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ForumsSemaglutide (Ozempic / Wegovy)Semaglutide cardiovascular benefit: SELECT trial deep dive Page 2

Semaglutide cardiovascular benefit: SELECT trial deep dive

Dr.CardioMD Thu, Mar 5, 2026 at 8:37 PM 21 replies 414 viewsPage 2 of 5
cory_ATX
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Jul 2024
Austin, TX
Mar 5, 2026 at 11:27 PM#6
Previously posted:
Weeks 1-4 (0.25mg): This is your "get used to it" phase. Honestly, at this dose most people feel very little.

This is so helpful, thank you!! Quick question — does it matter what time of day you inject? My doctor said once a week but didn't specify morning vs evening. I've seen some people say evening is better for managing nausea because you sleep through the worst of it?

35 10Dr.EndoEP, GraceAZ_72, carl_compliance and 32 others
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NeuroNate
Senior Member
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Dec 2023
Chicago, IL
Mar 5, 2026 at 11:44 PM#7

I do mine Saturday mornings so if I feel crappy I have the weekend to deal with it. Some people swear by evening injections so you sleep through the initial nausea wave. Honestly, semaglutide has a half-life of about 168 hours (a full week), so the drug levels stay pretty stable — the nausea isn't really about peak levels, it's more of an initial GI adjustment thing.

Just pick a day and time that works for you and stay consistent. The most important thing is not missing doses.

43 11wendy_avl, jason_paloalto, Dr.LeslieOBGYN and 40 others
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stefan_berlin
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Oct 2024
Berlin, DE
Mar 6, 2026 at 12:01 AM#8

ngl I was expecting way worse based on TikTok horror stories. My first month on 0.25 I had literally zero side effects. Like nothing. I actually called my pharmacy to make sure I got the real stuff lmao

It wasn't until 1.0 that I really felt it kick in. So don't panic if the first month feels like nothing is happening.

8 7KevinCompounds, TirzTom, TrialTracker_MD and 5 others
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PharmacoVig_BOS
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Feb 2024
Boston, MA
Mar 6, 2026 at 12:18 AM#9

Since we're talking expectations, here's a rough timeline of what the STEP trials showed for average weight loss at each phase. Keep in mind these are AVERAGES — individual results vary wildly:

TimepointDoseAvg Weight Loss (% body weight)Notes
Week 40.25mg~1.5%Sub-therapeutic dose
Week 80.5mg~3.5%Appetite effects begin
Week 161.0-1.7mg~7-8%Significant reduction in food noise
Week 282.4mg~10-12%Nearing plateau for many
Week 682.4mg~14.9%STEP 1 endpoint

So for the OP at 224lbs, a "typical" STEP-1-like result would be roughly 33lbs over 68 weeks. But there's huge variance — about a third of participants lost >20% body weight.[1]

48 23kate.chem, DataDave, Dr.GutHealth and 45 others
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ZaraB_AL
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Jan 2025
Alabama
Mar 6, 2026 at 12:35 AM#10

You guys are amazing. I feel so much more prepared now. I'm going to do my first injection Saturday morning, have ginger candies ready, fiber supplements on order, and a big water bottle charged up.

I'll report back next week with how it goes. Wish me luck! 🤞

1 14JennaRN
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