FDA-approved (as studied)
Semaglutide
Compounded medicines are not FDA approved.
Large, well-replicated weight loss in placebo-controlled trials — less than tirzepatide head to head — and the evidence is about weight rather than about health outcomes in women specifically.
- Research evidence score
- 10/10 · EstablishedGood human evidence that it works for this.This score reflects the cited research on the studied medicine. It does not rate the compounded preparation shown on this site.
- Judged for
- Weight management in adults with obesity, or overweight with a weight-related condition
- Regulatory status
- Approved for this use, after review of safety and effectiveness.What we offer is compounded: Mixed by a pharmacy for one patient. Not FDA-reviewed for safety, effectiveness or manufacturing quality.
Tests a clinician may consider
Architek does not routinely require lab tests for GLP-1 care. A clinician may request them based on your history.
Tells you and a clinician whether this is a weight question or a blood-sugar question, which changes the drug and the dose.
A clinician may request these tests when your history makes them clinically appropriate.
Claim by claim
Each claim carries what kind of study is behind it, what that study found, and how much it settles. Those are three different questions, and collapsing them is how a thin case is made to look strong.
“Semaglutide 2.4mg produces weight loss far beyond diet and exercise alone.”
STEP 1 randomised 1,961 adults without diabetes and found a mean weight change of −14.9% at 68 weeks against −2.4% on placebo. Large, blinded, placebo-controlled, and the effect size is not subtle. This is as settled as weight-loss pharmacology gets.
Wilding et al., New England Journal of Medicine, 2021 (STEP 1), n=1,961
“The STEP 1 result holds up across the whole trial programme, not just one study.”
A 2024 meta-analysis pooled six placebo-controlled trials of semaglutide 2.4 mg in 3,962 adults with overweight or obesity and no diabetes, including the two-year STEP 5 trial. Weight fell 11.8 percentage points more than on placebo (95% CI 10.68 to 12.93) — about 12.2 kg — with more people reaching 5, 10, 15 and 20% loss, and blood pressure, blood sugar, CRP and lipids improving. Stomach side effects were more common (risk ratio 1.49), mostly mild to moderate and temporary. This is what moves the score from one landmark trial to a settled question.
Harms and limits, checked
These do not move the score above, which is only about whether it works. They are about what it costs and where it stops — a “no effect” on a harm means it was looked for and not found, and a “negative” on a limit means the limit is real.
“The weight comes back when you stop.”
The STEP 1 extension stopped treatment at week 68 and followed people to week 120. Of the 17.3% mean weight lost on semaglutide, 11.6 percentage points came back in that year, leaving a net 5.6% below where they started — the authors’ own phrase is that participants regained two-thirds of their prior loss. This is a finding about the drug working as a treatment rather than a cure, and it is the single most important thing to know before starting.
“Semaglutide produces as much weight loss as tirzepatide.”
It did not in the randomised head-to-head trial. SURMOUNT-5 gave 751 adults with obesity and no diabetes the highest tolerated weekly dose of tirzepatide or semaglutide for 72 weeks: weight fell 20.2% on tirzepatide against 13.7% on semaglutide, and waist circumference 18.4 cm against 13.0 cm. Stomach side effects were the commonest on both, mostly during dose escalation. The trial was open-label and funded by tirzepatide's maker.
What is still missing
- Almost all of the headline trials measured weight, not outcomes women ask about — fertility, cycle regularity, or PCOS symptoms. Those are studied far less.
- Long-term use beyond a few years is still being learned, because the drugs have not been used this way for long.
Our verdict
If the question is weight, the evidence is strong and consistent across the trials; tirzepatide produced more weight loss in a randomised head-to-head trial, as both entries show. It is a treatment you stay on, not a course you finish, and the trials say so plainly.
Do we sell this?
Yes, as a compounded medication. It is one of our medication pathways, where online enrollment opens soon. Compounded medicines are not FDA approved.
See what a request involves →This is education, not a recommendation for you. A licensed clinician decides what is appropriate, may suggest something different, and may decide no prescription treatment is right. Medical disclaimer.