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ForumsSemaglutide (Ozempic / Wegovy)Semaglutide and gut microbiome changes — 16S rRNA sequencing data Page 2

Semaglutide and gut microbiome changes — 16S rRNA sequencing data

Dr.GutHealth Wed, Feb 18, 2026 at 8:33 PM 17 replies 775 viewsPage 2 of 4
BrianDallas92
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Oct 2024
Dallas, TX
Feb 18, 2026 at 11:23 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?

22 24Dr.PathRoch, mona_PHX, andrew_nyc and 19 others
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BariatricNurseD
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Feb 2024
Dallas, TX
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Feb 18, 2026 at 11:40 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.

Last edited: Feb 19, 2026 at 4:40 AM
10 12roxy_nash, tony_orlando, Dr.NephBHM_UK and 7 others
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emily_PDX
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Nov 2024
Portland, OR
Feb 18, 2026 at 11:57 PM#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.

11 10Dr.NateNeph, PharmD_Rodriguez, julia.endo and 8 others
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lucas_SP_BR
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Jun 2024
São Paulo, BR
Feb 19, 2026 at 12:14 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]

17 17KarenAZ_mom, zoe_NC, Dr.ObesityLA and 14 others
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newstart_MO
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Feb 2026
Springfield, MO
Feb 19, 2026 at 12:31 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! 🤞

22 10RunnerRach, TrialNerd_Beth, HPLC_Greg and 19 others
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