Average Weight Loss on Ozempic: What the Trials Found

Average weight loss, trial by trial

Two kinds of trials shown on this page report semaglutide weight loss: SUSTAIN trials in diabetes, at Ozempic-range doses, and STEP trials at 2.4 mg. This table keeps each result next to its dose.

Read the table from top to bottom and the pattern is plain. The Ozempic-dose rows in people with diabetes sit between 4.6 kg and 6.9 kg. The 2.4 mg rows are given in percent and run from 9.6% to 15.2%. Kilograms and percent are different measures, so the two groups of rows are not directly comparable, and the people in them were not the same either.

Disclaimer: this is label information, not a recommendation. Dose decisions belong with a licensed clinician who knows your history.

Sources: SUSTAIN 7 trial, 2018 (PubMed); SUSTAIN FORTE trial, 2021 (PubMed); STEP 1 trial, 2021 (PubMed); STEP 2 trial, 2021 (PubMed); STEP 5 trial, 2022 (PubMed)

How much weight did people lose at Ozempic doses?

In the diabetes trials, average loss rose with dose: 4.6 kg on 0.5 mg and 6.5 kg on 1.0 mg in SUSTAIN 7, and 6.9 kg on 2.0 mg in SUSTAIN FORTE.

SUSTAIN 7 compared semaglutide with dulaglutide, another weekly GLP-1 shot, in people with type 2 diabetes. At the lower doses, semaglutide 0.5 mg cut weight by 4.6 kg against 2.3 kg for dulaglutide 0.75 mg. At the higher doses, semaglutide 1.0 mg cut weight by 6.5 kg against 3.0 kg for dulaglutide 1.5 mg.

SUSTAIN FORTE tested a higher dose against the usual one. At week 40, mean weight change was 6.9 kg down with semaglutide 2.0 mg and 6.0 kg down with 1.0 mg. The extra milligram added under one kilogram on average.

The FDA label for Ozempic lists this step-up:

• Start at 0.25 mg once weekly.
• After 4 weeks, increase to 0.5 mg once weekly.
• If more blood sugar control is needed, or to lower the risk of kidney decline, end-stage kidney disease and cardiovascular death, increase to 1 mg once weekly after at least 4 weeks on 0.5 mg.
• If more blood sugar control is still needed, increase to 2 mg once weekly after at least 4 weeks on 1 mg. The maximum dose is 2 mg once weekly.

Disclaimer: this is label information, not a recommendation. Dose decisions belong with a licensed clinician who knows your history.

Note the reasons the label gives for going up are medical: better blood sugar control, or lowering the risk of kidney decline, end-stage kidney disease and cardiovascular death. Weight loss is not one of them. The full schedule, Ozempic and Wegovy side by side, is in our semaglutide dosage chart.

Sources: SUSTAIN 7 trial, 2018 (PubMed); SUSTAIN FORTE trial, 2021 (PubMed); Ozempic label (FDA, via DailyMed)

Why the 2.4 mg results are not Ozempic results

The STEP trials tested semaglutide 2.4 mg, the dose sold as Wegovy for weight. The STEP 2 report calls semaglutide 1.0 mg "the dose approved for diabetes treatment", so the two should not be mixed.

STEP 1 enrolled adults with overweight or obesity. From the start to week 68, mean weight change was 14.9% down on semaglutide against 2.4% down on placebo. In kilograms, that was 15.3 kg against 2.6 kg.

STEP 2 enrolled adults with overweight or obesity who also had type 2 diabetes. On 2.4 mg, estimated mean weight change at week 68 was 9.6% down, against 3.4% on placebo. That is the closest STEP trial to the people Ozempic is labeled for, and its result is clearly smaller than STEP 1.

STEP 5 ran for two years. At week 104, mean weight change was 15.2% down in the semaglutide group of 152 people, against 2.6% on placebo.

The Wegovy label prints the same STEP 1 and STEP 2 figures, 14.9% and 9.6%, in its body weight table. A 2026 network meta-analysis of drugs for adults with overweight or obesity found that injected semaglutide gave a mean difference of -9.8% in body weight (95% confidence interval -10.6% to -9.1%) compared with lifestyle change alone at one year. The line we read does not name a specific milligram dose, so treat it as a pooled summary across trials, not a single trial result. For how the two brands differ, see Wegovy vs Ozempic; for semaglutide against tirzepatide, see tirzepatide vs semaglutide.

Sources: STEP 1 trial, 2021 (PubMed); STEP 2 trial, 2021 (PubMed); STEP 5 trial, 2022 (PubMed); Wegovy label (FDA, via DailyMed); BMJ network meta-analysis of obesity drugs, 2026 (PubMed)

How many people lost at least 5% or 10%?

In STEP 1, at the 2.4 mg dose, 86.4% of people on semaglutide lost 5% or more of their weight, and 69.1% lost 10% or more.

This is the best answer the trials give to "will it work for me": most people on 2.4 mg passed the 5% mark, but not everyone. The SUSTAIN abstracts we used report averages only, so we have no matching split for Ozempic doses.

Sources: STEP 1 trial, 2021 (PubMed)

What happens outside clinical trials?

One real-world study of semaglutide in people with type 2 diabetes found median weight fell from 100.0 kg to 91.5 kg, and median BMI from 33.6 to 30.9.

A median is the middle person, not an average, and this study had no placebo group. Even so, the size of the drop sits close to the SUSTAIN range above, which fits the trial picture for people with diabetes.

Sources: Real-world semaglutide study, 2025

How long would it take to lose 20 lbs on Ozempic?

No trial we read reports a time to reach a set number of pounds. The results come as averages at fixed points: week 40, week 68 or week 104.

Twenty pounds is about 9 kg. Against that, the Ozempic-dose averages in diabetes were 4.6 kg to 6.9 kg, all under 9 kg, and SUSTAIN FORTE reached 6.9 kg at week 40. At the 2.4 mg Wegovy dose, STEP 1 averaged 15.3 kg at week 68, well over 9 kg. These are group averages, and the trials did not report weight week by week in the lines we used, so they cannot tell any one person how long it will take. For timing at the Wegovy dose, see how long Wegovy takes to start working.

Sources: SUSTAIN 7 trial, 2018 (PubMed); SUSTAIN FORTE trial, 2021 (PubMed); STEP 1 trial, 2021 (PubMed)

How does Ozempic work?

Ozempic is semaglutide, which the label calls a GLP-1 analogue with 94% sequence homology to human GLP-1. It is made to act like a gut hormone the body already releases.

The label's first listed use is as an add-on to diet and exercise to improve blood sugar control in adults with type 2 diabetes. Its other listed uses are about the heart and kidneys. Our search of the label found no weight loss use; that use belongs to Wegovy, the same drug at a different dose.

Sources: Ozempic label (FDA, via DailyMed)

Is Ozempic safe?

Ozempic is FDA approved for its labeled uses, and the label carries a boxed warning about thyroid tumors seen in rodents. The label also lists stomach side effects.

The boxed warning says that in rodents, semaglutide causes thyroid C-cell tumors that depend on dose and on time on treatment, at exposures relevant to people. The label's side effect table from its diabetes trials names nausea, vomiting, diarrhea, abdominal pain and constipation among them.

Our guide to GLP-1 side effects covers these in more depth, and Ozempic burps covers one common complaint.

Sources: Ozempic label (FDA, via DailyMed)

Common questions

Sources: Ozempic label (FDA, via DailyMed); SUSTAIN 7 trial, 2018 (PubMed); SUSTAIN FORTE trial, 2021 (PubMed); STEP 1 trial, 2021 (PubMed)