GLP-1
Semaglutide
SaveA once-weekly GLP-1 receptor agonist FDA-approved for type 2 diabetes (Ozempic), obesity (Wegovy), and available in oral form (Rybelsus). Demonstrated cardiovascular and renal benefits.
Quick verdict
The current standard-bearer for GLP-1 therapy with robust efficacy across diabetes, obesity, cardiovascular, and kidney endpoints. Transformative weight loss (~15% in STEP trials).
Evidence score
A rough internal score reflecting quantity, quality, and consistency of human evidence. Not a clinical recommendation.
What the research shows
The STEP program demonstrated ~15% mean weight loss at 2.4 mg/week. SUSTAIN-6 and SELECT showed cardiovascular benefit in diabetes and obesity populations respectively. Oral semaglutide (Rybelsus) provides a non-injectable option. SELECT showed a 20% reduction in MACE in people with obesity without diabetes.
Benefits
- ~15% mean weight loss in obesity trials
- Cardiovascular risk reduction in diabetes and obesity
- Available as injectable and oral formulations
- Renal protective effects emerging from trial data
Dosage notes
Obesity: titrate to 2.4 mg SC weekly over 16 weeks. Diabetes: up to 1 mg SC weekly. Oral: 7–14 mg daily.
Side effects
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Gallbladder events
Who should be cautious
Contraindicated in personal or family history of medullary thyroid carcinoma or MEN2. GI side effects are common. Concerns about pancreatitis, gallbladder events, and potential thyroid C-cell tumors.
What this page cannot tell you
Long-term weight regain after discontinuation is well documented. Cost and access remain barriers. GI tolerability can limit titration in some patients.
Leaderboard scores
- Weight loss90
- Longevity55
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