Semaglutide
Mechanism
Girl. A GLP-1 receptor agonist, in English: it walks straight up to your appetite and turns the volume down. Slower digestion, better insulin, way less interest in seconds.
Key Benefit
Sustained weight loss of 15–17% body weight in clinical trials (STEP program). Also cardiovascular risk reduction (SELECT trial).
Evidence Base
And no, this isn't some wellness-influencer rumor. It's Ozempic and Wegovy: FDA-approved, Wegovy for weight in 2021, Ozempic for type 2 diabetes in 2017. Still sitting on more phase III data than almost anything else on this list.
Route & Rationale
Subcutaneous injection (weekly). Peptide structure is destroyed by GI enzymes. Weekly SC dosing maintains steady receptor activation. Oral form exists (Rybelsus) but with lower bioavailability.
Interactions
Monitor blood glucose if on insulin or sulfonylureas (hypoglycemia risk). May slow absorption of oral medications.
Regulatory Status
FDA-approved, full stop. Compounded versions had their moment, but that window closed mid-2025 when the FDA called the shortage over.
Hard Contraindications
MTC/MEN2 thyroid cancer, Pregnancy/planning
Cautions
Pancreatitis, Diabetes
For information and research purposes only. This is not medical advice and not a recommendation to use this substance. Discuss anything here with your healthcare provider.
