# Semaglutide

> Evidence tier S — Approved · Metabolic · reviewed 2026-11-08
> Source page: https://peptidemeta.com/p/semaglutide/

Also known as: NN9535, Ozempic, Wegovy, Rybelsus

## Quick answers

**What is Semaglutide?**

A GLP-1 receptor agonist FDA-approved for type 2 diabetes (Ozempic) and chronic weight management (Wegovy).

**How strong is the evidence for Semaglutide?**

Tier S (approved) on the peptidemeta evidence scale. Multiple phase 3 RCTs (SUSTAIN, STEP, SELECT); FDA-approved in 2017 (Ozempic), later as Wegovy and Rybelsus, and authorised by the EMA.

**Is Semaglutide FDA-approved?**

Yes. The FDA approved Semaglutide (Ozempic, Wegovy, Rybelsus) in 2017. Approved for type 2 diabetes (Ozempic, 2017) and chronic weight management (Wegovy, 2021).

**Is Semaglutide banned in sport?**

No. Semaglutide is not on the World Anti-Doping Agency Prohibited List.

**How does Semaglutide work?**

Semaglutide is a GLP-1 receptor agonist with 94% homology to native GLP-1, modified with a C18 fatty diacid chain enabling albumin binding and once-weekly pharmacokinetics. It activates GLP-1 receptors in the pancreas (enhancing glucose-dependent insulin secretion), the gut (slowing gastric emptying), and the hypothalamus (reducing appetite and food reward signaling).

**What is known about the safety of Semaglutide?**

FDA-approved with robust Phase III data. Most common side effects are GI-related and dose-dependent: nausea, vomiting, diarrhea, constipation.

## Key facts

- **Evidence tier:** S (Approved)
- **FDA:** approved 2017 (Ozempic, Wegovy, Rybelsus)
- **WADA:** not on the Prohibited List
- **Peptide:** yes
- **Sequence:** H[Aib]EGTFTSDVSSYLEGQAAKEFIAWLVRGRG (31 residues)
- **Formula:** C187H291N45O59
- **Molecular weight:** 4113.6 g/mol
- **Discovered:** 2015 — Discovery published by Novo Nordisk scientists (Lau et al., J Med Chem 2015).
- **Routes studied:** Subcutaneous

## Overview

A GLP-1 receptor agonist FDA-approved for type 2 diabetes (Ozempic) and chronic weight management (Wegovy). It has become one of the most widely prescribed peptide-based therapies worldwide.

## Mechanism

Semaglutide is a GLP-1 receptor agonist with 94% homology to native GLP-1, modified with a C18 fatty diacid chain enabling albumin binding and once-weekly pharmacokinetics. It activates GLP-1 receptors in the pancreas (enhancing glucose-dependent insulin secretion), the gut (slowing gastric emptying), and the hypothalamus (reducing appetite and food reward signaling).

## Effects reported in research

_Reported outcomes, not promises; see the evidence tier._

- Clinically significant weight loss (up to 15%)
- Improved glycemic control
- Reduced appetite and food cravings
- Cardiovascular event risk reduction

## Safety & unknowns

FDA-approved with robust Phase III data. Most common side effects are GI-related and dose-dependent: nausea, vomiting, diarrhea, constipation. Boxed warning for thyroid C-cell tumors (rodent signal). Contraindicated in MTC/MEN 2 history. SELECT trial demonstrated 20% cardiovascular event reduction.

## Studies

- Wilding JPH, Batterham RL, Calanna S, et al. (2021). *Once-Weekly Semaglutide in Adults with Overweight or Obesity*. New England Journal of Medicine. Clinical trial. https://pubmed.ncbi.nlm.nih.gov/33567185/
  In the 68-week STEP 1 RCT in 1961 adults with overweight or obesity, mean body weight change was -14.9% with semaglutide 2.4 mg versus -2.4% with placebo.
- Marso SP, Bain SC, Consoli A, et al. (2016). *Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes*. New England Journal of Medicine. Clinical trial. https://pubmed.ncbi.nlm.nih.gov/27633186/
  In the SUSTAIN-6 RCT in 3297 patients with type 2 diabetes, the primary cardiovascular outcome occurred in 6.6% with semaglutide versus 8.9% with placebo (hazard ratio 0.74).
- Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. (2023). *Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes*. New England Journal of Medicine. Clinical trial. https://pubmed.ncbi.nlm.nih.gov/37952131/
  In the SELECT RCT in 17,604 adults with cardiovascular disease and overweight or obesity without diabetes, major cardiovascular events occurred in 6.5% with semaglutide versus 8.0% with placebo (hazard ratio 0.80).

## Status sources

- [Drugs@FDA — Ozempic (NDA 209637)](https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=209637)
- [Drugs@FDA — Wegovy (NDA 215256)](https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=215256)
- [KEGG DRUG D10025 — semaglutide (sequence, formula, MW)](https://www.kegg.jp/entry/D10025)
- [Wilding et al., NEJM 2021 (STEP 1 RCT)](https://pubmed.ncbi.nlm.nih.gov/33567185/)
- [Lau et al., J Med Chem 2015 (discovery)](https://pubmed.ncbi.nlm.nih.gov/26308095/)

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Educational reference only — not medical advice. No dosing information is published. Tiers rate the strength of published evidence, not effectiveness or safety.