10 min read
Written by: Amelia Willson
Reviewed by: Beverly Tchang, MD, DABOM and Raagini Yedidi, MD
Published: Dec 12, 2024
Updated: Jun 17, 2025
Reviewed By Beverly Tchang, MD, DABOM Beverly Tchang, MD, DABOM, is an Obesity Medicine Advisor for Ro and triple board-certified endocrinologist.
Semaglutide is the active ingredient in the brand-name drugs Ozempic, Wegovy, and Rybelsus and in compounded semaglutide. Ozempic and Wegovy are once-weekly injectable medications, while Rybelsus is a daily oral medication. Compounded semaglutide can come in different formulations, as it is customized by a compounding pharmacy to meet the needs of an individual patient. Compounded medications not FDA-approved and does not undergo FDA review for safety, effectiveness, or manufacturing. They may be prescribed when a patient’s needs cannot be met by a commercially available drug or during shortages.
Ozempic and Rybelsus are both approved by the US Food and Drug Administration (FDA) to treat adults with type 2 diabetes by controlling blood sugar levels. Wegovy is FDA-approved for chronic weight management in adults with obesity or with overweight and a weight-related health condition (e.g. high blood pressure, type 2 diabetes). Additionally, Ozempic and Wegovy are approved to treat heart disease in people with established heart disease who also have type 2 diabetes (Ozempic) or excess weight (Wegovy).
While Ozempic is not FDA-approved specifically for weight management, it may be prescribed off-label for weight loss. In this article, we’ll focus on the three types of semaglutide typically prescribed for weight loss: the injectable medications Ozempic, Wegovy, and compounded semaglutide.
Semaglutide works for weight loss by slowing down digestion, controlling the release of insulin and glucagon after you eat, and sending signals to your brain that enhance feelings of fullness and reduce your cravings for certain foods. Together, these effects lower your appetite and lead to weight loss.
It can take several weeks to months to reach your maintenance dosage of semaglutide for weight loss. The semaglutide dosage chart below offers a quick look at the typical dosing schedule for weight loss.
Semaglutide dosing for weight loss follows a process called titration, which is a fancy word that means your dose is gradually increased over time until you reach an effective maintenance dosage.
The FDA-approved starting dose of injectable semaglutide for weight loss is 0.25 mg once weekly. Then, your healthcare provider will guide you through the process, advising you when to increase your dose and to what dosage. Typically, your healthcare provider will have you increase the dosage every four weeks, until you reach a dose that is effective for you while keeping side effects manageable. This is called your maintenance dosage. The maximum dose of semaglutide is 2 mg weekly for Ozempic, and 2.4 mg weekly for Wegovy.
Oral semaglutide (brand name Rybelsus) also follows a titration schedule, but it differs slightly from injectable semaglutide. The starting dose of oral semaglutide is 3 mg daily. After 30 days on the 3 mg dosage, your healthcare provider may have you increase your dosage to 7 mg. If you spend 30 days on the 7 mg dosage and your healthcare provider determines that a higher dosage is needed, they’ll instruct you to increase your dosage to 14 mg daily. This is the maximum dose of Rybelsus.
Compounded semaglutide dosing often mirrors that of branded (Ozempic, Wegovy) semaglutide. However, some healthcare providers may choose to prescribe customized doses or dosing schedules based on an individual patient's needs. Providers can do so because compounded semaglutide often comes in vials, which enable the administration of different doses of medication (as opposed to the prefilled pens of Ozempic and Wegovy).
Providers may choose to customize a person's dose of compounded semaglutide for weight loss based on their medical history, side effects, or weight loss goals. Ultimately, any particular patient's treatment plan for compounded semaglutide—not unlike a titration schedule for branded medication—is up to the discretion of their provider.
Semaglutide is injected subcutaneously, which means under the skin. So, to take semaglutide for weight loss, you’ll need to give yourself a shot. Don’t worry; the needles on the injection pens are so thin and short that they won’t go very deep.
There are three recommended spots for injecting semaglutide: the upper arm,
