Information on semaglutide by weekly injection, who it may be appropriate for, and how monitoring works.
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Semaglutide, sold as Wegovy, is a prescription-only medicine given by weekly injection and licensed for weight management in adults meeting specific clinical criteria.
As with any prescribed treatment, it follows a full assessment rather than a request form.
Semaglutide is a GLP-1 receptor agonist. It mimics a gut hormone released after eating, reducing appetite and slowing stomach emptying.
It is given once weekly by pre-filled pen, starting low and increasing in steps over several months.
Licensed criteria are a BMI of 30 or above, or 27 or above with a weight-related condition. Suitability is confirmed at assessment, not before.
Semaglutide begins low and increases in steps over several months.
Tolerance, side effects and progress. Dose increases are made here, not on request.
Including an honest conversation about what happens when treatment stops.
The medication, charged by your pharmacy.
Nausea, vomiting, diarrhoea and constipation are common, particularly after dose increases. Serious but less common risks include pancreatitis, gallbladder disease and dehydration affecting the kidneys.
Seek urgent advice for severe, persistent abdominal pain.
Not suitable in pregnancy, when breastfeeding, or when trying to conceive. Not suitable with a personal or family history of medullary thyroid carcinoma or MEN 2, or previous pancreatitis.
Caution with a history of eating disorders, severe gastrointestinal disease, or diabetic retinopathy.
Semaglutide is titrated upward over roughly four to five months, and each step is a clinical decision made at a review rather than something issued on request.
Roughly a quarter to a third of weight lost on GLP-1 treatment is lean tissue unless you actively protect it. That affects how you feel now and how much you regain later.
The STEP 1 extension found participants regained roughly two-thirds of the weight lost within a year of stopping. That is the published evidence, and it is not a reflection on the individual.
Discuss the exit at the start rather than at the end — what happens to appetite, what habits are established, and whether continuing at a lower dose is appropriate.
Semaglutide for weight management is available on the NHS through specialist weight management services, on criteria that vary by area. Ask your NHS GP before paying privately — and note that NHS pathways usually include dietetic and psychological support that private prescribing does not, which measurably improves outcomes.
NHS tier 3 services and, for severe obesity, bariatric surgery — still the most effective long-term treatment — are both worth asking about.
Tirzepatide (Mounjaro) acts on two receptors rather than one and produces greater average weight loss in head-to-head evidence. Semaglutide's advantage is the longer track record and stronger published cardiovascular outcome data, which matters more for some people than the extra few per cent.
Below the licensed BMI threshold, we will not prescribe it — and a service that will is selling rather than assessing. With a current or past eating disorder, specialist input comes first.
£40 for the consultation, charged whether or not a prescription follows — you are paying for the assessment. Reviews are £40 each, and they are where dose increases happen.
We do not dispense or deliver, and we earn nothing from what is prescribed. You take the prescription to any UK pharmacy and pay them for the medicine.
The price varies significantly between pharmacies and increases with the dose. The starting dose is the cheapest month you will have — budget on the maintenance dose, not the first one.
This is long-term treatment, and stopping is generally followed by substantial regain. So the question is not whether you can afford a month — it is whether you can afford a year or two, and what the plan is if you cannot.
Do not buy semaglutide from anywhere that does not require a proper consultation. Counterfeit pens circulate in the UK, the MHRA has issued repeated warnings, and people have been hospitalised — several after injecting insulin sold as a weight-loss pen.
Treat upfront multi-month "packages" with caution. They give the seller a commercial interest in keeping you on treatment and escalating the dose, and they leave you out of pocket if it does not suit you.
In the STEP 1 trial, an average of about 15% of body weight over 68 weeks alongside lifestyle support — with wide individual variation.
Trial participants had structured dietary and behavioural support throughout. The medicine was not doing it alone.
The same drug — semaglutide — in different products at different doses. Wegovy is licensed for weight management; Ozempic is licensed for type 2 diabetes.
We will not prescribe a diabetes product for weight loss. Doing so has driven shortages that left people with diabetes unable to get their treatment, and it is off-licence use with no good justification when a licensed product exists.
Sometimes, through specialist weight management services, on criteria that vary by area. Ask your NHS GP first — the NHS route usually comes with dietetic and psychological support, which improves results.
For as long as you want to keep the weight off, in most cases. The STEP 1 extension found participants regained about two-thirds of the lost weight within a year of stopping.
That is the evidence rather than a judgement about anyone's discipline. Start with a long-term plan.
Tirzepatide produces more weight loss on average in head-to-head evidence. Semaglutide has the longer track record and stronger cardiovascular outcome data.
In practice, tolerance, availability and cost decide it more often than the average difference does.
Nausea, vomiting, diarrhoea and constipation are common, worst in the days after each dose increase, and usually settle. They are the main reason people stop.
Slowing the titration helps a great deal, and there is no advantage in rushing to the top dose. Smaller, lower-fat meals and stopping when full make a real difference.
Pancreatitis. Severe abdominal pain radiating to the back, especially with vomiting, needs urgent same-day assessment.
Gallstones are more common with rapid weight loss, and vomiting-related dehydration can affect the kidneys.
No — and it should be stopped at least two months before conceiving. Not suitable in pregnancy or while breastfeeding.
Semaglutide does not appear to reduce oral contraceptive absorption in the way tirzepatide can, but tell the GP what contraception you use, since severe vomiting affects absorption of any oral medicine.
Yes, some — typically a quarter to a third of the weight lost is lean tissue unless you counteract it.
Protein at every meal and resistance training twice a week are what protect it, and they matter more than cardio here.
It is a consequence of losing weight quickly, not a specific drug effect. Facial fat is lost along with the rest, and it is more noticeable in older people and after rapid loss.
Slower loss and preserving muscle mass both help.
No, and it is genuinely dangerous. Counterfeit semaglutide pens are in circulation in the UK, the MHRA has warned repeatedly, and hospital admissions have followed — including people who injected insulin sold to them as a weight-loss pen.
Any seller not requiring a real assessment should be avoided entirely.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 23, 2026
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