Compounded Semaglutide Produced Meaningful Weight Loss and Improved Body Composition in a Real-World Setting
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.
Quick Facts
What This Study 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.
Key Numbers
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 They Did This
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.
Why This Research 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 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.
What This Study Doesn't 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.
Questions This Raises
- ?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?
Trust & Context
- Key Stat:
- 4.57% body weight lost in 3 months 94 adults using compounded semaglutide in a commercial wellness setting, with body fat decreasing and muscle proportion increasing
- Evidence Grade:
- 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.
- Study Age:
- 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.
- Original Title:
- Weight loss and body composition after compounded semaglutide treatment in a real world setting.
- Published In:
- Diabetes, obesity & metabolism, 27(3), 1536-1543 (2025)
- Authors:
- Chun, Elizabeth, Siojo, Alexandra, Rivera, David, Reyna, Kirsten, Legere, Henry, Joseph, Richard, Pojednic, Rachele
- Database ID:
- RPEP-10499
Evidence Hierarchy
Frequently Asked Questions
What is compounded semaglutide and how is it different from brand-name versions?
Compounded semaglutide is made by compounding pharmacies rather than the brand manufacturer (Novo Nordisk). It contains the same active ingredient but may differ in formulation and is not FDA-approved as a finished product. It became popular during brand-name shortages and is typically less expensive.
Does semaglutide cause muscle loss along with fat loss?
This study found that participants lost some lean mass (1.43 kg) alongside fat mass (2.67 kg). However, as a proportion of total body weight, muscle mass actually increased while fat proportion decreased — meaning body composition improved overall even though some absolute muscle was lost.
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Cite This Study
https://rethinkpeptides.com/research/RPEP-10499APA
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
MLA
Chun, Elizabeth, et al. "Weight loss and body composition after compounded semaglutide treatment in a real world setting.." Diabetes, 2025. https://doi.org/10.1111/dom.16162
RethinkPeptides
RethinkPeptides Research Database. "Weight loss and body composition after compounded semaglutid..." RPEP-10499. Retrieved from https://rethinkpeptides.com/research/chun-2025-weight-loss-and-body
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkPeptides research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.