What did @thatssomelww actually say?
At week three of compounded semaglutide injections, the creator reports zero weight loss, no appetite suppression, and no reduction in cravings. She suspects she may have underdosed herself last week due to distraction. She also just started Strattera (atomoxetine) for ADHD and wonders if that might help more than the semaglutide has so far. Crucially, she says she won't self-escalate her dose early because "I'm not a doctor."
That last part deserves credit upfront. Self-escalating GLP-1 doses without clinical guidance is exactly how people end up with severe nausea, vomiting, and pancreatitis risk. The instinct to stay the course is medically sound, even if it's frustrating to sit with zero visible results at week three.
Does the science back this up?
Yes, largely. Three weeks on a starting dose of semaglutide producing no noticeable weight loss is not unusual. It is, in fact, the expected pattern for most patients during the titration phase.
The STEP 1 trial (Wilding et al., 2021, New England Journal of Medicine) showed that meaningful weight loss with semaglutide at therapeutic doses (2.4 mg weekly) averaged about 14.9% of body weight over 68 weeks. But the early weeks of treatment use much lower doses specifically to allow GI tolerance to build. At 0.25 mg or 0.5 mg weekly, which are typical starting doses, the drug is not expected to produce significant appetite suppression or weight change. The titration schedule exists for tolerability, not effectiveness.
A 2022 review by Rubino et al. in Obesity confirmed that appetite suppression and satiety effects become clinically meaningful only as doses approach the 1.0 mg to 2.4 mg range. Expecting fullness signals at week three on a starter dose is like expecting a car to highway-speed at idle RPM.
What did they get wrong (or right)?
She got the patience part right. She got one thing slightly off: semaglutide does not work primarily by stopping cravings in the way she describes. The mechanism is more about slowing gastric emptying and acting on hypothalamic receptors to reduce overall appetite signaling, not eliminating specific food cravings the way, say, naltrexone targets reward pathways.
The craving she describes, waking up and wanting something specific, is driven partly by dopaminergic reward circuitry. Semaglutide has some emerging evidence in this area (Blum et al., 2023, Journal of Clinical Medicine), but it is not the primary mechanism and is not reliable at low doses.
Her mention of Strattera (atomoxetine) as potentially curbing appetite is not unfounded. Atomoxetine is a norepinephrine reuptake inhibitor, and norepinephrine has appetite-suppressing properties. However, the interaction between a GLP-1 agonist and a norepinephrine reuptake inhibitor has not been well studied in weight management contexts, and she should be discussing this combination with whoever prescribed her semaglutide.
What should you actually know?
A few things matter here that the video glosses over. First, compounded semaglutide is not the same product as FDA-approved Wegovy or Ozempic. The FDA has repeatedly flagged concerns about inconsistent dosing, sterility, and inactive ingredients in compounded versions. Calling it "the medication" as if it is interchangeable with brand-name semaglutide is not accurate.
Second, her suspicion that she may have injected air or gotten an incomplete dose last week points to a real issue with self-administration technique. Subcutaneous injections using vials and syringes require proper training. Prefilled auto-injector pens, used with brand-name versions, largely eliminate this error. With compounded vials, air bubbles, improper angle, or incomplete plunger depression can all reduce the delivered dose.
Third, if someone is three weeks in with zero response and zero side effects, that can sometimes indicate the compounded product's concentration or stability is not what it should be. That is worth raising with the prescribing provider, not just attributed to "trusting the process."