Novo Nordisk’s once-weekly semaglutide injection is a prescription treatment available in Singapore for weight management in eligible patients. Its established 2.4 mg weekly dose has been studied in large clinical trials, but treatment begins at a much lower dose and is increased gradually under medical supervision.
If persistent hunger makes it difficult to change your eating habits, this treatment may help you manage your appetite and portions. Whether it is suitable for you depends on your weight-related health risks and medical history. This guide explains how it works, the results seen in studies, how the dose is increased, costs and the care needed to support longer-term weight control.
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This treatment contains semaglutide, a medicine that activates receptors for glucagon-like peptide-1, or GLP-1, a hormone involved in appetite and blood glucose regulation. The weight-management formulation is used alongside dietary changes and physical activity to help patients lose weight and keep it off.
You may have come across this treatment described as the 2.4 mg weekly injection. However, your first dose is much lower: treatment usually begins at 0.25 mg, giving your body time to adjust before the dose is increased. The dose progression section below also explains the 7.2 mg option for selected adults.
The injection is given under the skin once a week, usually on the same day each week, and can be taken with or without food. During training, we explain how to use your prescribed pen and rotate injection sites within areas such as the abdomen, thigh or upper arm. Always follow the instructions for the pen supplied to you. Injecting into the abdomen does not specifically target abdominal fat; the medicine works through its effects on appetite and related metabolic processes.
GLP-1 is a hormone involved in the body’s response to eating. Semaglutide mimics some of its actions and remains active for longer, allowing once-weekly treatment. By acting on appetite-regulating pathways in the brain, it can reduce hunger and help you feel satisfied with a smaller amount of food. Some people also notice that thoughts about food become less persistent.
Semaglutide can also slow stomach emptying, particularly early in treatment, and helps regulate blood glucose by influencing insulin and glucagon release. Its weight-loss effect is mainly linked to eating less because appetite and fullness signals have changed. It does not directly dissolve fat or remove the need for adequate nutrition.
In practical terms, you may find it easier to manage portions and follow a balanced eating plan without feeling as hungry between meals. You should still be able to eat and drink adequately. If appetite suppression or digestive symptoms make this difficult, contact the clinic so that we can review your treatment.
For adult weight management, the Singapore-registered indication covers an initial BMI of at least 30 kg/m², or at least 27 kg/m² with a weight-related condition. Examples include high blood pressure, high cholesterol, prediabetes, type 2 diabetes and obstructive sleep apnoea. Meeting a BMI threshold is a starting point for assessment; your doctor also needs to consider whether treatment is suitable for your health circumstances.
BMI is calculated by dividing weight in kilograms by height in metres squared. Asian populations can develop weight-related health risks at lower BMI levels, but these risk thresholds should not be confused with the eligibility criteria for this particular medicine. Your doctor considers both the product’s indication and your individual health circumstances.
During the consultation, we discuss previous weight-loss attempts, your eating patterns, current medicines and any conditions that may affect treatment safety. The goal is to improve your health and help you manage your weight over time, with a plan that you can follow and tolerate. This guide focuses on adult treatment; assessment for adolescents requires a separate discussion.
The usual weekly dose steps are 0.25 mg, 0.5 mg, 1 mg, 1.7 mg and 2.4 mg. Each of the first four steps usually lasts four weeks, allowing time to assess how you respond and helping to reduce digestive side effects. Your doctor may adjust the timing if you need longer to settle at a particular dose.
| Usual Treatment Stage | Weekly Dose | Purpose |
|---|---|---|
| Weeks 1–4 | 0.25 mg | Starting dose while your body adjusts |
| Weeks 5–8 | 0.5 mg | Next step if treatment is tolerated |
| Weeks 9–12 | 1 mg | Further increase with clinical review |
| Weeks 13–16 | 1.7 mg | Continued gradual escalation |
| From Week 17 | 2.4 mg | Established dose used in pivotal weight-management studies |
Before increasing the dose, your doctor reviews how your weight and appetite are changing, together with any side effects. If nausea, vomiting or other significant symptoms occur, an increase may be delayed or the dose temporarily reduced. Your ongoing prescription should follow the product guidance and your clinical needs; do not change the dose yourself.
A 7.2 mg weekly regimen is now included in Singapore prescribing information for selected adults with obesity, after at least four weeks on 2.4 mg when needed. Your doctor may discuss this option if further treatment is appropriate, taking account of your progress and side effects. It is not a starting dose, and availability should be checked with the clinic.
The STEP UP trial found greater average weight loss with 7.2 mg than with 2.4 mg, alongside more digestive symptoms and changes in skin sensation, such as tingling or unusual sensitivity. Your doctor will discuss whether the potential additional benefit is worthwhile for you, taking these side effects into account.
Read more about weekly semaglutide 7.2 mg at https://edwinlimclinic.sg/wegovy-7-2mg-singapore/
In STEP 1, adults with obesity or overweight and a related health condition, without diabetes, lost an average of 14.9% of their starting weight over 68 weeks with weekly semaglutide 2.4 mg. The placebo group lost an average of 2.4%. Both groups received lifestyle support, so the study assessed medication as part of a weight-management programme.
To put a percentage into context, a 15% reduction from a starting weight of 100 kg is 15 kg. This helps explain the size of the average change in the study, but your own result may be higher or lower. Some participants also stopped treatment before the study ended.
Results also depend on the population studied. In STEP 2, which enrolled adults with overweight or obesity and type 2 diabetes, average weight loss at 68 weeks was 9.6% with semaglutide 2.4 mg, compared with 3.4% with placebo. Having diabetes, needing a different dose or being unable to continue treatment can affect the result you achieve.
Appetite may change before the scales show a substantial difference. The early weeks are also a period of dose adjustment, so the first month should not be used to predict the full treatment outcome. Weight loss generally develops over months, and progress is best assessed as a trend rather than from day-to-day changes.
During follow-up, we consider how weight is changing alongside appetite, eating habits and side effects. Changes in waist measurement, physical function and weight-related health markers can also help us understand your progress where relevant. The aim is to improve your health while keeping you well nourished and able to manage daily activities.
A plateau does not necessarily mean that the medicine has stopped working. A smaller body requires less energy, and weight can fluctuate with fluid balance, constipation and other factors. Before changing treatment, your doctor reviews your weight trend, whether injections have been taken as prescribed, and how your eating and activity patterns have changed. The dose and any other medicines or health conditions that could affect progress are also considered.
This review helps identify whether changes to your eating and activity plan, management of side effects or an adjustment to medication would be useful.
For some patients, the benefits of semaglutide extend beyond weight loss. The clearest cardiovascular evidence comes from people who already have cardiovascular disease, such as a previous heart attack or stroke, alongside overweight or obesity.
In SELECT, adults aged 45 or older with established cardiovascular disease and overweight or obesity, but without diabetes, received semaglutide 2.4 mg or placebo. Over an average follow-up of approximately 40 months, cardiovascular death, non-fatal heart attack or non-fatal stroke occurred in 6.5% of the semaglutide group and 8.0% of the placebo group. This represented a 20% relative reduction in the risk of the combined outcome.
These findings are relevant to patients with established cardiovascular disease. They do not mean that every person taking semaglutide has the same benefit, and treatment does not replace appropriate management of blood pressure, cholesterol or other cardiovascular risk factors. Your doctor can explain whether this evidence is relevant to your own health history.
Both formulations contain semaglutide, but their main approved uses and dose schedules differ. The diabetes formulation is prescribed primarily for type 2 diabetes, while the formulation discussed in this guide has a weight-management indication. For a patient seeking treatment for obesity without diabetes, that distinction helps guide the prescribing decision.
Your doctor can explain which formulation fits your health needs and whether any proposed use falls outside its registered indication.
Read more about Novo Nordisk’s weekly semaglutide diabetes injection at https://edwinlimclinic.sg/ozempic-singapore/
Tirzepatide acts on both GIP and GLP-1 receptors, whereas semaglutide acts on GLP-1 receptors. In the SURMOUNT-5 head-to-head trial in adults with obesity without diabetes, tirzepatide produced greater average weight loss than semaglutide at 72 weeks: 20.2% compared with 13.7%. The study used maximum tolerated weekly doses of tirzepatide 10 mg or 15 mg and semaglutide 1.7 mg or 2.4 mg; it did not compare tirzepatide with semaglutide 7.2 mg.
The semaglutide result differs from the earlier STEP studies because these were separate trials with different participants and treatment protocols. Their percentages should therefore be read in the context of each study.
Average trial results are one part of the decision. Previous response, side effects, medical history, cost and the ability to continue treatment also matter. A patient doing well on semaglutide does not necessarily need to change treatment because another medicine has a higher average result in a study.
Learn more about Eli Lilly’s dual GIP/GLP-1 treatment at https://edwinlimclinic.sg/mounjaro-tirzepatide-injection-for-weight-loss-in-singapore-doctors-comprehensive-guide/
For an overview of the weekly injection options, read our weight-loss injection guide at https://edwinlimclinic.sg/weight-loss-injections-singapore-guide/
At Edwin Lim Medical Aesthetic Clinic, medication starts from S$598 before GST for a month’s supply at the lowest weekly dose of 0.25 mg. Prices vary with the prescribed dose, and we explain the cost of each prescription before you proceed.
The initial in-person consultation costs S$60 before GST and is charged separately. Follow-up consultations are also S$60 before GST per consultation. Injection training is included. During the consultation, we discuss the treatment plan so that you can consider the ongoing commitment as well as the first month’s expense.
Treatment begins with an in-person consultation. We assess BMI and blood pressure, review your medical history and current medicines, and discuss your goals and previous efforts to manage weight. This helps determine whether weekly semaglutide is appropriate and what needs attention during treatment. Blood tests are ordered when clinically indicated rather than routinely required for every patient.
If treatment is suitable and the prescribed medication is available, injection training and the first injection can take place on the same day as the consultation. We explain the pen technique, weekly schedule and what to do if side effects occur, so that you understand the plan before continuing at home.
The first follow-up takes place after the first pen is completed. We review progress and tolerability before deciding the next step. Once treatment is stable, progress is satisfactory and there are no significant side effects, consultations may be spaced approximately three to four months apart. Dose changes, troublesome symptoms or other clinical concerns may require earlier review.
Patients can contact the clinic through WhatsApp for questions between visits. Urgent symptoms require prompt medical attention rather than waiting for a message reply.
Learn more about our personalised medical weight-loss programme at https://edwinlimclinic.sg/personalised-medical-weight-loss-program-in-singapore/
Consultations are available at Changi City Point and Lucky Plaza in Orchard. Find our clinic details and contact information at https://edwinlimclinic.sg/contact-number/
Nausea, vomiting, diarrhoea, constipation and abdominal discomfort can occur, especially when treatment begins or the dose increases. Smaller meals, eating slowly and stopping when comfortably full may help. Keep drinking fluids, particularly if vomiting or diarrhoea occurs, and contact the clinic if symptoms interfere with eating, drinking or normal activities.
Persistent symptoms should prompt a review of the dose and treatment plan. Severe pain or repeated vomiting should not be dismissed as an expected part of weight loss.
Inflammation of the pancreas, called pancreatitis, and gallbladder problems can occur during treatment. Severe or persistent abdominal pain, particularly if it spreads to the back, needs urgent assessment. Upper abdominal pain with fever, repeated vomiting or yellowing of the skin or eyes also requires prompt medical attention. These symptoms should not be treated as ordinary nausea from a dose increase.
Tell your doctor about previous pancreatitis, gallbladder disease, severe digestive symptoms, kidney or liver disease, and diabetic eye disease. Also mention any personal or family history of thyroid cancer, particularly medullary thyroid carcinoma, or multiple endocrine neoplasia type 2. These details help your doctor assess the precautions relevant to you. A serious allergy to semaglutide or a product ingredient rules out its use.
If you use insulin or a sulfonylurea, your diabetes treatment may need adjustment to reduce the risk of low blood glucose. Do not use this injection at the same time as another semaglutide product or another GLP-1-based treatment. If you are switching medicines, your doctor will give you a plan for stopping one and starting the other. Inform the team managing any planned surgery or sedation because delayed stomach emptying may affect procedural care.
Semaglutide should not be used during pregnancy or breastfeeding. If you are planning pregnancy, it should be stopped at least two months beforehand because it remains in the body for some time. Discuss contraception and pregnancy plans before starting, and contact your doctor if you become pregnant during treatment.
Non-arteritic anterior ischaemic optic neuropathy, or NAION, is an eye condition caused by reduced blood supply to the optic nerve. The European Medicines Agency has classified it as a very rare side effect of semaglutide medicines. Sudden loss of vision or rapidly worsening eyesight requires urgent medical assessment.
This is different from diabetic retinopathy, which also needs attention in patients with diabetes, particularly when blood glucose improves quickly. Tell your doctor about existing eye disease and any new visual symptoms.
Seek urgent medical attention if you experience:
Do not wait for a routine follow-up or a WhatsApp reply if you have these symptoms.
Weight loss can include both fat and lean tissue, so protecting strength and muscle function should be part of the plan from the beginning. A smaller appetite can make it harder to obtain enough protein and other nutrients, even when the number on the scales is falling as intended.
Build meals around a suitable protein source, such as fish, eggs, lean meat, tofu, beans or dairy, alongside vegetables and other foods that provide fibre and nutrients. Protein needs should be individualised, especially if you have kidney disease or another condition affecting dietary requirements. Persistent difficulty eating enough deserves review rather than simply adding supplements without assessment.
Regular resistance exercise, adapted to your fitness and health, helps support muscle and strength during weight loss. Walking and other aerobic activity remain useful, but increasing protein intake alone is not a substitute for exercising the muscles. The aim is to become healthier and more capable as weight decreases, rather than to pursue the fastest possible reduction.
There is no single treatment duration that suits everyone. We review whether the medicine is continuing to help, how well you tolerate it and what support you need to manage your weight over time. Obesity often requires ongoing care, and reaching a target weight does not mean that the tendency to regain weight has disappeared.
Longer-term studies help explain the value of continued treatment. In STEP 5, adults with obesity or overweight and a related health condition, without diabetes, had an average weight reduction of 15.2% after 104 weeks with semaglutide 2.4 mg, compared with 2.6% with placebo. Both groups received behavioural support. This supports sustained benefit during continued treatment, although individual results vary.
In the STEP 1 extension, participants regained around two-thirds of the weight they had previously lost during the year after semaglutide and the study’s structured lifestyle intervention were stopped. This does not mean everyone will follow the same pattern, but it shows why a plan for stopping is as important as a plan for starting.
Before stopping, discuss how you will manage a return of hunger, maintain regular meals and continue resistance exercise and physical activity. Monitoring weight consistently can help identify an upward trend early. Arrange follow-up rather than waiting until substantial regain has occurred, and review alternative support or treatment if needed.
There is no established tapering schedule that guarantees prevention of weight regain. Any change in dose or decision to stop should be agreed with your doctor, with attention to nutrition, appetite and weight-related health conditions as well as body weight.
