How semaglutide actually works in the body

Your gut already makes a hormone called GLP-1. After every meal, it tells your pancreas to release insulin, slows your stomach from emptying too fast, and quietly tells your brain you've had enough. The problem is that natural GLP-1 only sticks around for a few minutes before your body breaks it down.

Semaglutide is a slightly modified version of that hormone that resists being broken down. One injection lasts about a week. While it's in your system, it does exactly what your own GLP-1 was doing — just for longer.

It's not willpower. The drug isn't doing anything magical. It's translating, in chemical terms, a signal your body was supposed to be sending you all along.

Three things follow

• You feel full faster.
• You feel full for longer.
• The chatter — the food thoughts that used to sit in the back of your head all day — gets a lot quieter.

Doses start very small — 0.25mg per week — and step up gradually. The slow ramp is the entire reason most people tolerate it. We don't move you up until your body's ready.

If you ever stop, the appetite signaling slowly returns to baseline. Sela's job is to use the time you have on the medicine to build the habits that hold afterwards: protein, sleep, walking, gentle accountability.