Previously posted:

For very lean patients, a 45-degree angle may be more appropriate to avoid intramuscular injection.

This is really important and I think under-discussed. As people lose weight on sema, they may need to adjust their technique. I started injecting into my abdomen at 90 degrees when I was 250lbs. Now at 195lbs, I have a lot less subcutaneous fat in my injection area and I switched to 45 degrees because I was getting more side effects — likely from IM injection causing faster absorption.

If you notice your side effects getting worse as you lose weight WITHOUT a dose change, this might be why.

Pro tip for anyone using compounded sema with insulin syringes (not the autoinjector): make sure you're drawing up the right amount. The concentrations vary between compounders. I accidentally double-dosed myself once because I didn't account for the concentration difference. Worst 48 hours of nausea ever.

Always triple-check your units to milligrams conversion.

tbh I'm terrified of needles and I almost didn't start sema because of it. But the Wegovy autoinjector is genuinely painless — you don't even see the needle. It clicks, you feel a tiny pinch, and it's done in like 5 seconds. If needle phobia is holding anyone back, just do it. It's nothing compared to a blood draw.

Update: fixed all my technique issues and I swear my side effects are more predictable now. The lump from my old injection site is slowly going down. Thanks for all the tips everyone!

Also the 30-minute warmup tip is everything. Zero injection pain now.

Great thread — pinning this in the FAQ section. Injection technique questions come up constantly and this covers all the key points. Thanks for being open about your mistakes, OP — it'll help a lot of people.