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Trial protocolFat loss and metabolism

Semaglutide 2.4 mg weekly, the STEP 1 escalation

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Weight loss in adults who are overweight or have obesity, and do not have diabetes

The schedule a registered study in people actually used, taken from the paper and the study's public registration, not from a label summary. Every one links a PubMed or ClinicalTrials record you can open.

Not advice. This is a record of a schedule, not a dose for you.

The schedule, as reported

Each field below is what the source states, not a rounded version of it. Where the source does not publish a detail, the field says so instead of filling the gap.

Amount
2.4 mg as the ongoing dose, reached by stepping up over 16 weeks
How often
Once weekly
How it is taken
Shot under the skin
How long
68 weeks including the step-up

How it was reached, step by step

  1. 01

    0.25 mg once weekly, weeks 1 to 4

  2. 02

    0.5 mg once weekly, weeks 5 to 8

  3. 03

    1.0 mg once weekly, weeks 9 to 12

  4. 04

    1.7 mg once weekly, weeks 13 to 16

  5. 05

    2.4 mg once weekly, weeks 17 to 68

What was measured

The main things measured: how much body weight changed, in percent, from the start to week 68, and how many people lost at least 5 percent. Also measured: weight in kilograms, heart and blood sugar risk factors, and how well people said they could move and function.

What was reported

Results as the study reported them, with what they were compared against.

  • At week 68, people on semaglutide lost 14.9 percent of their body weight on average, against 2.4 percent on the dummy shot. That is a gap of about 12.4 percentage points.

  • 1,047 people on semaglutide (86.4 percent) lost at least 5 percent, against 182 on the dummy shot (31.5 percent). 50.5 percent lost at least 15 percent, against 4.9 percent.

  • In kilograms, people lost 15.3 kg against 2.6 kg, a gap of about 12.7 kg.

  • Nausea and diarrhea were the most common side effects, and they usually passed. 4.5 percent of the semaglutide group stopped because of gut side effects, against 0.8 percent on the dummy shot.

Where this comes from

Wilding et al., Once-Weekly Semaglutide in Adults with Overweight or Obesity, New England Journal of Medicine, 2021. 1,961 adults, with two on the drug for every one on the dummy shot. Paid for by Novo Nordisk.

The week by week step-up above is the schedule written in the study's public registration, not pieced together from the drug label. The two happen to agree, and the registration is the original record.

What this protocol cannot tell you

Required on every entry in this registry, and never empty.

Everyone also got diet and exercise coaching, so the schedule was never tested on its own. The drug cannot be separated from the program around it. People with diabetes were left out, so the numbers do not carry over to them. 68 weeks says nothing about year three. The study measured weight, not the health problems underneath it that people actually care about. The step-up exists because the drug is hard to handle, and 4.5 percent still stopped for gut side effects, with a study team watching over them.

The compounds in this protocol

Each profile has the full evidence record, the legal status and what the studies did not show.

  • SemaglutideStrong. At least two finished studies in people, and at least 1,000 people who took it. 12 completed trials, 42,363 people given it.10 reported

    A once a week shot for type 2 diabetes and weight loss. It is approved, and big studies show it also lowers the risk of heart attack and stroke.

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