Not medical advice. Talk to your provider before using any peptide.
Full disclaimerSemaglutide Titration Protocol (Ozempic/Wegovy)
FDA-standard weekly titration from 0.25mg to 2.4mg over 16+ weeks. Hold current dose for an extra 4 weeks if GI side effects are severe.
Peptide Schedule Research TeamReviewed Apr 20262 Citations
For sustained weight loss through appetite reduction and improved glycemic control.
What This Protocol Does
Semaglutide activates GLP-1 receptors to reduce appetite, slow gastric emptying, and improve insulin sensitivity. The STEP 1 trial (n=1,961) showed 14.9% body weight loss at 68 weeks versus 2.4% with placebo. Most users notice reduced food noise within the first 2 weeks of titration.
Who Should Use This
Designed for adults with BMI 30+ (or 27+ with a weight-related condition) under physician supervision. Requires monthly titration monitoring and GI tolerance assessment. Do not use if you have a personal or family history of medullary thyroid carcinoma or MEN2 syndrome. Not suitable for combination with other GLP-1 receptor agonists.
What the Research Says
Semaglutide 2.4mg: STEP 1 trial (Wilding et al., NEJM 2021, PMID 33567185) demonstrated 14.9% weight loss at 68 weeks in 1,961 adults with obesity. STEP UP trial confirmed similar efficacy in real-world settings. FDA-approved for chronic weight management (Wegovy) and type 2 diabetes (Ozempic). GI side effects (nausea, diarrhea, constipation) affected 44% of participants but were mostly mild to moderate.
Important Notices
- Do not use with other GLP-1 receptor agonists
- Risk of thyroid C-cell tumors in rodents — clinical relevance unknown
- Rare cases of pancreatitis reported
- Postmarketing reports of ileus
Protocol Overview
Dosing Details
| Peptide | Dose | Frequency | Route | Weeks |
|---|---|---|---|---|
| 250mcg | Weekly | subcutaneous (abdomen) | Weeks 1-4 | |
| 500mcg | Weekly | subcutaneous (abdomen) | Weeks 5-8 | |
| 1mg | Weekly | subcutaneous (abdomen) | Weeks 9-12 | |
| 1.7mg | Weekly | subcutaneous (abdomen) | Weeks 13-16 | |
SemaglutideMaint. | 2.4mg | Weekly | subcutaneous (abdomen) | Week 17+ |
Semaglutide: Start low to assess GI tolerance
Semaglutide: Maintain at 2.4mg. Can hold at lower dose if GI effects persist.
Metrics Tracked
Schedule This Protocol
Set your start date and track every dose in your calendar.
Sources & Citations
Peptide Profiles & Calculators
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Semaglutide Microdose
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Semaglutide at 0.025-0.05mg weekly, roughly 1/10th the standard starting dose. Dr. Tyna Moore's philosophy: "Dose up to appetite control, not suppression." Exact microgram dose is not publicly verified; the approach and philosophy come from multiple interviews including Ben Greenfield Life. She treats GLP-1 as scaffolding for building metabolic habits, not a permanent prescription.
Peter Attia's GLP-1 Clinical Perspective
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Peter Attia prescribes GLP-1 agonists clinically and flagged the lean mass loss problem early: 39% of weight lost in the STEP 1 trial was lean tissue. His protocol follows standard FDA titration (0.25mg to 1mg+ weekly) but pairs it with resistance training and 1g protein per pound of bodyweight. This is a prescriber's perspective, not personal biohacking. DEXA scans and metabolic panels required.
Bryan Johnson's Tirzepatide Microdose (DISCONTINUED)
Tirzepatide
Three weeks, then done. Johnson tried tirzepatide at 0.5mg weekly (1/5th the standard starting dose) and halted when his data turned negative: resting heart rate up 3bpm, HRV down 7 points, sleep quality down 10%. He already had optimal metabolic markers, so the risk outweighed any benefit. This is some of the best-documented peptide discontinuation data available, with exact biomarker numbers attached.