How many months after starting Ozempic (semaglutide) does weight loss typically occur?

From the Guidelines

Weight loss with Ozempic (semaglutide) typically occurs within the first 3 months of treatment, with significant results often seen around this timeframe. According to the most recent and highest quality study 1, a loss of 5-15% of body weight over a period of 6 months is considered a feasible and clinically appropriate goal for many individuals. However, some antiobesity medications, including semaglutide, may not show maximal benefit until after 6 months.

Key Points to Consider

• The medication is typically started at a low dose (0.25 mg once weekly) for the first month to minimize side effects like nausea, then gradually increased to 0.5 mg weekly and potentially up to 1 mg or 2 mg weekly as tolerated 1.
• For optimal results, Ozempic should be used alongside lifestyle modifications including calorie reduction and increased physical activity.
• Patients should be aware that weight loss results vary between individuals, and some may experience more rapid or significant weight loss than others depending on factors like starting weight, diet adherence, and physical activity levels.
• The medication works by mimicking a hormone called GLP-1 that regulates appetite and food intake by acting on the brain's hunger centers, creating feelings of fullness and reducing hunger signals.

Monitoring and Evaluation

• Efficacy and safety should be assessed at least monthly for the first 3 months of treatment, and at least quarterly thereafter 1.
• If a patient’s response is deemed insufficient (weight loss <5%) after 3 months, or if there are significant safety or tolerability issues, the medication should be discontinued and alternative medications or treatment approaches should be considered 1.
• For individuals who respond with the requisite 5% weight loss, it is appropriate to continue treatment and evaluate the full treatment response after 12 months on the maximally tolerated dose 1.

From the Research

Weight Loss with Ozempic (Semaglutide)

• Weight loss with Ozempic (semaglutide) typically occurs within a few months of starting treatment, with significant weight loss observed at 3-6 months 2.
• Studies have shown that participants who received semaglutide achieved a mean weight loss of 5.9% to 10.9% after 3-6 months of treatment, with some achieving weight loss of 15% or more 3, 2.
• The magnitude of weight loss with semaglutide has been shown to be sustained over 12-24 months, with some studies reporting mean weight losses of 9.3% to 15.9% after 1-2 years of treatment 4.

Timeframe for Weight Loss

• Significant weight loss with semaglutide has been observed as early as 3 months after starting treatment, with continued weight loss over 6-12 months 2, 4.
• The STEP clinical trial program has reported mean weight losses of 14.9%-17.4% after 68 weeks (approximately 16-17 months) of treatment with semaglutide 2.4mg 5.

Factors Influencing Weight Loss

• The presence of type 2 diabetes may influence the magnitude of weight loss with semaglutide, with some studies suggesting that patients with type 2 diabetes may experience lower weight loss compared to those without diabetes 2, 4.
• The dose of semaglutide (1.7mg or 2.4mg) may also impact the magnitude of weight loss, with higher doses associated with greater weight loss in some studies 3, 2.