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A person starting semaglutide (the drug in Ozempic and Wegovy) posted that after four weeks on a low dose (0.25 mg) they’re eating very little—saying “one mill a day” which likely means one milliliter or a single dose—and are still gaining weight despite drinking lots of water and walking 10,000 steps. They’re asking if gaining weight is normal on this dose and sounding worried because it’s their first time using the medicine. Semaglutide is a medicine that acts like a natural gut hormone that tells your brain you’re full and slows how fast your stomach empties. Doctors use it for diabetes and, at higher doses, for long-term weight loss. It’s not a fat-melting drug; it changes appetite and some body signals so people tend to eat less and often lose weight over weeks to months. The dose the person mentioned (0.25 mg) is usually the very first “starter” dose in a multi-week plan that increases gradually. What the anecdote actually shows is one person’s early experience, not a scientific result. Clinical trials of semaglutide show weight changes over months, not weeks, and most people don’t see large drops right away. Some people gain weight early on because they’re retaining water, changing eating patterns, or because the dose is too low to produce the appetite-suppression effects yet. Also, self-reported stories on forums can be noisy: measurements might not be consistent, and short-term weight can bounce up and down a few pounds for many non-diet reasons. Why this matters: if you’re starting semaglutide, it’s useful to expect a gradual process. The first few weeks are often about letting your body adjust and increasing the dose slowly to reduce side effects. People who want weight loss should know it’s normal not to see immediate results and that lifestyle habits—consistent diet, sleep, and movement—still matter. It’s also reassuring to know your experience isn’t unique; others report similar early fluctuations. Caveats and risks: this post is a single person’s report, not a medical study. Short-term weight gain can come from temporary water retention, constipation, hormonal shifts, or changes in food choices—not necessarily the drug failing. Semaglutide can cause side effects like nausea, stomach discomfort, constipation or diarrhea, and it’s not suitable for everyone (for example, people with certain pancreas or thyroid conditions). If weight gain or other worrying symptoms persist, or if you’re unsure about dosing, talk to the prescribing clinician before making changes. Bottom line: early weight gain on a starter 0.25 mg semaglutide dose isn’t unheard of and doesn’t mean the drug won’t work, but it’s worth checking with your doctor if it continues or if you have other symptoms.
Source: r/Semaglutide