Activates GLP-1 receptors. Oral and injected semaglutide have the same receptor target; formulation and dose differ.
Adults with obesity, or overweight plus a weight-related condition, without diabetes
Study contextFDA-approved for adult weight management (Wegovy)
Status sourceStatus & indications14.9% reported weight loss · 2.4% loss with placebo · 68 weeks
STEP 1 · Phase 3 · peer-reviewed · 2.4 mg once weekly · Regardless of stopping treatment
Evidence & limitationsGI effects usually transient; GI-related discontinuation 4.5% versus 0.8% placebo.
Safety contextA next milestone is not summarized for this therapy.
Milestone detailsStudy results apply to their own population, dose and analysis. They do not establish a ranking between therapies.
Each result belongs to its own study population, dose and analysis. Open a result for its chart, comparator, safety findings and limitations.
13.6% reported weight loss · 2.2% loss with placebo · 64 weeks
25 mg once daily
Adults with obesity, or overweight plus a weight-related condition, without diabetes
Effect regardless of treatment discontinuation or rescue weight-management treatment FDA-approved December 22, 2025 for adult weight management (Wegovy pill)
GI adverse events 74.0% versus 42.2% placebo.
Limitations: Endpoint is week 64; total trial including follow-up was 71 weeks. Distinct from oral 50 mg.
14.9% reported weight loss · 2.4% loss with placebo · 68 weeks
2.4 mg once weekly
Adults with obesity, or overweight plus a weight-related condition, without diabetes
Effect regardless of treatment discontinuation or rescue weight-management treatment FDA-approved for adult weight management (Wegovy)
GI effects usually transient; GI-related discontinuation 4.5% versus 0.8% placebo.
Limitations: Different populations, durations and titration schedules prevent causal cross-trial ranking.
18.7% reported weight loss · 3.9% loss with placebo · 72 weeks
7.2 mg once weekly
Adults with BMI at least 30, without diabetes
Effect regardless of treatment discontinuation or rescue weight-management treatment FDA-approved March 19, 2026 for adult weight management (Wegovy HD)
GI events 70.8%; dysaesthesia 22.9% versus 0.5% placebo.
Limitations: Different populations, durations and titration schedules prevent causal cross-trial ranking.
1.5 percentage-point HbA1c decrease · 0.7 pp decrease with Sitagliptin 100 mg daily · 56 weeks
1 mg weekly
Adults with type 2 diabetes
ITT ANCOVA; randomized and exposed population; missing data imputed using retrieved dropouts.
Label describes GI adverse reactions; no trial-specific rate extracted.
Limitations: FDA-label estimates rounded to one decimal; analysis N differs from total randomized N.
1.68 percentage-point HbA1c decrease · 0.62 pp decrease with Placebo · 68 weeks
2.4 mg weekly
Adults with type 2 diabetes
Treatment-regimen estimate, regardless of treatment discontinuation or additional glucose-lowering therapy.
GI events 53.9%; adverse-event discontinuation 6.6%.
Limitations: Trial-wide baseline. Results do not establish superiority across unrelated trials. Diabetes brand information identifies the compound, not approval of this trial dose.
1.47 percentage-point HbA1c decrease · 1.91 pp decrease with Orforglipron 36 mg trial capsule · 52 weeks
14 mg daily
Adults with type 2 diabetes
Treatment-regimen estimate, regardless of treatment discontinuation or additional glucose-lowering therapy.
GI events 45%; adverse-event discontinuation about 5%.
Limitations: Open-label; trial-wide baseline. Diabetes oral formulation; not the 25 mg obesity dose.
17.8 kg body-weight loss with bimagrumab + semaglutide vs 14.2 kg with semaglutide · 48 weeks
The combination used bimagrumab 30 mg/kg plus semaglutide 2.4 mg; the comparison arm used semaglutide 2.4 mg plus bimagrumab placebo.
Adults with BMI ≥30, or ≥27 with an obesity-associated complication; diabetes excluded.
Least-squares means, treatment-regimen estimand: all randomized participants regardless of adherence or discontinuation; placebo-based imputation for missing values. Uncertainty below is standard error, not CI.
Muscle spasms, acne and diarrhea were more frequent with bimagrumab. LDL cholesterol increased with the combination.
Through week 48 · 57 participants were randomized per selected arm; 55 combination recipients and 56 semaglutide recipients received at least one study-treatment dose and entered the safety analysis.
Safety results & reporting detailsLimitations: Phase 2; nominal comparisons without multiplicity adjustment. Lean mass is not direct muscle measurement. Most grip-strength comparisons were nonsignificant. Muscle spasms, diarrhea, acne and laboratory/lipid changes matter; the 72-week extension is open-label and post hoc. A later withdrawal abstract reports partial regain after treatment stopped; see the safety notes for its separate follow-up population and limitations.
Status in this atlas: FDA-approved for adult weight management (Wegovy) Status source
Activates GLP-1 receptors. Oral and injected semaglutide have the same receptor target; formulation and dose differ.
What do these hormones do? GLP-1
Novo Nordisk · Developer and manufacturer of the branded semaglutide products.
Uses, doses and availability depend on the formulation, indication and country. Study doses below describe research; they are not prescribing instructions.
The active peptide and its covalent lipid/linker modifications, reproduced from the official product label.
Shown: Active peptide; formulation excipients excluded.
Official two-dimensional structural formula. The letters denote amino-acid residues; the lipid side chain and linkers are included. This is not an experimental three-dimensional conformation.
Novo Nordisk prescribing information via DailyMed/NLM
DailyMed WEGOVY label, section 11Semaglutide · compound history across indications
Selected phase 2 and phase 3 diabetes milestones before approval, followed by later formulations and indications. Phase 1 and preclinical development have not yet been reconstructed.
NCT00696657 began comparing once-weekly semaglutide with placebo and liraglutide. This is the actual study-start date, not the later registry-posting or publication date.
ClinicalTrials.gov · NCT00696657The trial began evaluating once-weekly semaglutide monotherapy against placebo in type 2 diabetes. Novo Nordisk’s clinical study report records this initiation date.
Novo Nordisk clinical study report · SUSTAIN-1 · page 2The phase 3a monotherapy trial reported efficacy and safety online in The Lancet Diabetes & Endocrinology, before Ozempic’s U.S. approval.
Sorli et al. · The Lancet Diabetes & EndocrinologyFDA approval for once-weekly semaglutide to improve glycemic control in adults with type 2 diabetes.
SourceFDA approval established oral semaglutide for type 2 diabetes; this was not the later obesity-dose Wegovy pill.
SourceFDA approved the 2.4 mg weekly obesity product, alongside reduced-calorie eating and increased activity.
SourceNovo Nordisk announced FDA approval of once-daily oral semaglutide 25 mg for weight management and specified cardiovascular risk reduction.
SourceFDA approved the 7.2 mg injection for weight loss and long-term maintenance in eligible adults.
SourceSponsor reported the 68-week BMI endpoint met in children aged 6 to under 12. Detailed data are scheduled for ObesityWeek; this is not an approval or an adult weight-loss estimate.
SourceCOMPETE SWITCH CV reports an association favoring semaglutide dose escalation among prior semaglutide 1-mg users; it cannot establish drug superiority. Observational treatment selection, unclear HR orientation and unavailable original tables prevent a causal ranking.
SourceSelected sources checked Sep 13, 2026. This is not an exhaustive history.
