Peptide Injections for Weight Loss: What to Expect from Therapy

Key Takeaways

• Compounds covered: Semaglutide (Wegovy), tirzepatide (Zepbound), liraglutide (Saxenda) — FDA-approved injectable GLP-1 and dual GIP/GLP-1 receptor agonists
• Goal area: Weight management via subcutaneous injection therapy with GLP-1 or dual GIP/GLP-1 receptor agonism
• Evidence range: Phase III RCT programs across STEP (semaglutide), SURMOUNT (tirzepatide), and SCALE (liraglutide) trial series; cardiovascular outcomes trials (SELECT); body composition substudies; real-world effectiveness data
• Regulatory range: All three injectable compounds are FDA-approved for chronic weight management (BMI ≥30 or ≥27 with comorbidity). Semaglutide and tirzepatide were removed from the FDA drug shortage list in 2024, which ended the broad-access compounding pathway that existed during the shortage period. As of April 2026, 503A compounding of these molecules is limited to patient-specific prescriptions documenting a clinical difference not met by the FDA-approved product (21 U.S.C. § 353a(b)(1)(D)).
• Key biomarkers for weight management: Fasting insulin, HbA1c, fasting glucose, triglycerides, TSH, liver enzymes (ALT, AST), eGFR, body composition baseline
• As of April 2026: Wegovy (semaglutide 2.4 mg) and Zepbound (tirzepatide up to 15 mg) are FDA-approved for chronic weight management. Following FDA's 2024 resolution of the semaglutide and tirzepatide shortages, routine 503A compounding of commercially available strengths is no longer permitted; compounding is limited to patient-specific prescriptions where a licensed prescriber documents a clinical difference from the FDA-approved product (21 U.S.C. § 353a(b)(1)(D)).
• Bottom line: GLP-1 receptor agonists have produced among the largest documented mean weight loss in randomized obesity pharmacotherapy trials to date; this therapy requires provider supervision, dose titration, baseline biomarker testing, and long-term commitment to maintain outcomes.

Understanding Weight Loss via Peptide Injections: The Biology

Injectable GLP-1 receptor agonists and dual GIP/GLP-1 agonists work through receptor-mediated pathways that modify multiple components of energy balance simultaneously. The subcutaneous injection route bypasses gastrointestinal degradation, achieving the systemic concentrations required for pharmacological GLP-1 receptor agonism in the hypothalamus, pancreas, gut, and cardiovascular system.

GLP-1 receptors in the hypothalamic arcuate nucleus respond to GLP-1 receptor agonist binding by reducing food intake and increasing satiety signals. Gastric emptying is slowed, extending the post-meal fullness window. Pancreatic beta cells respond with glucose-dependent insulin secretion, and glucagon from alpha cells is suppressed. Each of these mechanisms, documented across Phase III clinical trial and pharmacodynamic studies, contributes to reduced caloric intake. Nauck and colleagues' 2022 review in Cardiovascular Diabetology explained tirzepatide's dual GIP/GLP-1 mechanism in detail, characterizing how GIP receptor co-agonism adds distinct adipose tissue and energy expenditure effects beyond GLP-1 alone. This mechanistic layering explains tirzepatide's greater weight loss in Phase III trials versus pure GLP-1 agonists.

The subcutaneous injection route is critical to understanding why injectable GLP-1 therapy achieves the effects that oral alternatives cannot readily replicate at equivalent doses. Once injected, semaglutide's long half-life (approximately one week) and albumin-binding structure maintain stable plasma concentrations between weekly doses. Tirzepatide achieves similar pharmacokinetics through fatty acid conjugation. These engineered half-lives enable once-weekly dosing — a pharmacokinetic advantage that unmodified peptides do not have.

Injectable GLP-1 Peptides for Weight Loss: A Quick Comparison

The following FDA-approved injectable peptide therapies have published Phase III evidence for weight management. They are listed in order of published weight loss efficacy in pivotal trials.

Phase III trial data cited throughout this article was generated on the FDA-approved products (Wegovy, Zepbound, Saxenda). Efficacy and safety data from these trials do not automatically transfer to compounded formulations, which use the same active molecule but are prepared under Section 503A compounding practice standards rather than the cGMP standards that govern the approved products.

• • Compound: Tirzepatide (Zepbound, Mounjaro)
  • Mechanism: Dual GIP/GLP-1 receptor agonist; additive appetite suppression and metabolic effects beyond GLP-1 agonism alone
  • Evidence: Phase III RCT program (SURMOUNT-1 through 5; N=2,539 in SURMOUNT-1; 20.9% weight loss at 72 weeks)
  • FDA status: FDA-approved as Zepbound for chronic weight management and obstructive sleep apnea in adults with obesity; Mounjaro for type 2 diabetes glycemic control
  • SP availability: Available by prescription through Superpower's licensed provider network (FDA-approved product) following clinical evaluation; not available in NY, NJ, CA, SC, AL, AR, or LA. Eligibility is determined by a licensed provider.
  • Route: Once-weekly subcutaneous injection
• • Compound: Semaglutide (Wegovy, Ozempic)
  • Mechanism: GLP-1 receptor agonist; reduces appetite via hypothalamic signaling, slows gastric emptying, improves insulin sensitivity
  • Evidence: Phase III RCT program (STEP 1–5; SELECT cardiovascular outcomes trial N=17,604; 14.9% weight loss in STEP 1 at 68 weeks)
  • FDA status: FDA-approved as Wegovy for chronic weight management; Ozempic for T2D
  • SP availability: Available by prescription through Superpower's licensed provider network (FDA-approved product) following clinical evaluation; not available in NY or NJ. Eligibility is determined by a licensed provider.
  • Route: Once-weekly subcutaneous injection
• • Compound: Liraglutide (Saxenda, Victoza)
  • Mechanism: GLP-1 receptor agonist; same class mechanism as semaglutide; shorter half-life requires daily dosing
  • Evidence: Phase III RCT (SCALE; N=3,731; 8.4 kg weight loss vs 2.8 kg placebo at 56 weeks; Pi-Sunyer 2015 NEJM)
  • FDA status: FDA-approved as Saxenda for chronic weight management; Victoza for T2D and CV risk
  • SP availability: Available by prescription through Superpower's licensed provider network (FDA-approved product) following clinical evaluation; state availability to be confirmed. Eligibility is determined by a licensed provider.
  • Route: Once-daily subcutaneous injection

What Peptide Injection Therapy Involves: A Practical Guide

Understanding the structure of peptide injection therapy — from initial evaluation through long-term monitoring — helps set accurate expectations before starting.

Initial provider evaluation

All injectable GLP-1 receptor agonists require a prescription. The initial clinical evaluation establishes eligibility based on FDA-approved criteria (BMI ≥30 or ≥27 with a weight-related comorbidity), screens for contraindications, reviews current medications for interactions, and documents baseline health status. Gudzune and colleagues' 2024 comprehensive review in JAMA reviewed obesity pharmacotherapy evidence and the role of provider-supervised evaluation, the entry point for injectable peptide therapy. Samson and colleagues' 2023 AACE Comprehensive Type 2 Diabetes Management Algorithm in Endocrine Practice reviewed the AACE T2D algorithm that positions GLP-1 receptor agonists within supervised T2D treatment — a framework that clinicians frequently extend to weight-management practice. The FDA boxed warning for GLP-1 agonists mandates screening for personal or family history of medullary thyroid carcinoma or MEN2 before prescribing.

Baseline biomarker testing

Before initiating injection therapy, baseline biomarker testing establishes the metabolic and safety reference points that make treatment response interpretable. Standard pre-treatment biomarkers include fasting insulin and glucose, HbA1c, a complete lipid panel, TSH, and a comprehensive metabolic panel covering liver enzymes (ALT, AST) and kidney function (eGFR, creatinine). Sattar and colleagues' 2021 meta-analysis in Lancet Diabetes and Endocrinology documented GLP-1 RA cardiovascular and kidney outcomes — findings that reinforce why cardiovascular markers and kidney function are monitored during treatment, starting from a documented baseline.

Body composition assessment at baseline — DEXA or validated bioimpedance analysis — establishes lean mass and fat mass reference points separately from scale weight. This is increasingly recommended given the variable lean mass effects during GLP-1 therapy. Stefanakis and colleagues' 2024 review in Metabolism reviewed pharmacotherapy body composition effects on fat-free mass, muscle, and bone, establishing the clinical rationale for body composition monitoring beyond simple scale weight. Research into combination therapies aimed at preserving skeletal muscle mass during GLP-1 agonism is ongoing (Nunn and colleagues 2024, Molecular Metabolism, reported activin receptor research findings); no such combination is currently FDA-approved.

Dose titration

GLP-1 injection therapy begins at a low starting dose and is incrementally increased to the target maintenance dose over weeks to months. The titration protocol serves to minimize gastrointestinal adverse effects — nausea, vomiting, and diarrhea are most prominent at each dose escalation and typically diminish within days to weeks of holding a dose stable. Dose titration protocols are provider-directed; a prescriber determines and may adjust pace individually. In FDA labeling, semaglutide 2.4 mg titration follows a standard 16-week schedule (starting at 0.25 mg weekly, escalating monthly to the target maintenance dose). Tirzepatide titration proceeds over 20 weeks per FDA labeling to reach the 15 mg maintenance dose.

Chiang and colleagues' 2025 systematic review in Gastroenterology characterized GLP-1 GI adverse events as dose-dependent and most prominent during titration. This is the most commonly reported barrier to treatment adherence — and the primary reason that titration pace is individualized rather than fixed. A provider will adjust the pace based on tolerance. Dose titration is not a phase to rush through; the clinical trial results were achieved with the full titration protocol, not at abbreviated doses.

Expected timeline and outcomes

Clinically meaningful weight loss typically becomes apparent within 4 to 12 weeks of initiation. Maximal weight loss is reached at approximately 60 to 72 weeks based on STEP and SURMOUNT trial data. In the STEP 1 trial, published by Wilding and colleagues in NEJM in 2021, 1,961 adults achieved mean weight loss of 14.9% at 68 weeks. In SURMOUNT-1, published by Jastreboff and colleagues in NEJM in 2022, 2,539 adults achieved 20.9% at 72 weeks with tirzepatide 15 mg. In SURMOUNT-3, Wadden and colleagues' 2023 trial in Nature Medicine, reported SURMOUNT-3 trial outcomes — weight loss additive to an intensive lifestyle lead-in rather than replacing lifestyle changes.

STEP 5, published by Garvey and colleagues in Nature Medicine in 2022, reported STEP 5 two-year outcomes with semaglutide's 15.2% weight loss maintained over 104 weeks with continued treatment. For patients considering the long-term commitment, this two-year durability data is clinically important context. Real-world effectiveness data reviewed by Thomsen and colleagues in 2025 reviewed real-world GLP-1 effectiveness with outcomes in non-trial populations somewhat less than trial data due to adherence heterogeneity — setting realistic rather than idealized expectations is an important part of pre-treatment counseling.

A head-to-head comparison of tirzepatide versus semaglutide, published by Aronne and colleagues in NEJM in 2025, reported head-to-head trial results in a controlled comparative design. The Cochrane review of tirzepatide by Franco and colleagues in 2025, an independent Cochrane evidence synthesis, confirmed Phase III efficacy. Evidence from the SURMOUNT-CN RCT in Chinese adults with obesity, published by Zhao and colleagues in JAMA in 2024, reported SURMOUNT-CN trial results in Chinese adults with obesity.

What happens when you stop treatment

Weight regain after discontinuation is one of the most important clinical facts about injectable GLP-1 therapy. In the STEP 4 withdrawal trial, published by Rubino and colleagues in JAMA in 2021, participants continuing semaglutide lost an additional 7.9% of body weight over 48 more weeks after a 20-week run-in, while those switched to placebo regained 6.9% — confirming the chronic treatment paradigm. The STEP 1 extension trial, published by Wilding and colleagues in Diabetes, Obesity and Metabolism in 2022, reported STEP 1 extension outcomes showing participants who stopped treatment regained approximately two-thirds of their prior weight loss within 12 months. Berg and colleagues' 2025 meta-analysis in Obesity Reviews synthesized GLP-1 discontinuation data on weight regain, confirming the robustness of this pattern. Jastreboff and colleagues' 2025 SURMOUNT-1 extension in NEJM reported 3-year tirzepatide data including diabetes-prevention outcomes. These data do not mean injection therapy is ineffective — they mean the underlying biology requires ongoing intervention to maintain weight loss. This is analogous to the need for continued antihypertensive therapy to maintain blood pressure control.

Monitoring during treatment

Ongoing monitoring during GLP-1 injection therapy serves two purposes: assessing treatment response objectively and detecting adverse changes before they become clinically significant. Standard monitoring includes HbA1c and fasting glucose (glycemic response), a lipid panel including triglycerides (cardiometabolic changes — clinically relevant given SELECT trial MACE reduction data), liver enzymes (hepatic safety), and kidney function via eGFR (renal safety; dehydration-related acute kidney injury is a documented risk with GLP-1 therapy per FDA labeling, and kidney function monitoring is part of the standard prescribing workflow). Monitoring body weight on a standardized schedule and body composition periodically allows tracking of fat-versus-lean mass changes. Locatelli and colleagues' 2024 study in Diabetes Care reported resistance exercise findings on body composition changes during incretin-based weight loss pharmacotherapy, supporting the integration of exercise guidance into injection protocols. Ryan and colleagues' 2025 review in Reviews in Endocrine and Metabolic Disorders reviewed muscle preservation in obesity pharmacotherapy, reinforcing the rationale for protein intake guidance and resistance training recommendations alongside injection therapy.

Lifestyle integration

Phase III trials of GLP-1 injection therapy provided lifestyle counseling alongside pharmacotherapy. The STEP 3 trial, which combined semaglutide with intensive behavioral therapy in a separate population, reported 16.0% mean weight loss at 68 weeks. Lifestyle-intensity adjuncts alongside pharmacotherapy remain an active area of investigation; cross-trial comparison with STEP 1 outcomes is methodologically limited. Peptide injection therapy is most effective as part of a comprehensive approach that includes dietary change, physical activity, and behavioral support, not as a standalone intervention. Providers managing patients on GLP-1 injections typically include dietary guidance emphasizing adequate protein intake (to support lean mass preservation) and resistance training as components of the overall treatment program.

Regulatory Status at a Glance

As of April 2026, the injectable compounds discussed in this article carry the following regulatory statuses.

• Semaglutide (Wegovy): FDA-approved for chronic weight management (BMI ≥30 or ≥27 with comorbidity). Following FDA's May 2024 resolution of the semaglutide shortage, routine 503A compounding of commercially available strengths is no longer permitted; a 503A pharmacy may dispense a compounded formulation only on a patient-specific prescription where the prescriber documents a clinical difference not met by the FDA-approved product (21 U.S.C. § 353a(b)(1)(D)). Compounded formulations are not the FDA-approved product.
• Tirzepatide (Zepbound): FDA-approved for chronic weight management and obstructive sleep apnea in adults with obesity (Zepbound-brand indication, approved December 2024). Following FDA's October 2024 resolution of the tirzepatide shortage, routine 503A compounding is no longer permitted; a 503A pharmacy may dispense a compounded formulation only on a patient-specific prescription where the prescriber documents a clinical difference not met by the FDA-approved product (21 U.S.C. § 353a(b)(1)(D)). Compounded formulations are not the FDA-approved product.
• Liraglutide (Saxenda): FDA-approved for chronic weight management. Saxenda has not been on the FDA drug shortage list, so the narrow shortage-era compounding pathway that applied to semaglutide and tirzepatide never applied to liraglutide. Routine compounding is barred by 21 U.S.C. § 353a(b)(1)(D).

Both Section 503A pharmacy compounding and Section 503B outsourcing-facility compounding are governed by the "essentially a copy of a commercially available drug" prohibition (21 U.S.C. § 353a(b)(1)(D) for 503A; 21 U.S.C. § 353b(a)(5) for 503B). Following the 2024 semaglutide and tirzepatide shortage resolutions, neither pathway permits routine compounding of commercially available strengths of these molecules. The 503A clinical-difference exception is narrow and operates on a per-patient basis; 503B outsourcing facilities face the parallel restriction under § 353b(a)(5).

Considerations When Comparing Injectable Peptides for Weight Loss

Direct comparisons between injectable compounds require recognition that they have been studied in different populations, using different titration protocols and endpoints. The head-to-head trial by Aronne and colleagues (2025) comparing tirzepatide and semaglutide provides the most controlled comparative evidence available, showing tirzepatide's superiority in that specific design. Inferring relative effectiveness from separate trials (STEP 1 versus SURMOUNT-1) is methodologically limited because of differences in trial populations, follow-up duration, and dose protocols.

Metabolic baseline: Fasting insulin, HbA1c, and existing comorbidities (T2D, cardiovascular disease) are relevant to compound selection. The STEP 2 trial by Davies and colleagues in The Lancet in 2021 reported STEP 2 trial results showing semaglutide's 9.6% weight loss in adults with T2D and obesity, while SURMOUNT-2 addressed the same population for tirzepatide. The metabolic profile at baseline informs which compound's mechanism is most clinically relevant.

Titration tolerance: GI adverse events during titration are the primary reason for discontinuation. Some patients tolerate one compound better than another. The pace of titration can be adjusted by a provider based on individual tolerance — there is no clinically required minimum pace.

Body composition goals: For patients with significant obesity and concurrent sarcopenia, lean mass monitoring and preservation is a specific consideration that affects how a provider designs a monitoring protocol, including the recommendation for resistance training and protein intake guidance alongside injection therapy.

Long-term commitment framing: The weight regain data across the class makes clear that initiating peptide injection therapy is initiating a long-term intervention. Discussions about access, cost, compounding options, and monitoring logistics are part of the pre-treatment conversation, not afterthoughts.

This is not an exhaustive list. A licensed provider with experience in obesity pharmacotherapy is the appropriate resource for individualized compound selection and protocol design.

Safety Considerations

Injectable GLP-1 receptor agonists and dual GIP/GLP-1 agonists share a class-level safety profile established across thousands of clinical trial participants. Gastrointestinal adverse effects are the most common: nausea, vomiting, diarrhea, and constipation, dose-dependent and most prominent during titration. These effects are the primary driver of treatment discontinuation in practice. A clinical strategy of slower titration reduces the burden of GI effects while allowing dose escalation toward the maintenance dose studied in Phase III trials.

The FDA boxed warning regarding thyroid C-cell tumors applies to all approved agents in this class. The clinical basis is a rodent carcinogenicity signal published by Bjerre Knudsen and colleagues in Endocrinology in 2010 reported rodent thyroid C-cell findings showing GLP-1 receptor agonists activate rodent thyroid C-cells; the clinical relevance in humans remains under pharmacovigilance. Pancreatitis has been reported at low frequency and requires prompt evaluation if acute abdominal symptoms develop. Cholelithiasis (gallstone formation) is a documented risk, reflecting the effects of rapid weight loss on gallbladder function. Dehydration-related acute kidney injury is a documented risk with GLP-1 therapy per FDA labeling; kidney function monitoring is part of the standard prescribing workflow. Smits and Van Raalte's 2021 review of semaglutide safety provided a comprehensive safety profile analysis supporting the pre-treatment screening and ongoing monitoring protocols.

Contraindications that apply broadly to injectable GLP-1 class therapy include:

• Personal or family history of medullary thyroid carcinoma (MTC) or MEN2 — FDA boxed warning; mandatory pre-treatment screening
• Pregnancy — all injectable GLP-1 agonists should be discontinued before conception; fetal safety data are insufficient
• Known hypersensitivity to the active compound or formulation excipients
• History of pancreatitis — prior pancreatitis is a relative contraindication requiring clinical evaluation
• Concurrent use of other GLP-1 receptor agonists or dual agonists

For compound-specific side effect profiles, see the individual compound pages for semaglutide, tirzepatide, and liraglutide.

What to Test Before Starting Peptide Injection Therapy

Baseline biomarker testing before initiating any GLP-1 injection therapy establishes the metabolic and safety reference points required for objective monitoring of treatment response and early detection of adverse changes. A provider will require these labs as part of the clinical evaluation process.

• Fasting insulin: Documents insulin resistance severity before treatment. Insulin levels at baseline characterize the metabolic context in which GLP-1 agonism will operate. Significant insulin resistance is a clinical signal that GLP-1 receptor agonism may produce particularly meaningful metabolic improvements — trackable only against a documented starting value.
• HbA1c: Distinguishes pre-diabetes and undetected T2D from normoglycemia before treatment. A baseline HbA1c is typically included in pre-prescription GLP-1 evaluations and defines whether the T2D-approved compound dose ranges or obesity-approved ranges are appropriate.
• Fasting glucose: Concurrent blood glucose measurement. A fasting glucose baseline complements HbA1c in characterizing the glycemic state at treatment initiation.
• Triglycerides: Cardiovascular and metabolic context marker. The SELECT trial's MACE reduction for semaglutide and the lipid improvements documented across GLP-1 trials make a pre-treatment triglyceride baseline directly relevant for tracking cardiometabolic benefit during therapy.
• Lipid panel (LDL, HDL, total cholesterol): Full cardiovascular baseline supporting interpretation of lipid changes during treatment, relevant given GLP-1 class cardiovascular outcomes data.
• TSH: Thyroid function baseline, required given the FDA boxed warning for thyroid C-cell tumors. A baseline TSH documents normal thyroid function before starting and provides a reference for monitoring during treatment.
• Comprehensive metabolic panel (ALT, AST, eGFR): Liver and kidney function baseline for safety monitoring throughout therapy. Dehydration-related acute kidney injury is a documented risk with GLP-1 therapy per FDA labeling; kidney function monitoring is part of the standard prescribing workflow. See the metabolic health biomarker testing guide.
• Leptin: Appetite hormone produced by adipose tissue. A leptin baseline provides context on fat-mass-related appetite signaling and leptin resistance before treatment — context relevant for understanding the degree of appetite suppression expected during GLP-1 agonism.

Fasting insulin, HbA1c, thyroid panel, and a comprehensive metabolic panel are the minimum baseline for any peptide injection therapy candidate. Establishing these values before treatment begins creates the data timeline against which a provider can assess response, adjust dosing, and make evidence-based decisions about continued therapy.

How to Access Injectable Peptide Therapy Safely

All injectable GLP-1 receptor agonists approved for weight management require a prescription from a licensed healthcare provider. The access pathway involves a clinical evaluation (telehealth or in-person), baseline biomarker testing, and a prescription to a retail pharmacy for brand-name products; compounded formulations are permitted only through a 503A pharmacy on a patient-specific prescription where the prescriber documents, on an individualized patient-by-patient basis (not as a boilerplate rationale), a clinical difference from the FDA-approved product that is medically necessary for that specific patient (21 U.S.C. § 353a(b)(1)(D)).

Brand-name products (Wegovy, Zepbound, Saxenda) are available through retail pharmacies with a prescription. Following FDA's resolution of the semaglutide (May 2024) and tirzepatide (October 2024) shortages, compounding of these molecules under Section 503A is now limited to patient-specific prescriptions where a licensed prescriber documents a clinical difference from the FDA-approved product on an individual-patient basis (21 U.S.C. § 353a(b)(1)(D)) — for example, a documented allergy to an FDA-approved product excipient, or a dose not commercially manufactured. This is a narrow exception, not a general-availability channel. Routine compounding of commercially available strengths is no longer permitted. Patients considering compounded formulations should discuss this explicitly with a provider current on the regulatory landscape.

Self-directed acquisition of injectable peptides from non-pharmacy online sources is not a legitimate alternative to prescription access. Products from unregulated sources lack pharmaceutical-grade manufacturing oversight, cannot guarantee identity, purity, or potency, and have not been evaluated for human safety. Injectable compounds from unregulated channels carry infection risk from contamination and dosing risk from inconsistent concentration — risks that pharmaceutical-grade products from licensed pharmacies are specifically designed to eliminate.

Understanding Your Baseline

Peptide injection therapy for weight loss carries a substantial randomized evidence base in obesity medicine. The clinical data is robust, the mechanisms are well-characterized, and the monitoring protocols are established. What transforms that evidence base from general knowledge into a clinically useful tool for an individual is baseline biomarker data. Fasting insulin, HbA1c, lipid panel, and thyroid function before starting create the objective record that makes treatment response measurable, adverse changes detectable early, and the long-term commitment to therapy interpretable against real biological progress.

That measurement-first approach is foundational to Superpower's approach to preventive health. Whether the path leads to an FDA-approved brand-name injectable, a compounded formulation, or a different clinical approach, the starting point is always the same: objective data about where the relevant biology stands before treatment begins.

IMPORTANT SAFETY INFORMATION

Semaglutide (Wegovy) is an FDA-approved prescription medication for chronic weight management in adults with BMI ≥30 or ≥27 with a weight-related comorbidity. Superpower facilitates access to FDA-approved Wegovy through licensed healthcare providers. Compounded formulations are not the FDA-approved product. Compounded semaglutide is available only in the narrow patient-specific circumstances permitted under 21 U.S.C. § 353a(b)(1)(D).

Contraindications: Personal or family history of medullary thyroid carcinoma (MTC) or MEN2; known hypersensitivity to semaglutide or excipients. Discontinue at least 2 months before planned pregnancy.

Warnings: Thyroid C-cell tumors in rodent studies (human relevance under ongoing pharmacovigilance); pancreatitis; acute gallbladder disease; hypoglycemia with insulin/secretagogue combinations; acute kidney injury from GI-related dehydration; heart rate increase; not studied in severe GI disease.

Weight regain: Approximately two-thirds of prior weight loss may be regained within 12 months of stopping treatment (STEP 1 extension). GLP-1 injection therapy requires long-term continuation to maintain outcomes.

Common side effects: Nausea, vomiting, diarrhea, constipation, abdominal pain, injection site reactions, fatigue, headache.

Tirzepatide (Zepbound) is an FDA-approved prescription medication for chronic weight management and obstructive sleep apnea in adults with obesity. Superpower facilitates access to FDA-approved Zepbound through licensed healthcare providers. Compounded formulations are available only in the narrow patient-specific circumstances permitted under 21 U.S.C. § 353a(b)(1)(D) following the 2024 resolution of the tirzepatide shortage. Compounded tirzepatide is not the FDA-approved product (Zepbound or Mounjaro). Same contraindications, warnings, and weight-regain disclosure as semaglutide. Common side effects: nausea, vomiting, diarrhea, constipation, abdominal pain, injection site reactions, alopecia (reported in trial data).

Liraglutide (Saxenda) is an FDA-approved prescription medication for chronic weight management. Same class contraindications and safety profile apply.

Full FDA-approved prescribing information at dailymed.nlm.nih.gov.

Disclaimer: This article discusses FDA-approved injectable GLP-1 receptor agonists (Wegovy, Zepbound, Saxenda) for chronic weight management. Superpower Health facilitates access to these FDA-approved prescription medications through licensed healthcare providers. Following FDA's 2024 resolution of the semaglutide and tirzepatide shortages, routine 503A compounding of commercially available strengths of these molecules is no longer permitted; compounded formulations are available only in narrow patient-specific circumstances where a licensed prescriber documents a clinical difference not met by the FDA-approved product (21 U.S.C. § 353a(b)(1)(D)). Compounded formulations are not the FDA-approved products. Not all compounds mentioned are available through Superpower. This educational content is editorially independent.