Reviewed by Dr. Jason Wright, D.O. · September 23, 2026
The science
How it works
Pancreas: insulin only when needed
Signals beta cells to release insulin when blood sugar is high, and tells alpha cells to stop releasing glucagon. The effect is glucose-dependent, so on its own it doesn’t drive blood sugar too low.
Stomach: slower emptying
Delays gastric emptying, so a meal stays with you longer and fullness lasts. It’s also why large or fatty meals cause nausea in the first weeks.
Hypothalamus: hunger and fullness
Activates the POMC neurons that signal fullness and quiets the NPY/AgRP neurons that drive hunger. This is the appetite change patients notice most.
Reward pathways: food noise
Acts on dopamine-linked reward circuits, which is why many patients say food stops taking up mental space.
These effects are well established in large human trials of the FDA-approved medication.
Dosing
Your dosing plan
Dr. Wright sets your exact dose within this range at your visit.
Month 1
Form1.2 mg vial (0.6 mg/mL)
Dose0.25 mg (42 units)
ScheduleOnce weekly; step up only as tolerated
Based onFDA label schedule
Month 2
Form2.4 mg vial (1.2 mg/mL)
Dose0.5 mg (42 units)
ScheduleOnce weekly; step up only as tolerated
Based onFDA label schedule
Month 3
Form4.4 mg vial (2.2 mg/mL)
Dose1 mg (45 units)
ScheduleOnce weekly; step up only as tolerated
Based onFDA label schedule
Month 4
Form6.8 mg vial (3.4 mg/mL)
Dose1.7 mg (50 units)
ScheduleOnce weekly; step up only as tolerated
Based onFDA label schedule
Maintenance
Form11.2 mg vial (5.6 mg/mL)
Dose2.4 mg (43 units)
ScheduleOnce weekly; step up only as tolerated
Based onFDA label schedule
Side effects
Side effects and what to expect
NauseaCommon · First weeks and after dose increases
Smaller meals, eat slowly, and hold the dose if needed.
Constipation or diarrheaCommon · First weeks
Fiber, fluids, and a steady routine.
Gallbladder symptomsUncommon · Any time
Pain under the right ribs after meals: let us know promptly.
Severe, ongoing belly painRare · Any time
Stop and go to the emergency room.
A note from Dr. Wright
This is about methodical weight loss, not dropping as fast as possible. Losing weight quickly costs you muscle, and muscle is what keeps the weight off and keeps you strong. That’s why I build the plan around protein, strength training, and a pace you can hold. The scale isn’t the goal. Your body composition is.
Dr. Jason Wright, D.O. · Board certified, American Board of Cosmetic Surgery
Cost & access
Getting started with Semaglutide
Semaglutide
Semaglutide with vitamin B12, 2 mL vials matched to your dose · Labeled in your name
