⚖️

GLP-1 Weight Loss Starter (Semaglutide)

Standard semaglutide titration for metabolic weight loss, modelled on the STEP-1 trial schedule.

Weight loss & metabolic health Beginner Cycle: 16 weeks titration → ongoing maintenance

Overview

A conservative GLP-1 titration schedule designed to minimise GI side-effects while reaching therapeutic plasma levels. Weekly dose increases follow the FDA-approved Wegovy escalation. Weight loss plateaus around 60–68 weeks at steady state.

Dose schedule

Phase	Dose & route	Notes
Weeks 1–4	0.25 mg SC weekly	Initiation. Nausea most common in first 72 h after each dose. Rotate injection sites (abdomen, thigh, upper arm).
Weeks 5–8	0.5 mg SC weekly	First titration step. If GI effects are severe, hold at previous dose for 2 extra weeks.
Weeks 9–12	1.0 mg SC weekly	Metabolic effects (reduced appetite, fullness) usually clear by now.
Weeks 13–16	1.7 mg SC weekly	Approaching target. Expect noticeable weight loss trajectory.
Weeks 17+	2.4 mg SC weekly	Maintenance target dose. Steady state reached around week 20. Continue until goal weight or plateau.

Bloodwork cadence

Timing	Panel
Baseline	HbA1c, fasting glucose, lipid panel, lipase, eGFR, LFTs, TSH, CBC
Week 12	HbA1c, fasting glucose, lipase, weight, blood pressure
Week 24	Full repeat of baseline panel + lipid progress
Annually	Full baseline panel if continuing long-term

Expected timeline

Day 1: First injection. Mild nausea possible within 24 h.
Week 4: Appetite suppression stabilises. 2–3% body weight loss typical.
Week 12: 5–7% average body weight loss. Dose at 1.0 mg.
Week 20: Steady-state plasma reached. Dose at target 2.4 mg.
Week 36: 10–12% average weight loss (STEP-1 trajectory).
Week 68: STEP-1 average: 14.9% total body weight loss.

Red flags — stop and reassess

Severe abdominal pain radiating to the back (pancreatitis — stop immediately, seek urgent care).
Persistent vomiting beyond week 2 at any dose step (hold dose, consult prescriber).
Vision changes or diabetic retinopathy worsening in pre-existing diabetes.
Fast-growing neck mass (medullary thyroid carcinoma screening).

Contraindications

Personal or family history of medullary thyroid carcinoma or MEN2.
History of pancreatitis.
Pregnancy, breastfeeding, or planning pregnancy within 2 months.
Severe GI motility disorders (gastroparesis).

Linked resources

Sources

Educational use only. This protocol summarises published trial schedules, FDA labelling, and widely-referenced research-community practice. Doses, cycle lengths, and bloodwork recommendations should be reviewed with a qualified prescriber before use in any human. Several peptides discussed are not approved for human administration in most jurisdictions.