extra fats and cause disfigurement of the body in obese patients. In contrast, brown adipose tissues burn triglycerides and produce free fatty acids to generate body heat. This phenomenon reshapes your body to prevent disfigurement due to obesity and burns extra fats to promote weight loss.
Semaglutide effectiveness for weight loss
Many clinical trials have been conducted to review the effectiveness of semaglutide for weight loss. These trials involved participants with obesity (BMI 30 kg/m² or greater) and overweight (BMI 27 kg/m² or greater) who committed to persistent lifestyle modifications. The results of these studies are as follows:
| Clinical trials | Time on semaglutide | Amount of weight loss |
|---|---|---|
| STEP 1 | 68 weeks | 14.9% weight loss vs 2.4% with placebo |
| STEP 2 | 68 weeks | 9.6% weight loss vs 3.4% with placebo |
| STEP 3 | 68 weeks | 16% weight loss vs 5.7% with placebo |
| STEP 4 | 68 weeks | 7.9% weight loss after 20 weeks of semaglutide use Users who switched to placebo gained 6.9% over 48 weeks |
| STEP 5 | 96 weeks | 77% of semaglutide users lost at least 5% of their body weight vs. 34% with placebo |
| STEP 6 | 68 weeks | 13.2% weight loss with 2.4 mg 19.6% with 1.7 mg |
| STEP 8 | 68 weeks | 15.8% weight loss with semaglutide 6.4% weight loss with liraglutide |
| STEP UP Phase 3B | 72 weeks | 20.7% weight loss with 7.2 mg 17.5% weight loss with 2.4 mg |
| Mayo Clinic Study | 28 weeks | 7% weight loss on 1 mg 9.6% weight loss on 2.4 mg |
Weight loss with semaglutide occurs gradually over time and sustainable weight loss requires patience. As demonstrated in clinical trials, significant weight loss is typically seen over 28-68 weeks.
You will start semaglutide at a low dose and increase it gradually, depending on your body’s response and tolerance to side effects. However, many people experience a significant reduction in appetite within 1-4 weeks. According to the STEP 1 clinical trial, participants who were using semaglutide showed greater weight loss at week 4 than those on the placebo.
During the first month, you may also experience a few common side effects, such as nausea, abdominal discomfort, vomiting, and diarrhea. These side effects are usually mild and subside with time when you practice lifestyle modifications. If you experience severe side effects that do not subside, speak with your healthcare provider.
Some individuals also report increased energy levels as they start losing weight. A healthy lifestyle, increased physical activity, and a balanced diet might make you feel more energetic.
Semaglutide before and after: What to expect after 1 month on semaglutide
After 1 month on semaglutide, you will experience the following changes:
| Weeks | What to expect |
|---|---|
| Week 1 | Reduced food noise, slight (2-4 lbs), mild side effects such as nausea, vomiting, and diarrhea |
| Week 2 | Average weight loss of 1-2 lbs per week, appetite suppression |
| Week 3 | Average weight loss of 1-2 lbs per week, non-scale victories such as smaller portions, decreased inclinations towards savoury and palatable foods, and fewer cravings. |
| Week 4 | Improvement in blood sugar levels and glycated hemoglobin, loss of fat mass, less bloating, high energy levels |
Week 1: Initial side effects and adjustments
During the first week, you may experience reduced food noise (a feeling when your thoughts and actions revolve around eating food) and it’s possible that you might start losing weight (1-2 lbs). You may also experience mild nausea, vomiting, or diarrhea.
Week 2-3: Appetite suppression kicks in
During weeks 2-3, you may experience an average weight loss of 1-2 lbs/week. You will also observe non-scale victories such as smaller portions, decreased inclinations towards savory and palatable foods, and fewer cravings.
Week 4: Metabolic shifts
In week 4, you may notice an improvement in blood sugar levels and glycated hemoglobin. Your body starts to lose fat mass and preserve muscle mass and water weight. It means you will lose weight by shedding extra fats without affecting muscle mass and water content in the body. You may also experience less bloating and high energy levels as your body starts to adapt to these changes.
First month changes
You should notice an overall weight loss of 2-4 lbs, improved eating patterns and positive changes in body composition.
Factors influencing weight loss results after 1 month on semaglutide
Several factors influence how well an individual responds to semaglutide for weight loss. Medication adherence, including taking your weekly dosage consistently on the same day and using the correct dosage, plays a vital role.
Individual response varies by person. Genetics and metabolism can also influence how the body processes the medication. The following factors can also influence weight loss results when using semaglutide:
- Dosage: Semaglutide shows greater weight loss at high doses. A clinical trial on semaglutide shows that patients taking higher doses of semaglutide (1.7 mg and 2.4 mg once weekly) showed an average weight loss of 6.9% after 3 months. In comparison, lower doses (0.25 mg, 0.5 mg, and 1 mg) demonstrated a weight loss of 5.9% of body weight after 3 months. After 6 months, weight loss was 12.1% and 9.2% respectively. Stay patient as weight loss will improve over time.
- Individual metabolism: People with faster metabolism tend to metabolize semaglutide faster than others. They might need a higher dose of semaglutide to experience significant results. In contrast, patients with slow metabolism experience appetite suppression with semaglutide for longer.
- Gender: Clinical trials show that women generally lose more weight than men on semaglutide. While not fully understood, this can be due to factors relating to gender differences in hormones, body composition, and drug metabolism.
- Age: Older adults may experience slightly less weight loss with semaglutide compared to young adults due to age-related changes in metabolism, hormone levels, and body composition. However, semaglutide can still be an effective weight loss medication for adults, especially when combined with a healthy diet and exercise.
- Lifestyle factors: Semaglutide is FDA-approved for weight loss and type 2 diabetes, only when combined with exercise, increased physical activity, and a reduced-calorie diet. People who follow these healthy lifestyle modifications tend to lose weight faster than those with a sedentary lifestyle.
- Other medications: Some medications such as ritodrine, furosemide, and thiazide diuretics lower the effectiveness of semaglutide. You may not experience significant results if you are using these medications. Moreover, antidiabetic drugs such as insulin and sulfonylureas, antidepressants, and diuretics also influence the effect of semaglutide.
Tips for maximizing semaglutide results
Follow these tips to get maximum results with semaglutide to achieve and maintain a healthy weight:
- Take semaglutide exactly as prescribed. Do not take a lower or higher than recommended dosage. Semaglutide has a dosage schedule, you should follow it as prescribed to get optimal results.
- Get a personalized diet plan from a dietician to ensure you take a balanced and nutritious diet that supports weight loss, with an emphasis on high-protein meals to preserve muscle mass.
- To prevent constipation, add more dietary fibers to your diet.
- Eat in smaller portions to prevent nausea associated with semaglutide treatment.
- Take regular exercise and stay active to complement the effect of semaglutide. You can try light cardio, yoga, and strength training.
- Anxiety and stress can lead to emotional or stress eating, which may nullify the effect of semaglutide. Practice mindfulness, breathing exercises, and meditation to lower stress levels. Sleep for at least 7-8 hours at night as lack of sleep can also trigger stress.
- Track non-scale wins such as elevated energy levels, improvement in blood sugar levels, and changes in your clothes fitting to observe the impact of semaglutide.
- Stay in touch with your healthcare provider for continuous support and monitoring while you are on semaglutide treatment.
Having realistic expectations for semaglutide
Semaglutide is not a quick fix for obesity. The medication takes time to cause significant weight loss and improve blood sugar levels.
You can expect these changes in appetite, weight, and blood sugar levels over one month:
| Time after starting | Appetite | Weight loss | Glycemic control | Side effects |
|---|---|---|---|---|
| 1-2 hours | No effect | No effect | Improvement | Mild nausea and abdominal discomfort |
| 1-2 days | A slight reduction in hunger | No effect | Improvement | Nausea, bloating, constipation |
| Week 1 | Feeling fuller faster, reduced cravings | Slight weight loss (2-4 lbs) | Improvement | Nausea, bloating, constipation |
| Weeks 2-3 | Hunger reduces more | Weight loss (1-2 lbs) pr week may start | Major improvement | Side effects reduce |
| Week 4 | Appetite suppression greatly improves | Weight loss becomes steady, loss of fat mass, improveed energy levels | Blood sugar becomes well-controlled | Side effects become mild or unnoticeable |
What to expect after 1 month?
After one month on semaglutide, you may expect significant appetite suppression, controlled blood sugar levels, loss of fat mass, and weight changes.
Regular follow-ups with your healthcare provider are essential for ongoing monitoring and ensuring you stay on track with your weight loss goals. Depending on your response and progress, your provider may need to adjust the dosage of your medication.
Based on clinical trials and user reviews, you should expect to lose about 10% of your body weight at 6 months and 15% of your body weight at 1 year.
The effects of semaglutide may vary among individuals depending on dosage, lifestyle, food choices, and metabolism. If you do not experience significant results, consult with your healthcare provider for further assistance. They may adjust the dosage or change your prescription to another weight loss drug such as Zepbound (tirzepatide) which showed superior weight loss results in a head-to-head trial with semaglutide.
Semaglutide side effects
Common side effects of semaglutide are gastrointestinal-related and include:
- Nausea (44%)
- Diarrhea (30%)
- Vomiting (24%)
- Constipation (24%)
- Abdominal pain (20%)
- Headache (14%)
- Fatigue (11%)
Serious side effects of semaglutide are inflammation of the pancreas (pancreatitis), gallbladder issues, changes in vision (diabetic retinopathy), suicidal ideation, low blood sugar levels (hypoglycemia) and hypersensitivity or allergic reaction to semaglutide.
Semaglutide is not recommended for patients with a history of thyroid tumors (medullary thyroid cancer) and endocrine tumors such as MEN 2 syndrome (multiple endocrine neoplasia type 2 syndrome). Additionally, semaglutide is not safe for pregnant and lactating females and children.
How to manage the side effects
Common side effects of semaglutide are usually mild and subside over time. These include nausea, vomiting, diarrhea, and constipation.
If you encounter nausea and vomiting, eat frequently but in smaller portions. In case of diarrhea, keep yourself hydrated and consult your dietician for dietary modifications.
Eat fiber-rich foods and drink adequate water to prevent constipation. You might need to change your meal timing if you experience abdominal pain. In case of bloating, take regular exercise. Do not sleep immediately after having meals.
Frequently asked questions
How much weight can I expect to lose in the first month?
You may lose 2-4 lbs after the first month if you take the medication as prescribed and follow dietary modifications and lifestyle changes. According to a STEP 1 clinical trial, most patients lost 3.8% of their body weight in the first month on 2.4 mg of semaglutide, when combined with increased physical activity and a reduced calorie diet.
Will I see results in the first week?
You may experience reduced food noise or cravings, improvement in blood sugar levels, slight weight changes, and mild side effects in the first week.
What if I don’t see any changes after a month?
If you do not experience any weight changes after a month, find out the reason behind it. You may not be following your diet plan or not exercising regularly. If you don’t see any changes despite following lifestyle changes, it is also normal in the first month as the medication takes time to cause significant weight loss. Consult your healthcare provider and they may adjust the dosage of the medication or switch to another weight loss medication.
Is semaglutide safe for rapid weight loss?
No, semaglutide does not cause rapid weight loss. You can expect a weight reduction of 1-2 lbs/week with semaglutide.
Why am I not losing weight?
If you are not losing weight on semaglutide, the following reasons may explain why:
- You might not be taking an adequate dose of semaglutide.
- You are not following a diet plan that complements the effect of semaglutide.
- Your eating habits do not comply with the treatment plan.
- You have a sedentary lifestyle and you have not increased your physical activity.
- You might be taking medications that lower the effectiveness of semaglutide such as antidepressants and diuretics.
- Stress, anxiety, and inadequate sleep can also lead to stress eating, which can lead to weight gain.
Can I drink alcohol?
Alcohol can worsen nausea and vomiting when you are on semaglutide treatment. Although the manufacturer does not specifically state that you cannot drink alcohol with the medication, It is better to avoid alcohol intake during your treatment.
Bottom line
Semaglutide has the potential to achieve significant weight loss within the first month, as evidenced by clinical trials and real user reviews of the medication. You can expect improved blood sugar control, significant weight changes, loss of fat mass, increased energy levels, and reduced appetite after 1 month on semaglutide.
Remember, you must combine semaglutide with healthy lifestyle changes such as dietary modifications and increased physical activity for sustainable long-term results. There is no quick fix for weight loss and persistence is the key to success. Strictly adhere to the semaglutide dosing schedule provided by your healthcare provider for optimal results.
If you plan to start your weight loss treatment with semaglutide, consult with your healthcare provider first. They will assess your blood sugar levels, body mass index, HbA1c, and vital stats to see if semaglutide treatment is right for you. Never start the treatment by yourself as these medications have known side effects that need to be monitored continuously by healthcare professionals.
