Adults using compounded semaglutide at a commercial wellness studio lost an average of 4.1 kg over 3 months, with body composition shifting toward less fat and proportionally more muscle.
4.57% body weight lost in 3 months94 adults using compounded semaglutide in a commercial wellness setting, with body fat decreasing and muscle proportion increasing
What the researchers found
After 3 months on compounded semaglutide/cyanocobalamin, 94 participants lost an average of 4.11 kg (4.57% of body weight). Fat mass decreased by 2.67 kg and trunk fat by 1.10 kg. Lean mass decreased by 1.43 kg and skeletal muscle by 0.88 kg in absolute terms, but as a proportion of total body weight, lean and skeletal muscle mass actually increased while fat mass proportion decreased. This demonstrates that body composition improved despite some absolute lean mass loss.
Why it matters
Compounded semaglutide has become widely used outside the brand-name pharmaceutical supply chain, but real-world effectiveness data has been scarce. This study shows that compounded semaglutide produces meaningful weight loss in a commercial setting, and importantly provides body composition data addressing the concern that GLP-1 drugs may cause excessive muscle loss.
The numbers in context
n=94 · avg weight loss 4.11 kg (4.57%) at 3 months · fat loss 2.67 kg · trunk fat loss 1.10 kg · lean mass loss 1.43 kg · skeletal muscle loss 0.88 kg · dose range 0.25–2.4 mg/week
How the study worked
Retrospective study of 94 individuals in a commercial weight management programme at a wellness studio from June 2023 to January 2024. Participants received weekly subcutaneous compounded semaglutide/cyanocobalamin injections starting at 0.25 mg/0.125 mg and titrated up to 2.4 mg/0.24 mg. Weight and body composition were measured at baseline and 3 months.
Who was studied
94 adults (81 female, 13 male, mean age 46.6 years) in a commercial weight management programme receiving compounded semaglutide/cyanocobalamin
What this study cannot tell us
This is a retrospective study with no control group, so it's impossible to isolate the effect of semaglutide from other programme components like dietary counseling. The sample was predominantly female (86%) and from a commercial wellness studio, which may not represent the general population. The 3-month follow-up is relatively short. Compounded semaglutide is not FDA-approved and may differ from brand-name formulations.
How to read the evidence
Retrospective observational study without a control group from a single commercial site. Provides useful real-world data but cannot establish causation or compare to placebo. The predominantly female, self-selected sample limits generalizability.
When this study was published
Published in 2025 using 2023–2024 data, this study is highly current and addresses the timely question of compounded semaglutide effectiveness during a period of intense public interest in GLP-1 drugs.
The bigger picture
As GLP-1 receptor agonists become the most prescribed weight loss drugs in history, questions about muscle preservation are front and center. This real-world data suggests that while some lean mass is lost, body composition overall shifts favorably. The study also adds to the limited evidence base for compounded semaglutide formulations, which have become a significant market segment.
Questions still open
- How does compounded semaglutide's efficacy and safety compare directly to brand-name Wegovy or Ozempic in a controlled trial?
- Would adding resistance training to the programme preserve more lean mass during semaglutide-induced weight loss?
- What are the longer-term (6–12 month) body composition outcomes with continued compounded semaglutide use?
Common questions
What is compounded semaglutide and how is it different from brand-name versions?
Does semaglutide cause muscle loss along with fat loss?
Read the original research
Weight loss and body composition after compounded semaglutide treatment in a real world setting.
Diabetes, obesity & metabolism, 27(3), 1536-1543
Citation
Chun, Elizabeth; Siojo, Alexandra; Rivera, David; Reyna, Kirsten; Legere, Henry; Joseph, Richard; Pojednic, Rachele. (2025). Weight loss and body composition after compounded semaglutide treatment in a real world setting.. Diabetes, obesity & metabolism, 27(3), 1536-1543. https://doi.org/10.1111/dom.16162