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, usually at 2.4 mg/week. Since March 2026 a higher 7.2 mg weekly dose (Wegovy HD) is also approved, for adults with obesity who have tolerated 2.4 mg for at least 4 weeks and need more weight loss. The higher dose causes more altered skin sensation (dysesthesia): 22% of patients at 7.2 mg versus 6% at 2.4 mg. '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.