What it is
Semaglutide is a long-acting GLP-1 receptor agonist studied for type-2 diabetes and obesity. The weekly obesity dose is 2.4 mg in the STEP program.
Evidence boundary
Human evidence exists for the studied indications.
Trial evidence
- PMID 42686906 — Late-life semaglutide treatment slows ageing and extends lifespan in female mice.
- PMID 42747817 — Efficacy and Safety of Semaglutide According to Frailty Status: A Post Hoc Analysis of the SELECT Randomized Clinical Trial.
- PMID 42657770 — Effects of Semaglutide versus Bariatric Surgery on Noninvasive Markers of Hepatic Steatosis and Fibrosis in Obesity with Type 2 Diabetes.
Preparation and measurement
Reconstitution: 10 mg vial + 1 mL BAC = 10 mg/mL.
Concentration matches.
Reference schedule
| Phase | Dose | Draw / measure | Frequency | Weekly total |
|---|---|---|---|---|
| Weeks 1–4 | 250 mcg | 2.5 U (0.025 mL) | Once weekly | 250 mcg/week |
| Weeks 5–8 | 500 mcg | 5 U (0.05 mL) | Once weekly | 500 mcg/week |
| Weeks 9–12 | 1 mg | 10 U (0.1 mL) | Once weekly | 1 mg/week |
| Weeks 13–16 | 1.7 mg | 17 U (0.17 mL) | Once weekly | 1.7 mg/week |
| Weeks 17+ | 2.4 mg | 24 U (0.24 mL) | Once weekly | 2.4 mg/week |
Weeks 1–4
- Dose
- 250 mcg
- Draw / measure
- 2.5 U (0.025 mL)
- Frequency
- Once weekly
- Weekly total
- 250 mcg/week
Weeks 5–8
- Dose
- 500 mcg
- Draw / measure
- 5 U (0.05 mL)
- Frequency
- Once weekly
- Weekly total
- 500 mcg/week
Weeks 9–12
- Dose
- 1 mg
- Draw / measure
- 10 U (0.1 mL)
- Frequency
- Once weekly
- Weekly total
- 1 mg/week
Weeks 13–16
- Dose
- 1.7 mg
- Draw / measure
- 17 U (0.17 mL)
- Frequency
- Once weekly
- Weekly total
- 1.7 mg/week
Weeks 17+
- Dose
- 2.4 mg
- Draw / measure
- 24 U (0.24 mL)
- Frequency
- Once weekly
- Weekly total
- 2.4 mg/week
Weekly totals apply only during the active phase.
Titration rules
- 0.25 mg weekly is the cautious start.
- 0.5 mg weekly is the next step.
- 1 mg weekly is the middle step.
- 1.7 mg weekly is the higher step.
- 2.4 mg weekly is the usual maintenance dose in obesity trials.
- Hold each step for 4 weeks before moving on.
Cycle length and breaks
Reassess after the main study window instead of inventing a break schedule.
What to monitor
- Weight-loss response
- HbA1c / glycemic response
- Blood pressure and lipids
- GI effects during escalation
- Appetite suppression
- Tolerability
- Do not read this as an approved label.
Practical rules
- Subcutaneous, once weekly.
- Rotate injection sites.
- Smaller meals and slower titration help with GI effects.
- Keep protein and resistance training in the plan if lean mass matters.
Research coverage
Related reporting from Compound Chronicle, which tracks the peer-reviewed literature on Semaglutide.
- Semaglutide STEP UP: Thigh Muscle and Fat Infiltration Sep 21, 2026
A STEP UP analysis found semaglutide reduced thigh muscle fat infiltration while preserving sit-to-stand function — a look at muscle quality, not just mass.
- How Structural Design Defines Next-Generation GLP-1 Analogs Sep 15, 2026
A structural overview of how DPP-4 resistance, lipidation, signaling bias, and multi-receptor agonism produce progressively more sophisticated incretin therapies.
- GLP-1 Agonists for MASH Fibrosis: an Overview Sep 8, 2026
A Cell Reports Medicine review surveys incretin-based therapies for MASH fibrosis — from FDA-approved semaglutide to emerging dual and triple GLP-1 agonists.
- IDE and GLP-1 Degradation: A New Stability Pathway Sep 1, 2026
- What Happens to Muscle When Semaglutide Drives Weight Loss Aug 31, 2026
A 12-month semaglutide study found absolute lean mass fell while a muscle quality index improved and handgrip strength stayed preserved in participants.
- Semaglutide, Muscle Loss, and the Protein Question Aug 28, 2026
A 12-month routine-care study shows absolute lean mass falls with semaglutide while reference-based muscle status improves — and a parallel review argues protein intake deserves more…
- Semaglutide and NAION: What the New Correspondence Shows Aug 28, 2026
New correspondence in JAMA Ophthalmology argues over the data and temporal risk in semaglutide–NAION analyses — the exchange itself is a reminder that the safety question is a methods…
- Semaglutide vs. Bariatric Surgery for Liver Disease Aug 28, 2026
A 92-patient observational comparison over 72 weeks finds semaglutide and sleeve gastrectomy both improve noninvasive liver markers in MASLD — with a hint that semaglutide's liver…