Your First Month on Semaglutide: What to Expect Week by Week
Medically Reviewed
Dr. Amanda Foster
MD, Board Certified in Obesity Medicine
Obesity Medicine & Weight Management
Last reviewed: August 4, 2024
Starting semaglutide is exciting, but knowing what to expect can make the experience much smoother. The first month is an adjustment period where your body adapts to the medication while you begin seeing initial results. This week-by-week guide will help you navigate your first 30 days with confidence.
What Makes the First Month Different?
The first month focuses on tolerability, not maximum weight loss. You'll start at a low dose (typically 0.25mg weekly) that introduces the medication gently while your body adjusts. Dramatic results come later—this month is about building a foundation.
Week 1: Getting Started (0.25mg)
What's Happening:
Your first injection introduces semaglutide at the lowest therapeutic dose. The medication begins working immediately to slow stomach emptying and reduce appetite signals, but effects build gradually over several days.
Common Experiences:
- • Reduced appetite: Many notice decreased hunger within 2-3 days, though some don't feel changes until week 2-3
- • Mild nausea: 30-40% experience light nausea, usually worst 1-2 days after injection, then fading
- • Fullness after small meals: Portions that normally satisfied you now feel too large
- • Food aversions: Some foods (especially rich, fatty, or sweet items) suddenly seem unappealing
- • Fatigue: Lower calorie intake can cause temporary tiredness while your body adjusts
Typical Weight Loss:
1-3 pounds. Some people lose more (especially those with higher starting weights), others see no change yet. Both are normal.
Week 1 Tips:
- • Inject on a day with no major plans (many choose Friday evening to manage weekend side effects)
- • Eat smaller portions even if you don't feel hungry—your body needs fuel
- • Stay well-hydrated; aim for 64+ oz water daily
- • Avoid rich, greasy foods that can worsen nausea
- • Track your experience—noting side effects and appetite changes helps inform dose adjustments later
Medical Disclaimer
This article is for informational purposes only and does not constitute medical advice. Semaglutide should only be used under the supervision of a licensed healthcare provider. Individual experiences vary significantly. Always consult your provider with questions or concerns about your treatment.
References
- 1. Wilding JPH, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021;384(11):989-1002.
- 2. Davies M, et al. Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2). Lancet. 2021;397(10278):971-984.
- 3. Rubino D, et al. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight. JAMA Intern Med. 2022;182(2):186-193.
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