Week 2 semaglutide results: what 5 pounds actually means

What did @alexislachelle_ actually say?

The creator said she lost five pounds in her first week on "Sima Goutai" (semaglutide), that she's on the 0.25 mg starting dose, and that she had zero nausea. She's promoting a telehealth service called @myweightlosspartner and offering $100 off for anyone who uses her name. She also showed the injection process, including the alcohol swab prep.

To her credit, she was transparent about the dose, showed the actual needle, and specifically told viewers not to book consultations unless they intended to follow through. That's a more responsible framing than most GLP-1 influencer content, which typically skips the practical details entirely. But the affiliate discount code embedded in a medical product promotion is worth flagging. More on that below.

Does the science back this up?

Five pounds in week one is plausible, but it's almost certainly not fat loss. That needs to be said plainly. Early weight loss on semaglutide is largely water weight and glycogen depletion, not adipose tissue reduction.

The STEP 1 trial (Wilding et al., 2021, New England Journal of Medicine) found that participants on 2.4 mg semaglutide lost an average of 14.9% of body weight over 68 weeks. That's an average of roughly 0.2 to 0.3 pounds per week across the full trial period. Week-one numbers, especially at the 0.25 mg titration dose, are not representative of sustained fat loss. Researchers studying GLP-1 pharmacodynamics note that appetite suppression at 0.25 mg is minimal compared to therapeutic maintenance doses. The drug hasn't even reached steady-state plasma levels in week one.

Her report of no nausea at 0.25 mg is also consistent with the literature. The STEP trials reported that nausea was most common at dose escalation points, not at the starting titration dose (Davies et al., 2021, Lancet).

What did they get wrong (or right)?

She got the dose transparency right. Showing the needle and stating "point two five milligrams" gives viewers actual clinical context, which is rare in this content category. She also framed the product correctly as a shot rather than a supplement, which matters legally and medically.

What she got wrong, or at minimum didn't address: she never specified whether this is compounded semaglutide or a brand-name product like Wegovy or Ozempic. That distinction is not minor. Compounded semaglutide is not FDA-approved and has no confirmed bioequivalence data against brand-name formulations. The FDA issued warnings in 2023 and 2024 about compounded semaglutide products from 503A and 503B facilities, citing quality and dosing concerns. Presenting an affiliate-linked telehealth service without clarifying whether the product is compounded leaves viewers without information they need to make an informed decision.

The "$100 off by mentioning my name" structure also means she has a financial stake in viewer conversions, which wasn't disclosed in the video itself.

What should you actually know?

If you're considering semaglutide for weight management, the starting dose of 0.25 mg is a titration dose, not a therapeutic dose. Clinical guidelines from the American Diabetes Association and the manufacturer's prescribing information both specify that 0.25 mg is used for four weeks to improve tolerability, not to produce weight loss. Expecting five-pound weekly losses to continue at this dose is not realistic.

The more important question for most viewers is whether the product being sold through linked telehealth platforms is compounded or brand-name. Compounded semaglutide was placed on the FDA's list of drugs with shortage-based compounding permissions, and as brand-name supply has improved, FDA has moved to restrict compounding. As of early 2025, the legal status of compounded semaglutide is actively contested. Patients using these products should ask their prescriber directly: is this compounded, from which facility, and what quality testing has been done.

A referral code attached to a prescription medication service is a financial conflict of interest. That doesn't mean the product is bad, but it means you are watching an advertisement, not a health update.