Semaglutide (Wegovy / Ozempic)

Same drug — semaglutide — different branding and dosing. Ozempic is FDA-approved for type 2 diabetes (max 2 mg/week); Wegovy is FDA-approved specifically for weight loss (max 2.4 mg/week). 'Ozempic for weight loss' is off-label use of the diabetes version. Med spas and weight-loss clinics typically prescribe Wegovy or, where compliant, pharmacy-prepared semaglutide.

The pivotal STEP 1 trial averaged about 15% of body weight over 68 weeks at the full 2.4 mg dose — roughly 35 lb for a 230 lb patient. Real-world results spread widely around that average: some lose 20%+, and roughly 1 in 7 patients are minimal responders. Most loss happens in the first 6–12 months. Head-to-head data (SURMOUNT-5, 2025) found tirzepatide outperformed semaglutide on average — see our tirzepatide page for the comparison.

Brand-name Wegovy lists around $1,350/month without insurance, though the manufacturer's direct-pharmacy pricing has brought cash prices down substantially — commonly around $499/month. Med spa and clinic programs using pharmacy-prepared semaglutide have typically run $250–$500/month including supervision. Ask exactly which formulation a provider uses and how it's sourced — FDA rules on compounded semaglutide tightened after the official shortage ended in 2025.

Nausea is the big one, especially during dose escalation — it improves for most people within weeks at each dose level. Constipation, diarrhea, fatigue, and reflux are also common. Serious but uncommon: pancreatitis, gallbladder problems, and dehydration-related kidney issues. Anyone with a personal or family history of medullary thyroid cancer or MEN-2 syndrome should not take GLP-1s. Rapid facial volume loss — 'Ozempic face' — is a cosmetic side effect many patients address with dermal fillers or Sculptra.

Studies show roughly two-thirds of lost weight returns within a year of stopping, because the appetite-suppression only works while the drug is in your system. Long-term users either continue on a lower maintenance dose or lock in lifestyle changes during treatment. Have the exit-strategy conversation with your provider before your first injection, not after your last.

If you have insurance that covers Wegovy, your primary-care doctor is usually the cheapest path. If you're paying cash, med spa and clinic programs compete well on price and typically include labs, dose management, and in-person check-ins that telehealth-only services skip. Whichever route: legitimate providers require labs and medical history first — an injection with no screening is a red flag.