Semaglutide
Proven for weight, diabetes, heart risk and MASH. Failed in Alzheimer's.
A long-acting copy of the gut hormone , taken weekly as an injection or daily as a tablet for weight loss and type 2 diabetes. It also cuts heart attacks and strokes in people with heart disease and excess weight. A made by Novo Nordisk, also called Ozempic, Wegovy, Rybelsus and Wegovy pill.
What the evidence shows
Side effects and risks
Who should avoid it: Pregnancy or trying to conceive (stop at least two months before), medullary thyroid cancer or MEN 2 in you or your family, and past pancreatitis unless a specialist agrees.
Athletes: Monitoring. Not prohibited. On the monitoring program since 2024 so WADA can track use. Still listed for 2027. USADA advisory on 2027 WADA list, 2026-10
How it works
- Where it acts
- GLP-1 receptors in the pancreas, the stomach and the appetite centres of the brain.
- What it changes
- More insulin when blood sugar is high, less glucagon, a slower-emptying stomach and fewer hunger signals.
- What people notice
- A smaller appetite and earlier fullness within weeks. Nausea or constipation are common while the dose is being raised.
How it is taken
Weekly injection under the skin, starting at 0.25 mg and rising every four weeks to a maintenance dose of 2.4 mg, or 7.2 mg where that dose is approved. The weight-loss tablet is taken daily on an empty stomach with a sip of water, 30 minutes before food, stepping up from 1.5 mg to 25 mg. A prescriber sets the schedule.
Getting it in the United States
The legal route for Semaglutide
Get a prescription from a licensed clinician. Fill it at a licensed pharmacy or through the maker's own direct service.
Routes people use for any peptide in the United States
Telehealth prescribing
Online clinics prescribe after a questionnaire, sometimes with no live doctor visit, and mail the drug. FDA moved in February 2026 to restrict mass-marketed compounded copies and claims that they are generic equivalents.
Risk: Thin medical screening. Compounded versions are not reviewed by FDA for quality.
Covers: Approved GLP-1 drugs, compounded semaglutide and tirzepatide
Source: GZERO Media, Apr 2026
Clinical trial enrolment
The only lawful way to get an unapproved peptide drug with medical monitoring. ClinicalTrials.gov lists eligibility, sites and phone numbers. Researchers note recruitment is hard when people can buy the drug on the gray market instead of risking placebo.
Risk: Possible placebo assignment, strict eligibility and travel to a study site.
Covers: Investigational peptide drugs still in development
Source: NIH, finding a clinical trial
Telehealth with compounded copies
Mass-marketed compounded semaglutide stopped being lawful once the shortage ended. Some telehealth firms still sell it as personalised dosing. FDA sent 30 warning letters in 2026 over claims that copies match approved drugs.
Source: Fierce Pharma, 2026-03
Routes people use for any peptide in the United States
Compounding pharmacy with prescription
A clinician prescribes and a pharmacy compounds. Twelve peptides left the FDA do-not-compound category in April 2026 and a panel backed six in July, but they are not yet formally eligible. Pharmaceutical-grade ingredient is scarce.
Risk: Legal status is unsettled until FDA rulemaking ends. Pharmacies may use research-grade ingredient.
Covers: BPC-157, TB-500, KPV, MOTS-c, Semax, Epitalon and similar
Source: Frier Levitt, Apr 2026
Med spas and weight-loss clinics
Very common. Secret shoppers called 75 clinics and med spas in two states after shortages ended. 92 percent offered compounded semaglutide and 87 percent tirzepatide, often mixed with B vitamins to look custom.
Risk: Four of 23 suppliers lacked sterile compounding licenses and four had disciplinary records.
Covers: Compounded semaglutide and tirzepatide
Source: American Med Spa Association on JAMA Health Forum study, Jul 2026
Concierge and longevity doctors
Cash-pay physicians build peptide plans for wealthy clients. Reporting from San Francisco says some source from overseas channels, domestic research-use-only sellers or the few compounding pharmacies that will supply clinicians.
Risk: A doctor's involvement does not guarantee a pharmaceutical-grade product.
Covers: BPC-157, thymosin alpha-1, Selank, Semax, CJC-1295, ipamorelin, retatrutide
Source: San Francisco Standard, Sep 2025
Cross-border purchase or import
FDA says importing drugs for personal use is illegal in most cases but it may not object to small personal quantities in limited situations. Reporting also describes people travelling to Mexico for injections.
Risk: Packages can be seized. Product origin and cold-chain handling are hard to check.
Covers: Approved prescription peptides sold abroad
Source: FDA, personal importation
Counterfeit pens in pharmacy supply
FDA has seized fake Ozempic pens from the legitimate supply chain three times: thousands in 2023, hundreds in 2025-04 and dozens in 2025-12. The fakes carried real lot numbers.
Source: FDA alert, 2025-12
Routes people use for any peptide in the United States
Research-chemical websites
Sites sell vials marked for research or not for human consumption, with no prescription. FDA says some ship direct to consumers with dosing directions, and it has sent warning letters. Retatrutide exists only through this route or trials.
Risk: Unknown identity, strength and sterility. No pharmacist or prescriber involved.
Covers: Retatrutide, semaglutide, tirzepatide, BPC-157 and most unapproved peptides
Source: FDA, unapproved GLP-1 drugs page
Direct orders from Chinese factories
Buyers message factory sales agents and pay by crypto or payment app. A minimum order of about ten vials pushes people to buy in bulk and share. A blockchain analysis found US buyers were the largest source of funds.
Risk: Many of the same vendors list fentanyl precursors. Lab reports sent by sellers cannot be verified.
Covers: GLP-1 copies, melanotan II, BPC-157, TB-500, GHK-Cu, epitalon
Source: TRM Labs, Oct 2026
Chat groups and social sellers
Dealers are found through Telegram, WhatsApp, Discord and influencer discount codes. In a May 2026 survey of 1,000 US users, 14.5 percent bought this way and three quarters asked an AI chatbot for dosing.
Risk: 45 percent of social media buyers in that survey reported an emergency or urgent care visit for a reaction.
Covers: Retatrutide and other research-use-only peptides
Source: The Ethos, May 2026
This describes what people do. It is not advice. The decision is yours.
What users report
Recurring themes in public forum posts, unverified and with no comparison group.
Reported benefits
- Quieter thoughts about food
- Steady loss over months
- Fewer cravings for alcohol and snacks
Reported problems
- Nausea and constipation in the first weeks at each dose
- Tiredness, sulfur burps
- Hair shedding during fast loss
- Regain after stopping; cost and supply
The themes match the trial data closely, which is unusual for forum reports.
What experts and influencers say
Recorded views, not a survey or scientific consensus. Cautions may concern misuse or unapproved products. Statements are paraphrased; check each source for context.
Supportive expert view
Says responders describe less food noise and more room for life, side effects cluster during dose increases, and most people regain weight after stopping, often because insurers drop coverage rather than by choice.
Fatima Cody StanfordWikipediaRecommends
Photo source: Sebdubois77 / CC BY-SA 4.0
Cautionary expert view
Said people microdosing semaglutide or tirzepatide are in effect test subjects, because neither the benefits nor the risks of very small doses have been studied.
Source: STAT, 2025-11
Reshma RamachandranWebsiteWarns against
Photo source: medicine.yale.edu
See all views 58
Pledged swift action against firms mass-marketing copycat semaglutide after a telehealth company tried to sell a compounded version of the Wegovy pill. FDA then sent 30 warning letters over misleading compounded GLP-1 claims.
Source: Fierce Pharma, 2026-03
Marty MakaryXWarns against
Judges each peptide separately. He sees no use case for BPC-157: no human evidence, animal data mostly from one lab, and claims that keep widening. He is not a proponent of growth-hormone peptides such as CJC-1295, citing short studies and no long-term safety data. He says elamipretide makes sense only for Barth syndrome, that the risks of melanotan II probably outweigh a cosmetic tan, and that he stopped prescribing bremelanotide. He regards the GLP-1 drugs as clearly effective.
Peter AttiaInstagramMixed view
Says responders describe less food noise and more room for life, side effects cluster during dose increases, and most people regain weight after stopping, often because insurers drop coverage rather than by choice.
Fatima Cody StanfordWikipediaRecommends
Photo source: Sebdubois77 / CC BY-SA 4.0
Said people microdosing semaglutide or tirzepatide are in effect test subjects, because neither the benefits nor the risks of very small doses have been studied.
Source: STAT, 2025-11
Reshma RamachandranWebsiteWarns against
Photo source: medicine.yale.edu
As commissioner said FDA wanted to see good data and would sort harmless peptides from those needing study. Also warned sellers of unapproved compounded GLP-1 products of seizure or injunction.
Source: STAT / Undark, Feb 2026
Marty MakaryXMixed view
On sharing the 2024 Lasker Award, said the prize celebrates science moving from academic discovery through pharmaceutical development to a finished medicine.
Source: STAT, 2024-09
Svetlana MojsovWebsiteRecommends
Photo source: breakthroughprize.org
Says semaglutide and tirzepatide work, but less than the media suggest. Criticises cosmetic use given stomach side effects, weight regain after stopping and unknown long-term effects, and puts prevention first.
Source: Altroconsumo, 2025-03
Silvio GarattiniWikipediaWarns against
Photo source: Unknown author (Wikimedia Commons) / Public domain
Said the field now has to work out exactly what the new drugs do. Pointed to heart, kidney and survival gains in trials and early signs of fewer obesity-linked cancers, but said a few years of use is too short for firm conclusions.
Daniel DruckerWebsiteMixed view
Photo source: torontolife.com
Launching the first WHO guideline on GLP-1 drugs for obesity, said medicines alone will not solve the crisis but can help millions. The recommendation is conditional because long-term data are limited and costs are high.
Tedros Adhanom GhebreyesusWikipediaRecommends
Photo source: Lula Oficial / CC BY-SA 2.0
Lost 42 pounds on Ozempic, had weeks of nausea, felt she had become too thin, and stopped.
Source: TODAY, celebrity round-up, 2025
Sharon OsbourneInstagramWarns againstSays they used it
Calls GLP-1 drugs helpful but not a miracle. Nausea is common, gallbladder problems are rare, and weight tends to return after stopping, so diet, protein, daily activity and medical supervision still matter.
Source: WBUR On Point, 2026-07
Jens Juul HolstWebsiteMixed view
Money: Paid Novo Nordisk consultant from 1992 to 2013; says he holds no shares
Photo source: cbmr.ku.dk
Said in 2023 that she uses a weight-loss medicine, which she did not name, as a tool to stop yo-yo dieting, and described it as a relief.
Source: TODAY, celebrity round-up, 2025
Oprah WinfreyInstagramRecommendsSays they used it
Stopped Ozempic in 2023 after feeling nauseous and deciding it was not right for her.
Source: TODAY, celebrity round-up, 2025
Chelsea HandlerInstagramWarns againstSays they used it
Fronted a year-long CNN investigation of Ozempic, Wegovy, Mounjaro and Zepbound. Stressed that the drugs can help with weight loss but are not a cure-all, and that diet and exercise remain central to health.
Source: CNN Press Room, 2024-10
Sanjay GuptaWikipediaMixed view
Photo source: Asealy77 / CC BY-SA 4.0
Says a GLP-1 medicine, which she did not name, improved her blood sugar and her joints, and rejects the idea that it is a shortcut.
Source: TODAY, celebrity round-up, 2025
Serena WilliamsInstagramRecommendsSays they used it
Said in 2024 that he gained 40 pounds after using Ozempic.
Source: TODAY, celebrity round-up, 2025
Tracy MorganInstagramWarns againstSays they used it
Stopped Ozempic because of nausea and said she could not tolerate Wegovy. She later reported doing well on Mounjaro.
Source: TODAY, celebrity round-up, 2025
Amy SchumerInstagramMixed viewSays they used it
Called public interest in cheaper semaglutide unprecedented. Expected cash-paying patients to get generics first while drug plans catch up. Advised asking a pharmacist about coverage.
Source: BNN Bloomberg, 2026-05
Mina TadrousWebsiteRecommends
Photo source: pharmacy.utoronto.ca
Backed Australia's ban on compounded semaglutide copies. Called conditions in a raided lab appalling and questioned the ethics of heavy marketing aimed at vulnerable people.
Source: RACGP newsGP, 2024-05
Nicole HigginsWebsiteWarns against
Photo source: internationalwomensday.com
Led the first randomized trial of semaglutide in alcohol use disorder. Reported less craving and heavy drinking than placebo and said the results justify larger trials before any treatment use.
Source: USC Today, 2025-02
Christian HendershotWebsiteMixed view
Photo source: ias.usc.edu
Said being able to prescribe generic semaglutide is very exciting. Said cost, not side effects or doubts about efficacy, is the biggest barrier for his patients.
Photo source: drehudur.com
Told Today no studies show what microdosed GLP-1 drugs do and warned that weight is likely to return once people stop.
Source: Today.com, 2025-11
Caroline ApovianWebsiteWarns against
Photo source: bostonobesity.com
Started Ozempic through a private doctor and described a sharp drop in appetite with mild nausea. Says he is torn: sees real health promise, but worries about unknown long-term effects and eating disorder misuse.
Johann HariWebsiteMixed viewSays they used it
Money: Sells a book about the drugs
Said evidence shows people respond to drug prices. Expected more Canadians to pay out of pocket once generics cut the price, and mail-order pharmacies to get many calls.
Source: Globe and Mail, 2025
Michael LawSourceRecommends
After the board revoked four med spa licenses, said the sourcing was very concerning: bulk chemicals from China and research-only material that cannot be given to patients.
Source: WYSU / Ohio Newsroom, May 2025
Cameron McNameeSourceWarns against
Brought in tighter rules for online supply. Said medicines should follow a proper consultation and that the regulator had seen too many unsafe online supplies.
Source: ITV News, Feb 2025
Duncan RudkinWebsiteMixed view
Photo source: pharmacyregulation.org
Said more than a million people in Canada take the company's semaglutide brands. Promised financial and savings support for some uninsured patients who do not want a generic.
Vince LamannaWebsiteRecommends
Money: Leads the company that sells brand-name semaglutide
Photo source: globeandmailevents.com
Told physicians they may not compound, give, prescribe or recommend research-grade peptides, or delegate that to nurses or assistants. A consent form does not remove liability.
South Carolina Board of Medical ExaminersSourceWarns against
Said the injections can work well inside a managed programme. Warned that rules let some patients get them inappropriately and that sales targets must not shape clinical decisions.
Source: Irish News (PA), Jan 2025
Money: Represents community pharmacies that sell these medicines
Co-authored a study estimating that at least four in ten Australian adults meet criteria for an approved weight-management medicine. Hundreds of thousands more qualify for GLP-1 treatment to prevent repeat heart disease.
Jasmin CastrillonSourceRecommends
Defended the ASA crackdown on online pharmacies advertising weight-loss injections. Argued that powerful prescription-only medicines are among the most harmful things to promote to the public.
Nicky MorganWebsiteWarns against
Worried that cosmetic use of prescribed drugs such as semaglutide raises demand and cost for patients who need them. Also warned that copies from unknown sources may not match the real drug.
Source: CTV News via CP24, 2026-07
David SabatinoWebsiteMixed view
Photo source: aps2022.org
Said he microdosed a GLP-1 drug through the summer, lost weight and found it eased his cravings. Disclosed it because hiding it would be hypocritical given how often he asks guests about their bodies. Has since stopped.
Source: People via AOL, 2025-09
Andy CohenWikipediaRecommendsSays they used it
Photo source: PhilipRomano / CC BY-SA 4.0
Ruled against nine advertisers and said every injectable weight-loss treatment is prescription-only. Indirect hints, such as the phrase weight loss injections or pen images, also break the ban on advertising to the public.
Source: Pharmacy Magazine, Jul 2025
Advertising Standards AuthoritySourceWarns against
Welcomed approved generic semaglutide at about 100 dollars a month. Said compounded versions carry more risk because nobody reviews them. Unsure whether generics will displace the grey market.
Source: Science-Based Medicine, 2026-09
Scott GavuraSourceMixed view
Said he never expected the GLP-1 research from his lab in the late 1980s to become a major drug, and welcomed Mojsov sharing the Lasker Award.
Source: STAT, 2024-09
Joel HabenerWebsiteRecommends
Photo source: hms.harvard.edu
Said the pharmacy regulator works with the ASA and MHRA on rule-breaking adverts and will review rulings against six registered pharmacies. Action can target owners, superintendents and individual professionals.
Source: The Pharmacist, Jul 2025
Dionne SpenceSourceWarns against
Allowed compounding semaglutide only as a last resort during shortage. Required prescriber confirmation, patient consent and sterile standards. Said calling a compounded product by the brand name is misleading.
Ontario College of PharmacistsSourceMixed view
Said the Lasker Award shows industry science can be recognised and that young scientists can do high-impact work inside a company. Credited the many Novo Nordisk researchers behind the drugs.
Source: STAT, 2024-09
Lotte Bjerre KnudsenWebsiteRecommends
Money: Novo Nordisk employee
Photo source: nature.com
Told BBC Breakfast the drugs are meant for people with obesity, yet many treat them as a lifestyle product. Listed nausea, stomach upset and gallstones as side effects.
Source: Eastern Eye, Jan 2025
Ashley CohenWebsiteWarns against
Photo source: pharmacy.biz
Reported that WADA put semaglutide on the monitoring program from 2024 to measure use in sport, without banning it. The same update added MOTS-c to the banned list as an unapproved weight-loss peptide.
Source: USADA athlete advisory, 2023-10
Said officials have worked hard to push down GLP-1 prices and stressed the drugs' major health benefits, as Medicare prepared to offer Wegovy and Zepbound to some enrollees at a low monthly copay.
Source: KPRC Click2Houston, 2026-06
Photo source: United States Centers for Medicare and Medicaid / Public domain
Described a patient admitted to hospital after an online pharmacy supplied a weight-loss medicine despite a healthy BMI. Said he reports such prescribing to the pharmacy regulator.
Source: The Pharmacist, Jun 2025
Philip Newland-JonesWebsiteWarns against
Photo source: abcd.care
Acknowledged using Ozempic alongside diet changes and exercise. Described it as a drug that makes you feel full, while arguing the same result can come from mind over matter.
Source: Sinclair news roundup, 2025-07
LizzoWikipediaMixed viewSays they used it
Photo source: MILLION DOLLAZ WORTH OF GAME / CC BY 3.0
Sees drugs as an increasingly important part of obesity care alongside diet and exercise. Expects the semaglutide pill to make starting easier, and criticises German insurers for rarely covering obesity drugs.
Source: ZDFheute, 2026-09
Matthias BlüherWebsiteRecommends
Photo source: herzmedizin.de
Warned that GLP-1 drugs offered on social media and websites are often counterfeit. Stated that online sale of these prescription drugs is banned in France and that agencies never put their logo on products.
Source: ANSM, Sep 2025
Said she used Ozempic after a pregnancy loss left her body stuck. Before her dose was adjusted, eating felt forced, and she felt guilty taking it while selling indulgent food.
Source: TODAY, 2025-09
Chrissy TeigenWikipediaMixed viewSays they used it
Imposed a trade ban on two peptide websites and has more investigations open. Says selling medicines without a licence is illegal even with a research-only label, and calls buying them life-threatening.
Source: AVROTROS Radar, Mar 2026
IGJ (Health and Youth Care Inspectorate)SourceWarns against
Said nausea is the main side effect and slower dose increases help most people. Warned the drugs may weaken the contraceptive pill, lack pregnancy safety data, and that most people regain weight when they stop.
Source: The Naked Scientists, 2025-06
John WildingWebsiteMixed view
Photo source: worldobesity.org
Received two reports in autumn 2025. One person needed intensive care with brain, kidney and eye damage from high blood pressure, possibly after a retatrutide injection. The other involved illegally sold semaglutide.
Source: AVROTROS Radar, Mar 2026
At a Senate hearing, called US prices for Ozempic and Wegovy far too high and accused Novo Nordisk of treating Americans as a cash cow while charging people in other countries much less.
Source: CBS News, 2024-09
Bernie SandersWikipediaMixed view
Photo source: Anderseidesvik / CC BY-SA 4.0
Warned of a sharp rise in illegal products sold as GLP-1 drugs. Authorities found hundreds of fake Facebook profiles, adverts and listings, many hosted outside the EU and misusing official logos.
Source: EMA, Sep 2025
EMA and Heads of Medicines AgenciesSourceWarns against
Operation SHIELD VI ran in 30 countries from April to November 2025. It seized products worth about 33 million euro, including counterfeit semaglutide, closed 66 websites and led to cases against 3,354 people.
Source: Le Specialiste, Feb 2026
Passed on Health Canada's view that most GLP-1 compounding in pharmacies is unlicensed manufacturing. Said its compliance officers will apply that view during inspections.
College of Pharmacists of British ColumbiaSourceWarns against
Announced removal of GLP-1 drugs from the pharmacy compounding exemption from 1 October 2024. Said at least 20,000 Australians were injecting compounded copies and that the risk of not acting was greater.
Mark ButlerWikipediaWarns against
Photo source: Yu Chu Chin / CC BY-SA 4.0
Says synthetic peptides have become more common and are pushed on social media, and that possessing or importing them without a prescription is illegal. Notes many imported products do not contain what labels claim.
Alcohol and Drug FoundationSourceWarns against
Predicted a backlash over Ozempic, citing label warnings on thyroid tumours, gallbladder disease and pancreatitis and weight regain after stopping. Said she does not judge people who use it.
Jillian MichaelsWikipediaWarns against
Photo source: Wikimedia Commons (author not listed) / CC BY-SA 4.0
Reported that physicians and researchers see no robust clinical evidence that semaglutide or tirzepatide work at the very small doses promoted under the microdosing trend by telehealth firms and celebrities.
Source: STAT, 2025-11
Katie PalmerWebsiteWarns against
Photo source: statnews.com
More contextCase reports, watch and read, emerging uses and chemistry
Case reports
From journals, regulators and studies of users. One case proves little.
Benefit reportedtrial result in rare group - 64 people - 2026
Open-label single-centre trial in China of women with PCOS-related infertility and excess weight. Adding semaglutide to metformin restored periods in more women and improved insulin measures. No placebo, short follow-up, pregnancy outcomes not measured.
FDA adverse event reports for compounded GLP-1 drugs
Harm reportedcase series - 2024
By late November 2024 the FDA had received more than 392 adverse event reports for compounded semaglutide and more than 215 for compounded tirzepatide. The agency says the true number is likely higher because most state-licensed pharmacies do not have to report.
Source: FDA, 2024
Overdoses from compounded semaglutide vials and syringes
Harm reportedcase series - 2024
The FDA described reports of people drawing up 5 to 20 times the intended amount from multi-dose vials, and of prescribers miscalculating when converting between milligrams, millilitres and syringe units. Some patients were hospitalised. Reported effects included vomiting, fainting, dehydration, acute pancreatitis and gallstones.
Source: FDA alert, 2024
US poison centre calls on GLP-1 drugs
Harm reportedpoison centre data - 22966 people - 2025
US poison centres logged 22,966 GLP-1 agonist exposure cases from 2019 to 2025, a rise of nearly 1,500 percent in calls. Most were accidental dosing errors. With compounded products, some callers had taken ten times the intended amount after misreading syringe units.
Source: America's Poison Centers, 2025
UK hospitalisations after fake weight-loss pens
Harm reportednews-reported case - 2023
The UK regulator reported that a very small number of people were hospitalised after using potentially fake semaglutide or liraglutide pens bought without a prescription. Effects included hypoglycaemic shock and coma, suggesting the pens held insulin. It had seized 369 suspect pens since January 2023.
Source: MHRA, 2023
WHO alert on three falsified semaglutide batches
Harm reportednews-reported case - 2024
WHO warned of three falsified batches of a branded semaglutide pen found in Brazil and the UK in October 2023 and the US in December 2023. It said reports had risen in all regions since 2022 and that fake devices may hold other undeclared ingredients such as insulin.
Source: WHO, 2024
Counterfeit semaglutide pens in US supply chain
Harm reportednews-reported case - 5 people - 2023
The FDA seized thousands of counterfeit branded semaglutide pens in December 2023 and more in 2025. Five adverse events were linked to the 2023 lot. None were serious and all matched known stomach and bowel side effects. The needles were also counterfeit, so sterility could not be confirmed.
Source: FDA, 2025
Falsified semaglutide pens caught at EU wholesalers
No effectnews-reported case - 2023
The EU regulator reported falsified pens with German labels at wholesalers in the EU and UK. Inactive serial numbers exposed them when scanned. It found no evidence that any reached patients through legal pharmacies and had no reports of harm.
Source: EMA, 2023
Test purchases of no-prescription semaglutide online
Harm reportedstudy of online posts - 2024
Researchers searched for no-prescription sellers and placed six test orders. Three never arrived and the sellers demanded extra fees. The three received products contained semaglutide but purity was 7 to 14 percent against 99 percent claimed. Content exceeded the label by about a third and one sample showed endotoxin.
Source: JAMA Network Open, 2024
Hospitalisations and deaths in compounded semaglutide reports
Harm reportednews-reported case - 2024
A manufacturer statement said the FDA voluntary database held hundreds of reports for compounded semaglutide by the end of March, including 99 hospitalisations and seven deaths. Brand-name versions also appear in the database with hospitalisations and deaths.
Source: NPR, 2024
Online compounded semaglutide user reports weight loss
Benefit reportednews-reported case - 1 person - 2024
A woman in Ohio bought compounded semaglutide online after a virtual consultation and reported substantial weight loss over several months with no complications. Her primary care doctor criticised her for using it.
Source: NPR, 2024
Watch and read
Explainers, reporting and podcasts worth your time. Summaries are ours. No sellers.
As GLP-1s reshape America, questions and new uses emerge
William Brangham, correspondent; Julia Belluz, journalist and author
Traces the GLP-1 story from Gila monster hormone to blockbuster drugs, weighing benefits beyond weight loss against regain, side effects, lawsuits and cost.
Recent, balanced overview of the whole GLP-1 landscape
Ozempic: Is It Scarier Than We Thought?
Wendy Zukerman, host; guests include endocrinologist Dr Vibha Singhal and gastroenterologist Dr Michael Camilleri
Fact-checks claims about GLP-1 drugs, from stomach paralysis to muscle loss and suicidal thoughts, finding most risks rare or comparable to other weight loss.
Careful, evidence-first look at the main safety worries
Obesity Doctor on Everything You Need to Know About Ozempic
Dr Fatima Cody Stanford, obesity medicine physician
An obesity medicine specialist answers broad questions about Ozempic in a short broadcast interview.
Short, plain interview with a practising obesity specialist
FDA takes aim at telehealth companies for promoting unofficial weight loss drug dupes
Matthew Perrone, Associated Press
Explains the FDA's warning letters to telehealth sellers of compounded copies of Wegovy and Ozempic, and why those versions are not reviewed by regulators.
Useful warning about cheaper compounded semaglutide offers
When options run out
Uses people turn to when standard treatment has failed.
Alcohol use disorder
- Who
- People with heavy drinking who have not been helped by, or do not want, the few approved addiction medicines.
- Evidence
- One 48-person, nine-week randomized trial in people not seeking treatment showed less craving, fewer drinks per drinking day and fewer heavy drinking days than placebo. Not approved for this use. Larger trials are needed.
Source: USC Today, 2025-02
Add-on to insulin in type 1 diabetes
- Who
- Adults with type 1 diabetes and obesity who struggle with weight and glucose targets despite automated insulin delivery.
- Evidence
- One 72-person, 26-week randomized trial funded by a type 1 diabetes charity. About a third on the drug hit combined glucose and weight targets, none on placebo. No ketoacidosis, and severe lows were equal in both groups. Off-label. Lead author Viral Shah has called for a registration trial.
Idiopathic intracranial hypertension
- Who
- People with this rare pressure-on-the-brain condition who face vision loss, shunt or stent surgery, or side effects from standard tablets.
- Evidence
- US records study of 1,110 matched patients found fewer symptoms and procedures in GLP-1 users, semaglutide included. Retrospective, drugs not compared. No randomized trial yet.
Legal last-resort routes
Expanded access (compassionate use)
For a serious or life-threatening condition with no comparable alternative and no trial you can join. Your physician asks the company for the drug, then files with FDA and an ethics board. The company can refuse. Costs are often not insured.
Right to Try
For a life-threatening condition after approved options are exhausted and no trial is open to you. The drug must have finished Phase 1 and be in active development. Your doctor asks the manufacturer directly. FDA does not review requests.
Source: FDA, Right to Try
Trial finders
Search ClinicalTrials.gov by condition or drug name, check eligibility and call the listed site. ResearchMatch is a free NIH-funded registry that lets researchers find you. Discuss risks with your own clinician before enrolling.
Source: NIH, finding a clinical trial
Personal import for serious conditions
FDA may not object when a US citizen imports up to about three months of a drug for a serious condition with no effective US treatment, with written personal-use confirmation and a US doctor's details. It is discretion, not a right.
Source: FDA, personal importation
Patient-specific compounding
When the approved product cannot meet a specific need of an identified patient, a prescriber can order a compounded version from a licensed pharmacy. Lower price alone does not qualify. Ingredients must be pharmaceutical grade.
Amino-acid sequence
Position 20 carries a fatty-acid side chain. Ringed tiles are amino acids not found in natural proteins.
Questions people ask
Are Ozempic and Wegovy the same drug?
Yes. Both are semaglutide from Novo Nordisk. Ozempic and the Rybelsus tablet are approved for type 2 diabetes, while Wegovy, as a weekly injection or a daily pill, is the weight-loss brand.
How much weight do people lose on semaglutide?
In the STEP 1 trial, average loss was about 15% at 68 weeks. A higher dose reached 18.7% at 72 weeks in STEP UP, and the daily pill reached 16.6% in people who stayed on it in OASIS 4.
What are the side effects of semaglutide?
Nausea, vomiting, diarrhea and constipation are common, mostly while the dose is rising. Serious risks include pancreatitis, gallbladder disease, a boxed warning for thyroid C-cell tumors seen in rodents, and a very rare kind of sudden vision loss (NAION).
What happens when you stop taking semaglutide?
Weight usually returns. In one trial people regained about two-thirds of the lost weight within a year of stopping.
How much does Wegovy cost without insurance in the US?
The maker's self-pay prices in October 2026 were $149 to $299 a month for the pill and $349 a month for the injection, or $399 for the highest dose, with a new patient's first two months at $199. Large-scale compounding lost its legal basis when the shortages ended in 2025, and FDA has sent warning letters over compounded versions that are still sold.
Your notebook
Taking it? A ten-second daily check-in keeps a record of how you feel, to talk through with your clinician.
Sources
- Novo Nordisk: FDA approves the Wegovy pill (22 Dec 2025)
- Drugs.com: Wegovy approval history
- EMA: Wegovy product page
- EMA: Kayshild product page
- NovoCare: Wegovy self-pay prices
- Health Canada: first generic semaglutide (28 Apr 2026)
- Health Canada: first generic semaglutide for weight loss (29 Jun 2026)
- Novo Nordisk: half-year report 2026
- Gallup: GLP-1 use reaches new high (7 Jul 2026)
Structure: PubChem