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Most people who try oral semaglutide after injectable tirzepatide report preferring to return to weekly injections due to the superior convenience and effectiveness of the injectable route

In other cases, you might need to stay on it for years

### Semaglutide Mechanism of Action Semaglutide achieves **weight loss** through multiple complementary pathways: - **Central appetite suppression** acts on hypothalamic GLP-1 receptors to reduce hunger and increase satiety - **Delayed gastric emptying** slows stomach emptying, prolonging feelings of fullness - **Improved insulin sensitivity** reduces insulin resistance and promotes healthy glucose metabolism - **Reward pathway modulation** reduces cravings and food-seeking behavior by acting on mesolimbic dopamine circuits - **Potential direct effects on adipose tissue** emerging research suggests GLP-1 may directly influence fat metabolism For a complete breakdown of semaglutide's dosing protocol, see our [semaglutide dosing schedule week-by-week guide](/guides/semaglutide-dosing-schedule-week-by-week-guide)

The compound did not affect fasting glucose, insulin, HbA1c, IGF-1, cortisol, thyroid hormones, or liver enzymes (Thompson et al., 2004)