Semaglutide
Semaglutide is a modern medicine used for weight loss and to control type-2 diabetes. It works like a hormone (GLP-1) that your body naturally produces.
This medicine:
- Reduces appetite
- Makes you feel full with smaller meals
- Reduces frequent food cravings
- Slows down how quickly food leaves the stomach
- Helps control blood sugar in patients with diabetes
The goal isn't to keep you hungry, it's to help you feel satisfied with less food and manage your weight over the long term.
🔸 Please note: this medicine is not for type-1 diabetes.
At a Glance
Good clinical studies show that, with an appropriate weight-management dose of semaglutide, patients lose an average of about 10–15% of their body weight. Some patients lose more, some lose less.
| Starting weight | 10% loss | 15% loss | 20% loss |
|---|---|---|---|
| 70 kg | 7 kg | 10.5 kg | 14 kg |
| 80 kg | 8 kg | 12 kg | 16 kg |
| 90 kg | 9 kg | 13.5 kg | 18 kg |
| 100 kg | 10 kg | 15 kg | 20 kg |
| 110 kg | 11 kg | 16.5 kg | 22 kg |
| 120 kg | 12 kg | 18 kg | 24 kg |
Your result will depend on your starting weight, dose, diet, and physical activity. Losing 20% is possible for some patients, but it isn't the case for everyone.
Semaglutide isn't given at the full dose from day one, the dose is increased gradually to let your body adjust. So if you don't lose much weight in the first few weeks, that's nothing to worry about.
It's not necessary to lose weight every single week, your weight may stay steady for a while sometimes.
- Weight doesn't drop at the same pace every week.
- Some weeks your weight may not change at all, that can be normal.
- It's normal for weight loss to slow down after several months, that doesn't mean the medicine has stopped working.
- Your waist measurement, appetite control, and keeping off the weight you've already lost are also part of a successful treatment.
- Going 1–2 weeks without weight loss doesn't mean you should increase the dose yourself.
Most patients take it without any serious problems. The most common side effects are related to the stomach, and are usually mild and temporary.
- Nausea
- Feeling full quickly, or reduced appetite
- Gas, constipation, or diarrhoea
- Occasional vomiting or stomach heaviness
These problems tend to happen especially at the start of treatment or after a dose increase, and usually settle down on their own over time.
Just as there's a small risk every time we step out on the road, yet we still go about our normal lives and most people reach their destination safely, semaglutide can also cause some serious problems, but they are very rare. Most patients take this medicine without any serious problems.
- Inflammation of the pancreas (Pancreatitis)
- Gallstones or gallbladder inflammation
- Severe, ongoing vomiting or diarrhoea leading to dehydration and effects on the kidneys
- Severe allergic reaction
- Thyroid warning: if you or a family member has a personal or family history of Medullary Thyroid Cancer (MTC) or MEN-2, this medicine is not suitable for you. This was seen in animal studies; a link to this type of cancer in humans has not been proven.
You're being told about these only so that, if any unusual symptom occurs, you can recognise it in time, not because they're likely to happen.
Most patients never experience any of these. But if you have:
- Very sharp, continuous stomach pain, especially spreading toward the back
- Continuous vomiting where you can't even keep water down
- Very little urine output
- Sharp pain in the upper right side of the abdomen with fever or yellowing of the skin (jaundice)
If you notice any of these symptoms, see your doctor immediately.
Mild nausea, feeling full quickly, or slight constipation are not signs of these serious problems.
- Eat smaller amounts at a time, eat slowly, and chew well
- Cut down on fried, oily, and heavy food, keep drinking enough water
- If constipated, increase fibre, water, and physical activity
- Limit alcohol
The dose is always increased gradually, exactly as your doctor advises, don't change it on your own. Increasing the dose slowly is a normal part of treatment, not a weakness.
Our goal isn't to give the highest possible dose, it's to give the dose that provides the best benefit while your body tolerates it well. If a lower dose is already working well, your doctor may keep you on it.
This is an example of a dose-escalation schedule (Titration) commonly used for weight management. Your own dose, brand, and treatment purpose (Indication) may follow a different schedule. Take only the dose your doctor has prescribed.
The main purpose of increasing the dose gradually is to keep side effects low and help your body tolerate the medicine better.
Taking semaglutide doesn't mean starving yourself or fasting. Even while losing weight, it's important to get enough protein, vegetables, fruit, water, and vitamins/minerals. Eating too little can cause weakness and muscle loss.
What should I eat while on Semaglutide?
Protein
Eggs • Paneer/curd • Lentils/chickpeas/kidney beans • Chicken/fish (if you eat them)
Vegetables & fruit
Vegetables • Salad • Fruit in reasonable amounts
Water & drinks
Water and sugar-free drinks
Cut down on
Fried food • Oily/heavy food • Sugary drinks • Excess sweets
The goal isn't just to lose weight, it's also to protect your muscles and strength.
The risk of severely low blood sugar (Hypoglycaemia) is generally very low when taking semaglutide alone. But when combined with insulin or other diabetes medicines, their dose may need to be reduced.
There's no fixed 3 or 6-month course. How long treatment lasts is different for each person. As long as the medicine is giving good benefit, the side effects are tolerable, and your doctor considers it appropriate, it can be continued long-term, sometimes for several years. Obesity and the tendency to regain weight are usually a long-term condition, not a problem lasting just a few months.
Reaching your target weight doesn't mean the medicine is stopped right away. It doesn't mean treatment ends that day. Reaching your target weight is the first part, maintaining it is the second part. Your doctor decides, based on your appetite, weight stability, and health, whether to keep you on a lower dose or try stopping the medicine.
After stopping, your appetite may increase again and some of the weight may return. That doesn't mean the weight will definitely come back, or that all the weight you lost will return. Controlling portion sizes, healthy eating habits, enough protein, regular exercise and strength training, and regular medical follow-up all help in keeping the weight off.
Semaglutide injection is usually given once a week. It can be given in any of these places:
- Take only the dose your doctor has prescribed, don't increase it on your own
- Don't share the injection pen with anyone else
- Keep changing the injection site
💊 If you miss a dose: if more than 5 days remain before your next scheduled dose, take the missed dose as soon as possible. If less than 5 days remain, skip the missed dose and take the next one on your regular day. Never take a double dose.
❄️ How to store the pen: before first use, keep it in the fridge (2-8°C), not the freezer. After first use, it can be kept at room temperature (below 30°C), away from sunlight and heat. How many days the pen can be used after opening varies by brand, please confirm this with your doctor or pharmacist.
There's no need to weigh yourself daily, once a week, at roughly the same time, is enough. At follow-up, your doctor checks your weight, blood pressure, blood sugar, side effects, and dose.
This medicine slows down how quickly the stomach empties, so before any operation, endoscopy, or procedure involving sedation/anaesthesia, let your doctor or anaesthetist know that you are taking semaglutide. Whether to pause the dose or not will be decided based on your situation.
I don't feel hungry at all, is that okay?
Yes. Reduced appetite and feeling full on less food are among the main effects of this medicine. You don't need to force yourself to finish your usual amount of food, stop eating once you feel comfortably full. But eating very little all day, drinking too little water, or not getting enough protein isn't a good idea.
Can I drink alcohol?
It's better to keep it limited. It can cause nausea, dehydration, or affect blood sugar control. Patients with pancreas, gallbladder, or liver problems should get personal advice from their doctor.
Can I eat mangoes or other fruit?
Yes. Fruit isn't restricted while on semaglutide. If you have diabetes, keep an eye on the amount and your total carbohydrate intake.
Can I fast?
With long fasts, reduced appetite from the medicine can mean very little food and fluid intake. Patients on other diabetes medicines should talk to their doctor before fasting, about their medicines and blood sugar monitoring.
Can I travel?
Yes. Travel is generally fine. Keep the injection within its recommended storage range, and protect it from extreme heat or freezing.
What if I miss a dose?
If more than 5 days remain before your next scheduled dose, take the missed dose as soon as possible. If less than 5 days remain, skip it and take the next one on your regular day. Never take a double dose. (Full details are given above under "How is the injection taken?".)
Can I exercise?
Yes. Regular walking/aerobic activity and strength training are an important part of treatment, do them according to your ability.
Can I take protein powder?
If you're not getting enough protein from food, a protein supplement may help some patients; it isn't compulsory. If you have diabetes or kidney disease, ask your doctor or dietitian about the right product and amount.
Can I take semaglutide with thyroid medicine?
Having ordinary hypothyroidism, or taking regular thyroid medicine, does not by itself rule out semaglutide. The main specific restriction is a personal or family history of MTC or MEN-2.
Will I need to take this for life?
There's no fixed course. How much longer you need it depends on how well it's working, weight maintenance, how well it suits you, and your doctor's assessment.