Lower than the label suggests, and lower than the trials ran. Twelve months after starting, 48% of one clinic’s 206 patients were still taking semaglutide. Among those the maintenance dose split three ways: 40% at 1.0 mg a week or less, 30% at 1.7 mg and 30% at 2.4 mg. Titration was slower and maintenance lower than the approved labeling describes, which is a gap between what a product is licensed to do and what people actually settle into.
One thing not to do with that number is treat a pause as free. A case report describes a woman who had taken 2.4 mg for a year without trouble, stopped for five weeks, and then restarted at the same dose[2]. One day later she needed hospital care for severe nausea, vomiting, diarrhea and electrolyte abnormalities. That is a single patient and says nothing at all about how often it happens, but restarting at the old dose is the part worth asking about.
Almost every price on this roster is quoted as though a buyer will land on one dose and stay there, and almost every trial is run as though everyone escalates to the top. This study is a look at what a real clinic’s patients did instead, and it matches neither assumption. That matters, because the assumption is what the figure on the card is priced against. The related question of who is still paying anything at all is in two-thirds stop within a year.
What was observed
Researchers followed 206 people prescribed semaglutide for weight management in a single general practice, of whom 76% were women [1]. Mean age was 48 and mean starting weight 105 kg.
At twelve months, 78 people (38%) had permanently discontinued and 30 (15%) had paused treatment, leaving 98 — 48% — still taking it. Of those ninety-eight, 40% were being maintained at 1.0 mg a week or less, 30% at 1.7 mg, and 30% at 2.4 mg.
The result, with its clause attached
Mean relative weight change at twelve months was −13.6% (95% CI −15.0 to −12.2). That figure belongs to the 48% who had not discontinued, so it is not what the average person who walked in and started treatment lost, and the study does not claim it is.
Read with that clause, it is still striking: the people who stayed on lower maintenance doses, reached by slower titration than the label describes, lost a great deal of weight. The authors’ own conclusion is that semaglutide is frequently discontinued, and titrated more slowly and to lower maintenance doses than the approved labeling describes. The weight loss among those continuing was substantial nonetheless.
What it means for a price
If most people settle below the top of the ladder, a flat rate is worth more than it first appears and a dose-scaled rate is less alarming than it sounds. That holds only where the seller says which it is. On this roster 135 sellers state a flat figure and 37 state that the price climbs, out of 430. The remainder — 258 of them, 60% — say nothing at all, and silence is the one answer a buyer cannot plan against.
At the median billed figure of $179 a month, a year of injected semaglutide here is $2,148 if the price holds. Whether it holds is precisely what most of these sellers decline to say. Roster read September 2026, and the fee arithmetic behind the median is in what a GLP-1 actually costs.
The other implication is about expectations, because a buyer comparing storefronts is implicitly planning a year of purchases. This study says slightly under half of a real clinic’s patients were still buying at month twelve, and what stopping costs is the part nobody puts on a pricing page.