SemaglutideDosage Chart & Reconstitution Calculator for Weight Loss
FoxAI semaglutide reconstitution and dosage calculator
FoxAI will help you calculate ideal BAC water volume (mL) and exact syringe units. You will need:
- Semaglutide Vial Size (mg)
- Desired Semaglutide Dose (mg or mcg)
How do you calculate semaglutide dosage and BAC water volume?
Semaglutide dosing starts with the weekly milligram dose, then converts that dose into milliliters and U-100 syringe units based on vial concentration. The labeled Wegovy weight-loss ladder is 0.25 -> 0.5 -> 1.0 -> 1.7 -> 2.4 mg weekly, holding each step for at least 4 weeks. The 0.25 mg dose is a starter/tolerance dose. The clearest practical lower-dose maintenance band is 0.5-1.0 mg weekly; 0.25 mg is better framed as a starter, taper floor, or cautious restart rather than a tested long-term maintenance dose.
The draw formula is: concentration = vial mg / BAC water mL, then volume to draw = target dose mg / concentration. On a U-100 syringe, 1 mL = 100 units. Example: a 10 mg vial mixed with 2 mL BAC water is 5 mg/mL. A 0.25 mg dose draws 0.05 mL, or 5 units. A 1 mg dose draws 0.2 mL, or 20 units.
Semaglutide Dosage Chart
Semaglutide is the once-weekly GLP-1 drug behind Ozempic and Wegovy. It usually produces less weight loss than tirzepatide, but it has a longer safety record and more published outcomes data: heart-event reduction in SELECT, kidney protection in FLOW, and years of diabetes-trial exposure. The dosing decision depends on the job: weight loss, blood-sugar control, cardiovascular-risk reduction, maintenance, or accurate vial-based dosing.
| Dose band | Weekly dose | Practical read | Evidence boundary |
|---|---|---|---|
| Sub-label microdose | 0.1-0.2 mg | Low-exposure experiment, usually for cautious tolerance testing or step-down | No weekly injection trial below 0.25 mg; inferred from drug-level behavior and daily-injection phase 2 data¹³ |
| Starter dose | 0.25 mg | First 4 weeks of the label ladder; mostly GI adaptation | Label and trial protocol; not a chronic weight-loss endpoint |
| First maintained dose | 0.5 mg | Standard Ozempic maintenance dose; first broadly characterized chronic dose | SUSTAIN diabetes trials |
| Lower active dose | 1.0 mg | Best supported dose below the obesity ceiling | STEP-2: about 73% of the 2.4 mg effect in type 2 diabetes + obesity¹⁰ |
| Bridge step | 1.7 mg | Wegovy escalation step on the way to the top dose | Label and STEP program; less often the destination |
| Full obesity dose | 2.4 mg | Wegovy trial dose and SELECT cardiovascular-outcomes dose | STEP-1 / STEP-5 / SELECT¹ ³ |
| Above label | >2.4 mg | No prospective semaglutide evidence | Do not exceed the trial-tested ceiling |
For maintenance, 0.25 mg can be useful as a starter, taper floor, or cautious restart, but it should not be treated as a tested long-term maintenance dose. The more defensible low-dose maintenance band is 0.5-1.0 mg weekly, because 0.5 mg has years of use in diabetes trials and 1.0 mg has direct dose-comparison evidence.¹⁰ ¹¹
Semaglutide has one dosing wrinkle that deserves more attention: body weight changes drug exposure. Drug-level data show a 55 kg user has about 40% higher exposure than an 85 kg reference user at the same dose, while a 127 kg user has about 27% lower exposure.¹² That does not mean dose should be chosen by weight alone, but it explains why lighter users can feel "overdosed" on low steps and heavier users can feel little at the starter dose.
Wegovy and Ozempic Dose Schedule
The Wegovy weight-loss ladder is 0.25 -> 0.5 -> 1.0 -> 1.7 -> 2.4 mg weekly. Each step is normally held for at least 4 weeks because semaglutide takes several weeks to settle at a new exposure level. Its half-life is about 7 days, and full washout after the last dose takes about 5 weeks.⁷
| Weeks | Wegovy dose | What it means |
|---|---|---|
| 1-4 | 0.25 mg weekly | Starter and tolerance dose; minimal weight change is normal |
| 5-8 | 0.5 mg weekly | First broadly characterized chronic dose |
| 9-12 | 1.0 mg weekly | Lower active step; about 73% of the 2.4 mg effect in STEP-2 type 2 diabetes + obesity¹⁰ |
| 13-16 | 1.7 mg weekly | Escalation step toward the full obesity dose |
| 17+ | 2.4 mg weekly | Full Wegovy obesity dose and SELECT cardiovascular-outcomes dose¹ ³ |
Ozempic uses a related but different type 2 diabetes ladder: 0.25 -> 0.5 -> 1.0 -> 2.0 mg weekly. The 2.0 mg Ozempic dose is a blood-sugar-control ceiling, not the Wegovy obesity ceiling. In SUSTAIN-FORTE, 2.0 mg added about 0.23 percentage points of HbA1c reduction and about 0.93 kg of weight loss beyond 1.0 mg in type 2 diabetes.¹¹ That is real, but incremental.
Do not escalate through unresolved side effects. If nausea, vomiting, constipation, reflux, or food aversion from the prior step has not settled, hold the dose. Most semaglutide discontinuation happens during titration, not after someone has stabilized at a tolerated maintenance dose.¹
What Semaglutide Actually Delivers
STEP-1 is the main non-diabetic obesity anchor. At 2.4 mg weekly, semaglutide produced about 15-17% body-weight loss over 68 weeks depending on analysis set, with a strong responder tail: 86.4% reached at least 5% loss, 69.1% reached at least 10%, 50.5% reached at least 15%, and 32.0% reached at least 20%.¹
| Evidence lens | Semaglutide result | Practical meaning |
|---|---|---|
| STEP-1 non-diabetic obesity | About -15.6% in-trial at 68 weeks | Main Wegovy weight-loss anchor¹ |
| STEP-2 type 2 diabetes + obesity | -7.2% at 1.0 mg vs -9.9% at 2.4 mg | Weight loss is smaller in type 2 diabetes; 1.0 mg still carries most of the 2.4 mg effect¹⁰ |
| STEP-1 body-composition scan | About 62:38 fat-to-lean loss | Semaglutide works, but the fat-to-lean split is less favorable than tirzepatide's non-diabetic scan data⁵ |
| SELECT heart-outcomes trial | 20% fewer major heart events at 2.4 mg in established cardiovascular disease + BMI >=27, no diabetes | Cardiovascular benefit is real, but this is secondary prevention, not a general primary-prevention claim³ |
| FLOW kidney-outcomes trial | 24% lower kidney-outcome risk at 1.0 mg in type 2 diabetes + chronic kidney disease | Kidney-outcomes evidence belongs to that specific population, not general obesity¹⁴ |
| Le Roux 2026 routine-care data | -8.83% adjusted 6-month loss in real-world non-diabetic semaglutide users | Real-world mixed-dose outcomes sit below long STEP-1 duration and reflect access, titration, and adherence¹⁵ |
In the direct head-to-head obesity trial, tirzepatide produced greater weight loss than semaglutide at maximum dose: 20.2% vs 13.7% at 72 weeks.² The body-composition comparison also favors tirzepatide in non-diabetic obesity, roughly 75:25 fat-to-lean for tirzepatide versus about 62:38 for semaglutide.⁵ Semaglutide's case is different: longer outcomes data, access, simpler GLP-1-only signaling, and oral Rybelsus as an option.
Where Semaglutide Still Makes Sense
Semaglutide can still fit well when the goal is not maximum weight loss.
| Use case | Why semaglutide can make sense |
|---|---|
| Established cardiovascular disease + BMI >=27 | SELECT measured a 20% reduction in major adverse cardiovascular events at 2.4 mg³ |
| Type 2 diabetes + chronic kidney disease | FLOW measured kidney-outcomes benefit at 1.0 mg in that specific population¹⁴ |
| Type 2 diabetes glucose control | Ozempic and Rybelsus have years of blood-sugar and safety data |
| Access or insurance | Semaglutide may be the covered or available option |
| GLP-1-only preference | No GIP arm and no glucagon arm; simpler mechanism and long safety record |
| Oral route | Rybelsus exists, though its exposure is lower and dosing conditions are strict |
For pure obesity weight loss, body-composition preservation, or high-starting-weight cases that need more than the typical 15% STEP-class result, tirzepatide is usually the next comparison.
Compounded Semaglutide and Reconstitution
Branded Ozempic and Wegovy pens hide the math. A 0.5 mg pen delivers 0.5 mg. Vial-based semaglutide is different: the vial contains a fixed number of milligrams, and the BAC water volume sets concentration. The total amount of drug does not change. Only the draw volume changes.
Product access and compounding rules change. The FDA's current position is that the semaglutide shortage has been resolved, and FDA has also proposed excluding semaglutide from the 503B bulks list.¹⁶ ¹⁷ Do not assume a vial-based product is legal, available, or clinically appropriate just because the math is possible. If vial-based dosing is being used under clinician supervision, verify source, sterility, concentration, and current rules first.
The arithmetic is simple:
Concentration (mg/mL) = total vial amount (mg) / BAC water added (mL)
Volume to draw (mL) = target dose (mg) / concentration (mg/mL)
U-100 units = volume (mL) x 100
Worked example: 10 mg vial, 2 mL BAC water
- Total vial: 10 mg
- BAC water added: 2 mL
- Concentration: 10 mg / 2 mL = 5 mg/mL
- Starting dose: 0.25 mg
- Draw volume: 0.25 mg / 5 mg/mL = 0.05 mL
- U-100 syringe units: 0.05 mL x 100 = 5 units
At the same concentration, 1.0 mg draws 0.2 mL, or 20 units. The 2.4 mg Wegovy dose draws 0.48 mL, or 48 units.
Reconstituting Semaglutide With BAC Water
Reconstitution means adding bacteriostatic water to dry semaglutide powder so the dose can be drawn accurately. More water makes the solution more dilute and the injection volume larger. Less water makes the solution more concentrated and the draw smaller. Neither changes the milligrams delivered.
New to reconstitution? The PeptideFox reconstitution guide covers sterile technique, storage, and common handling mistakes.
How to reconstitute semaglutide
- Wipe the peptide vial stopper and BAC water stopper with alcohol.
- Draw the chosen BAC water volume into a sterile syringe.
- Aim the water down the inside glass wall of the vial, not directly onto the powder.
- Swirl gently until dissolved. Do not shake.
- Refrigerate the reconstituted vial at 2-8°C between draws.
- Use a fresh sterile syringe for each draw.
- Discard if the solution becomes cloudy, discolored, or visibly particulate.
Reconstitution chart by vial size
| Vial | Example BAC water | Concentration | 0.25 mg draw | 1.0 mg draw | 2.4 mg draw |
|---|---|---|---|---|---|
| 2 mg | 1 mL | 2 mg/mL | 0.125 mL (13 units) | 0.5 mL (50 units) | Exceeds vial |
| 3 mg | 1.5 mL | 2 mg/mL | 0.125 mL (13 units) | 0.5 mL (50 units) | Exceeds vial |
| 5 mg | 2 mL | 2.5 mg/mL | 0.1 mL (10 units) | 0.4 mL (40 units) | 0.96 mL (96 units) |
| 10 mg | 2 mL | 5 mg/mL | 0.05 mL (5 units) | 0.2 mL (20 units) | 0.48 mL (48 units) |
| 15 mg | 3 mL | 5 mg/mL | 0.05 mL (5 units) | 0.2 mL (20 units) | 0.48 mL (48 units) |
| 20 mg | 2.5 mL | 8 mg/mL | 0.031 mL (3 units) | 0.125 mL (13 units) | 0.3 mL (30 units) |
| 30 mg | 3 mL | 10 mg/mL | 0.025 mL (3 units) | 0.1 mL (10 units) | 0.24 mL (24 units) |
Match vial size to dose and realistic use time. At 0.25-0.5 mg weekly, very large vials create tiny draws and long post-reconstitution timelines. At 1.7-2.4 mg weekly, small vials run out quickly. Reconstituted-use windows depend on product, sterility, and pharmacy instructions; when in doubt, use the shortest labeled or pharmacy-provided window.
Semaglutide Maintenance Dose After Weight Loss
The clearest lower-dose maintenance band is 0.5-1.0 mg weekly. The 0.5 mg dose has years of use in the SUSTAIN diabetes trials. The 1.0 mg dose has direct STEP-2 dose-comparison evidence and retains about 73% of the 2.4 mg effect in type 2 diabetes + obesity.¹⁰ ¹¹
The clearest evidence is not "microdose forever." It is "continued treatment prevents regain better than stopping." STEP-4 showed continued 2.4 mg treatment maintained and extended weight loss after the run-in, while placebo-switch produced regain.⁴ The STEP-1 extension showed about two-thirds of lost weight returned within 52 weeks after stopping semaglutide.⁶
| Maintenance path | Dose | Evidence read |
|---|---|---|
| Continue full dose | 2.4 mg weekly | Best evidence for obesity maintenance and SELECT-like CV exposure³ ⁴ |
| Step down | 1.0 mg weekly | Best tested dose below the obesity ceiling¹⁰ |
| Lower maintenance | 0.5 mg weekly | Years of type 2 diabetes exposure; plausible weight maintenance for selected users¹¹ |
| Taper floor / restart | 0.25 mg weekly | Starter-dose drug activity; useful for transition, not tested long-term maintenance |
| Every other week | 0.25-0.5 mg every 14 days | Community practice; drug levels fall meaningfully before the next injection |
Real-world prescribing supports the idea that many users do not reach or stay at 2.4 mg quickly. In Le Roux 2026, 79.9% of semaglutide users started at 0.25 mg, and only 67.7% reached at least 1.7 mg by month 6.¹⁵ That means 32.3% were still below 1.7 mg at six months. The cohort still lost -8.83% adjusted body weight over six months, but this is mixed-exposure real-world evidence, not proof that every lower dose is enough for every user.
Stopping Semaglutide
Semaglutide does not cause a classic withdrawal syndrome. You can stop it abruptly in the narrow drug-clearance sense. The problem is regain, not withdrawal. Appetite signaling returns as drug levels fall, gastric-emptying delay fades, and the body is often defending a lower weight with less lean mass than it had at baseline.
The STEP-1 extension is the main warning: participants regained about two-thirds of the weight they had lost within 52 weeks after stopping.⁶ That is not a willpower story. It is the expected biology of removing a satiety drug after major weight loss.
Three forces matter after stopping:
| Force | What changes | Practical response |
|---|---|---|
| Appetite signal returns | Food noise and hunger rise as semaglutide clears over about 5 weeks | Taper or maintenance dosing buys time; do not wait for regain to start planning |
| Lean mass is already lower | STEP-1 body-composition data suggest about 38-39% of fat-plus-lean loss was lean mass⁵ | Protein and resistance training become load-bearing |
| Set-point defense persists | Hormonal defense of the prior weight can persist long after the drug clears | Track weight, waist, hunger, strength, glucose, and lipids for months |
A practical taper is usually 8-12 weeks at the lowest effective dose, not because receptors require tapering, but because the transition period needs support. If a user is coming from 1.7-2.4 mg, a common structure is 1.0 mg for 8-12 weeks, then 0.5 mg for 8-12 weeks, then either remain at 0.5 mg, step to 0.25 mg as a floor, or stop with close monitoring. That sequence is clinical-practice logic layered on top of continuation and withdrawal evidence, not a tested taper protocol.
The base layer is simple: protein at roughly 1.6 g/kg/day if tolerated, progressive resistance training, and waist plus strength tracking. Optional support compounds belong only to measured problems. Tesamorelin, MOTS-c, and NAD+ are not a tested post-semaglutide protocol; they are off-label tools sometimes considered when visceral-fat markers, fatigue, or training output justify the discussion.
Real-World Evidence and Reddit Data
Real-world evidence and trial evidence answer different questions. Health-record data show what happens in routine care. Reddit data show how users describe dosing, side effects, and tradeoffs in their own words.
Le Roux 2026 is routine-care health-record evidence. It shows what mixed-dose, mixed-access semaglutide use looks like over six months in non-diabetic obesity: -8.83% adjusted weight loss, many users still below the high-dose Wegovy range by month 6, and a real-world gap versus tirzepatide.¹⁵ It does not replace STEP-1 or prove that lower doses work the same way for every user.
The Reddit 2026 semaglutide extraction is patient-generated evidence. It screened 33,382 non-diabetic authors and found 1,389 authors with starting weight, numeric dose, and timing. Its useful layer is language and pattern recognition: stomach side effects dominate; fatigue and anxiety/insomnia appear as secondary signals; and starting weight changes how users narrate outcomes. This is not a side-effect rate and not proof that a dose caused an outcome. It belongs here as a guide to what users ask, feel, and report between trial visits, not as a replacement for trial tables.
Oral Semaglutide: Rybelsus Equivalence
Rybelsus is semaglutide taken by mouth with an ingredient that helps it absorb through the stomach lining (SNAC¹²). The molecule is the same, but the exposure is not the same as an injection. Oral semaglutide has low and variable absorption, so the dosing rules are strict: take it on an empty stomach with no more than 4 oz of plain water, then wait at least 30 minutes before food, drink, or other oral medication.
The common shortcut "14 mg oral equals 1.0 mg injectable" is too high. Published steady-state exposure points put 14 mg oral daily closer to about a 0.5 mg weekly injection.¹²
| Oral dose | Better injection exposure match | Practical implication |
|---|---|---|
| 7 mg daily | About 0.2 mg weekly injection | Near the injectable starter range |
| 14 mg daily | About 0.5 mg weekly injection | Not equivalent to a 1.0 mg injection |
| 25 mg daily | About 0.9 mg weekly injection | Higher oral-dose evidence is still not the same as Wegovy 2.4 mg |
Switching routes should be treated as an exposure change, not a simple brand swap. A user moving from 14 mg Rybelsus to 1.0 mg Ozempic is roughly stepping up, not matching.
FAQ
Dosing basics
What is the starting dose of semaglutide?
The labeled starting dose is 0.25 mg weekly for weeks 1-4. It is a starter and tolerance dose, not the dose expected to carry most weight loss. The usual Wegovy ladder is 0.25 -> 0.5 -> 1.0 -> 1.7 -> 2.4 mg weekly, with at least 4 weeks at each step.
What is the maximum dose of semaglutide for weight loss?
The maximum labeled Wegovy dose is 2.4 mg weekly. STEP-1 and the broader STEP program anchor the obesity evidence at that dose.¹ There is no prospective semaglutide evidence above 2.4 mg weekly, and pushing higher should not be treated as a useful plateau strategy.
Is 1 mg semaglutide enough for weight loss?
It can be enough for some users, especially when tolerability, cost, or maintenance is the main issue. STEP-2 showed 1.0 mg retained about 73% of the 2.4 mg weight-loss effect in type 2 diabetes + obesity.¹⁰ That is not the same as saying 1.0 mg equals 2.4 mg for everyone, but it is the clearest direct lower-dose evidence semaglutide has.
What is a semaglutide microdose?
A semaglutide microdose usually means less than the 0.25 mg label starter, often 0.1-0.2 mg weekly. The evidence is thin. The closest direct low-exposure anchor is O'Neil 2018, where daily injections totaling roughly 0.35 mg/week produced measurable weight loss over 52 weeks.¹³ That supports low-exposure activity, not a tested weekly microdose protocol.
Calculator and reconstitution
How do I calculate semaglutide dosage in units?
First calculate concentration: total vial milligrams divided by BAC water milliliters. Then divide the target dose by concentration to get milliliters. On a U-100 syringe, multiply milliliters by 100 to get units. A 10 mg vial mixed with 2 mL BAC water is 5 mg/mL, so 1 mg draws 0.2 mL, or 20 units.
How much BAC water do I mix with 10 mg semaglutide?
A common balanced choice is 2 mL BAC water. That makes a 5 mg/mL solution. At that concentration, 0.25 mg draws 5 units, 0.5 mg draws 10 units, 1.0 mg draws 20 units, and 2.4 mg draws 48 units on a U-100 syringe.
Does BAC water volume change how strong semaglutide is?
No. The vial contains a fixed number of milligrams. BAC water only changes concentration and draw volume. A more diluted vial requires a larger draw for the same milligram dose; a more concentrated vial requires a smaller draw.
Which semaglutide vial size makes the most sense?
Match vial size to weekly dose and realistic post-reconstitution use. Small vials are easier for 0.25-0.5 mg starts or tapers. A 10 mg vial is practical around 1.0-2.4 mg weekly. Very large vials create tiny low-dose draws and may sit too long after mixing.
Maintenance and stopping
What is the maintenance dose of semaglutide after weight loss?
The clearest lower-dose maintenance band is 0.5-1.0 mg weekly. The 0.25 mg dose can be useful as a taper floor or cautious restart, but it should not be overcalled as tested long-term maintenance. The clearest evidence is that continuing semaglutide prevents regain better than stopping.⁴ ⁶
Can you stop semaglutide cold turkey?
Yes, in the sense that semaglutide does not cause a classic withdrawal syndrome. The problem is regain. Drug levels fade over about 5 weeks, appetite signaling returns, and STEP-1 extension data show about two-thirds regain of lost weight within 52 weeks after stopping.⁶
Do you gain weight back after stopping semaglutide?
Often, yes, without continued support. Wilding 2022 showed about two-thirds regain after full discontinuation.⁶ A taper, lower-dose maintenance, protein, resistance training, and clinician-guided monitoring can reduce risk, but no post-stop protocol guarantees weight will hold.
How do you keep weight off after stopping semaglutide?
Use the transition period to preserve muscle and catch drift early: taper rather than disappearing the drug signal overnight, keep protein around 1.6 g/kg/day if tolerated, train with progressive resistance, and track weight, waist, hunger, strength, glucose, and lipids. Optional support belongs to measured problems, not routine stacking.
Safety, outcomes, and comparisons
Does semaglutide preserve lean mass as well as tirzepatide?
Probably not in non-diabetic obesity. STEP-1 body-composition data put semaglutide around 62:38 fat-to-lean loss, while tirzepatide's non-diabetic scan data are closer to 75:25.⁵ This is cross-trial evidence, not a head-to-head maintenance-dose body-composition trial, so protein and resistance training still matter either way.
Does semaglutide protect cardiovascular health?
Yes, for the SELECT-like population: adults with BMI >=27, established cardiovascular disease, and no diabetes. SELECT tested semaglutide 2.4 mg weekly and found a 20% reduction in major adverse cardiovascular events.³ That evidence should not be casually transferred to lower maintenance doses or to primary prevention.
What are the most common side effects of semaglutide?
The most common side effects are stomach-related: nausea, diarrhea, vomiting, constipation, reflux, and reduced appetite. Gallbladder risk is also part of the semaglutide safety discussion, especially with rapid weight loss. Trial incidence and Reddit symptom reports should be kept separate: Reddit is useful for patient language, not verified rates.
How does semaglutide compare to tirzepatide?
Tirzepatide usually produces more weight loss and better body-composition results. In the head-to-head obesity trial, tirzepatide produced 20.2% weight loss versus 13.7% for semaglutide at 72 weeks.² Semaglutide's counterweight is evidence maturity: SELECT cardiovascular outcomes, FLOW kidney outcomes in type 2 diabetes + chronic kidney disease, oral Rybelsus, and the longest safety record in the class.³ ¹⁴
Oral semaglutide
What about oral semaglutide (Rybelsus)?
Rybelsus is oral semaglutide with an ingredient that helps it absorb through the stomach lining. It must be taken on an empty stomach with no more than 4 oz of water, then no food, drink, or other oral medication for at least 30 minutes. The common shortcut is wrong: 14 mg oral daily is closer to 0.5 mg weekly injection exposure, not 1.0 mg.¹²
Related Topics
- Semaglutide Deep Dive - mechanism, outcomes, trial data, and side-effect depth
- Tirzepatide Dosing - the stronger weight-loss and body-composition comparator
- Retatrutide Dosing - investigational triple-agonist dosing
- GLP-1 Lean Mass - protein and resistance-training protocol
- Stopping GLP-1s - cross-compound stopping and maintenance framework
- Reconstitution Guide - sterile handling, storage, and calculator basics
References
¹ Wilding JPH, Batterham RL, et al. "Once-weekly semaglutide in adults with overweight or obesity." N Engl J Med. 2021. STEP 1 - pivotal non-diabetic obesity trial at 2.4 mg.
² Aronne LJ, et al. "Tirzepatide versus semaglutide for obesity." N Engl J Med. 2025. SURMOUNT-5 - head-to-head obesity trial.
³ Lincoff AM, Brown-Frandsen K, et al. "Semaglutide and cardiovascular outcomes in obesity without diabetes." N Engl J Med. 2023. SELECT - 20% reduction in major adverse cardiovascular events, a composite of cardiovascular death, non-fatal heart attack, and non-fatal stroke, at 2.4 mg in established cardiovascular disease + BMI >=27.
⁴ Rubino D, et al. STEP-4: continued weekly semaglutide vs placebo switch for weight maintenance. JAMA. 2021. DOI 10.1001/jama.2021.3224
⁵ STEP-1 DXA body-composition substudy. PMC8089287 - DXA is a body-composition scan; semaglutide showed about 62:38 fat-to-lean loss by derived fat-plus-lean denominator.
⁶ Wilding JPH, et al. STEP-1 extension: weight trajectory 1 year after withdrawal of semaglutide. Diabetes Obes Metab. 2022. DOI 10.1111/dom.14725
⁷ Dhillon S. "Semaglutide: a review in type 2 diabetes and obesity." Drugs. 2021. PMID 33296025 - half-life and pharmacology overview.
⁸ GLP-1 receptor agonists and gallbladder/biliary disease risk meta-analysis. JAMA Intern Med. Article
⁹ Newsome PN, et al. Semaglutide in patients with metabolic dysfunction-associated steatohepatitis. N Engl J Med. 2025. PMID 40305708
¹⁰ Davies M, et al. "Semaglutide 2.4 mg once a week in adults with overweight or obesity and type 2 diabetes." Lancet. 2021. STEP-2 - 1.0 mg vs 2.4 mg dose comparison.
¹¹ Frías JP, et al. "Efficacy and safety of once-weekly semaglutide 2.0 mg versus 1.0 mg in adults with type 2 diabetes." Lancet Diabetes Endocrinol. 2021. SUSTAIN-FORTE
¹² Ozempic FDA label §12.3, Wegovy FDA label §12.3, Rybelsus FDA label §12.3; Carlsson Petri et al. 2018 Diabetes Ther. Carlsson 2018 - body-weight covariate, oral-vs-injection exposure context, and SNAC oral absorption enhancer.
¹³ O'Neil PM, et al. Semaglutide compared with liraglutide and placebo for weight loss in obesity. Lancet. 2018. DOI 10.1016/S0140-6736(18)31773-2 - phase 2 daily-injection dose finding.
¹⁴ Perkovic V, et al. Effects of semaglutide on chronic kidney disease in patients with type 2 diabetes. N Engl J Med. 2024. FLOW
¹⁵ Le Roux CW, et al. Real-world tirzepatide vs semaglutide in non-diabetic obesity. J Endocrinol Invest. 2026;49:413-423 - routine-care health-record cohort, semaglutide arm n=1,393.
¹⁶ FDA. "FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize." 2025. FDA statement
¹⁷ FDA. "FDA proposes to exclude semaglutide, tirzepatide, and liraglutide from 503B bulks list." 2026. FDA statement
Medical Disclaimer
The content in this calculator is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before beginning any new protocol, supplement, or medication.
