Is compounded semaglutide the same as Wegovy?

It is meant to contain the same molecule, but it is not the same product. Wegovy is FDA-approved and was tested in the trials on this page. A compounded preparation is made by a pharmacy and is not FDA-approved or reviewed before it reaches you.

What happens if I stop taking semaglutide?

In STEP 4, people who switched to placebo after 20 weeks regained 6.9% of their body weight over the next 48 weeks, while those who continued lost a further 7.9%.

Semaglutide

A once-weekly GLP-1 injection with some of the largest trials of any drug on this site. The trials studied the approved product; most telehealth sellers dispense a compounded version.

Weight

U.S. status: FDA-approved; Wegovy (semaglutide) injection, NDA 215256, approved for chronic weight management.; FDA source, read September 2026.
Evidence cited here: Weight: Large trials1 randomized trial of 1,000 or more people cited here for weight.; Lincoff 2023 (17,604 people) did not measure weight, so it counts toward no label here. It is still listed with the studies below.
Forms sold: Injection · Oral · Sublingual

1. What Semaglutide is

Semaglutide is a GLP-1 receptor agonist, a lab-made version of a gut hormone that signals fullness. It is approved for chronic weight management as Wegovy, a once-weekly injection.

Most telehealth sellers do not dispense Wegovy. They dispense compounded semaglutide, made by a pharmacy for an individual prescription. A compounded preparation is not FDA-approved, and the FDA does not review it for safety, effectiveness or quality before it reaches you.

2. How it works

Semaglutide binds the GLP-1 receptor, the same receptor the body's own hormone uses after a meal. It slows how fast the stomach empties and acts on appetite centers in the brain, so people tend to eat less.

The molecule was modified to last far longer than the natural hormone, which is why it can be injected once a week. The dose is raised in steps over several months; in STEP 1, nausea and diarrhea were the most common side effects and eased with time.

3. What the studies measured

STEP 1 randomized 1,961 adults with obesity or overweight, without diabetes, to weekly semaglutide 2.4 mg or placebo for 68 weeks. Body weight fell 14.9% on semaglutide and 2.4% on placebo. Gastrointestinal side effects led 4.5% of the semaglutide group to stop, against 0.8% on placebo.

SELECT followed 17,604 adults with cardiovascular disease and a BMI of 27 or more, none with diabetes. Heart attack, stroke or cardiovascular death occurred in 6.5% on semaglutide and 8.0% on placebo, a hazard ratio of 0.80. Adverse events led 16.6% on semaglutide to stop, against 8.2% on placebo.

STEP 4 asked what happens after stopping. After 20 weeks on semaglutide, 803 people were randomized to continue or switch to placebo. Over the next 48 weeks the continuing group lost a further 7.9%, while the placebo group regained 6.9%.

4. What they did not measure

Every trial above used the approved product at labeled doses. None tested a compounded preparation, so their results describe Wegovy, not what a compounding pharmacy makes.

The weight results come from trials that also included a lifestyle program. The trials do not tell you how much of the effect lasts without the drug; STEP 4 says most of it does not.

The studies behind this page

The evidence label above is computed from these papers: their design and how many people they enrolled.

Randomized trial
1,961 people
Counts toward: Weight
Mean weight change of −14.9% on semaglutide against −2.4% on placebo.
Adults with obesity or overweight, without diabetes; semaglutide 2.4 mg weekly or placebo for 68 weeks.
Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, et al. (2021). Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. PMID 33567185
Randomized trial
17,604 people
Counts toward no label
Heart attack, stroke or cardiovascular death in 6.5% on semaglutide against 8.0% on placebo (hazard ratio 0.80).
Adults 45 or older with cardiovascular disease and a BMI of 27 or more, without diabetes; mean follow-up 39.8 months.
Lincoff AM, Brown-Frandsen K, Colhoun HM, Deanfield J, Emerson SS, Esbjerg S, et al. (2023). Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. N Engl J Med. PMID 37952131
Randomized trial
803 people
Counts toward: Weight
Weight change of −7.9% with continued semaglutide against +6.9% after switching to placebo.
Adults who had taken semaglutide for 20 weeks, randomized to continue or switch to placebo for 48 weeks.
Rubino D, Abrahamsson N, Davies M, Hesse D, Greenway FL, Jensen C, et al. (2021). Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA. PMID 33755728

Semaglutide

Frequently asked questions

Is compounded semaglutide the same as Wegovy?: It is meant to contain the same molecule, but it is not the same product. Wegovy is FDA-approved and was tested in the trials on this page. A compounded preparation is made by a pharmacy and is not FDA-approved or reviewed before it reaches you.
What happens if I stop taking semaglutide?: In STEP 4, people who switched to placebo after 20 weeks regained 6.9% of their body weight over the next 48 weeks, while those who continued lost a further 7.9%.