GLP-1 Weight Management
Compounded Semaglutide Weight Loss Therapy
Semaglutide is a GLP-1 receptor agonist that helps regulate appetite, slow gastric emptying, and support sustainable weight loss when combined with diet and exercise. Available in three concentrations to match your treatment phase.
15%
Avg Body Weight Loss
68
Week Clinical Trial
1x
Weekly Injection
22+
BHRC Locations
Choose Your Formulation
We offer three concentrations to support you from initial titration through long-term maintenance. Your physician will recommend the best option based on your treatment phase.
5mg per vial
Ideal For
New patients beginning semaglutide therapy who need lower doses during the titration period.
10mg per vial
Ideal For
Patients who have completed titration and are on therapeutic doses during active weight loss.
20mg per vial
Ideal For
Patients on maximum dose (2.4mg) or those preferring fewer refills with extended supply.
The Science
Semaglutide is a GLP-1 (glucagon-like peptide-1) receptor agonist that mimics a hormone naturally produced in your gut after eating. This hormone signals your brain to feel satisfied, reduces appetite, and slows the rate at which food leaves your stomach.
Originally developed for type 2 diabetes management, semaglutide demonstrated such significant weight loss effects that the FDA approved it specifically for chronic weight management in adults with obesity or overweight with at least one weight-related condition.
At BHRC, our physicians prescribe semaglutide as part of comprehensive programs that include nutrition counseling, lifestyle guidance, and ongoing monitoring to help you achieve and maintain your goals.
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How It Works
Semaglutide works through multiple pathways to support sustainable weight loss.
Activates receptors in the brain that control hunger and satiety, helping you feel satisfied with smaller portions and reducing cravings between meals.
Delays stomach emptying so food stays in your system longer. This prolongs feelings of fullness and helps prevent overeating at subsequent meals.
Stimulates insulin release when blood sugar rises and reduces glucagon secretion, helping maintain stable glucose levels throughout the day.
Clinical Benefits
In the STEP 1 trial of the approved 2.4mg brand dose, participants lost an average of 15% of their body weight over 68 weeks—significantly more than diet and exercise alone.
Works with your body's natural hunger signals to reduce cravings and help you feel satisfied with smaller portions.
May improve blood sugar control, blood pressure, and cholesterol levels—benefits that extend beyond weight loss alone.
Studies indicate reduced risk of major cardiovascular events in adults with obesity and established heart disease.
Just one injection per week—simple to incorporate into your routine without daily medications or complicated schedules.
When combined with lifestyle changes, helps establish healthier eating patterns that can be maintained long-term.
Your Journey
Our medical team guides you through every step—from initial consultation to ongoing optimization.
Meet with our physician to discuss goals, review health history, and determine if semaglutide is right for you.
Complete necessary bloodwork to check whether treatment is appropriate and establish your baseline.
Start at a low dose (S5) that gradually increases over weeks to minimize side effects and optimize results.
Regular check-ins to monitor progress, adjust dosing (S10/S20), and provide nutrition guidance.
Safety & Candidacy
Brand-name semaglutide (Wegovy) is FDA-approved for adults with a BMI of 30 or higher, or 27+ with at least one weight-related condition such as hypertension, type 2 diabetes, or high cholesterol.
2021
FDA approval for chronic weight management in adults
STEP
Comprehensive clinical trial program with thousands of participants
At a glance
Your plan
The BHRC clinical team reviews your weight history, BMI, waist, weight-related conditions such as high blood pressure, prediabetes, sleep apnea or high cholesterol, previous attempts, eating pattern and medications. The label criteria for the approved product, generally a BMI of 30 or more, or 27 or more with a weight-related condition, are the starting framework. Your goals matter too: a plan aimed at a specific health marker, such as blood pressure or HbA1c, is reviewed differently from one aimed at a target weight.
Personal or family history of medullary thyroid cancer or MEN 2, pancreatitis, gallbladder disease, kidney function, diabetic eye disease, pregnancy plans and current diabetes medication are reviewed. Baseline labs typically include a metabolic panel, HbA1c and lipids. If you already see a primary care doctor or endocrinologist, BHRC can share results with them so your care stays joined up.
The provider discusses whether a brand product is appropriate and available to you, including insurance coverage, or whether compounded semaglutide is clinically justified. If compounded, the plan starts with the S5 vial and a written titration schedule. The provider explains why a compounded product was chosen for you, and that reason is documented in your record.
Because vials do not have the built-in dose counter of a pen, the clinic teaches you exactly how to draw your dose, what the syringe markings mean for your vial's concentration, and how to store and discard it. You confirm the dose back before leaving. FDA and poison-control data show dosing errors with compounded vials are a real risk, so this step is not skipped.
Check-ins during titration review weight, side effects and readiness to step up. Once you reach your maintenance dose, the plan moves to a larger vial and less frequent visits, with periodic labs and a discussion about long-term use, since weight tends to return after stopping. Some people stay on a maintenance dose long term, others taper with close monitoring; the choice is made with the provider, not by running out of medication.
Timeline
Low starting dose. Appetite may soften and some people feel mild nausea or fullness. Weight change is usually small at this stage; the goal is tolerability. Eating smaller meals, stopping when full and avoiding very fatty food make the first weeks easier for most people.
Stepwise dose increases. Stomach side effects tend to cluster around each increase and then ease. Most visible weight change begins here. A dose increase is never automatic; if side effects are still settling, the provider may hold you at the same step for longer.
Maintenance dosing. In the STEP 1 trial of the approved 2.4mg weekly dose with lifestyle support, average weight loss was about 15% at 68 weeks versus about 2% on placebo. Individual results vary widely.
Long-term plan. In the STEP 1 extension, people who stopped semaglutide regained about two-thirds of the weight they had lost within a year.
Compare
| Option | Form | Evidence | Status |
|---|---|---|---|
| Compounded semaglutide (S5 and larger vials) | Multi-dose vial and syringe, weekly | Relies on trials of the brand product | Not FDA-approved |
| Wegovy (semaglutide) | Prefilled pen, weekly | STEP and SELECT trials | FDA-approved for chronic weight management and cardiovascular risk reduction in eligible adults |
| Tirzepatide | Weekly injection; compounded vial or brand pen | SURMOUNT trials | Brand products FDA-approved; compounded vials are not |
| Lifestyle program alone | Nutrition, activity, sleep and behavior coaching | Extensive | No prescription needed |
Is it right for you?
Monitoring
Every visit records weight, waist and blood pressure, along with side effects. Stomach effects such as nausea, vomiting, diarrhea and constipation are the most common reason people stop early, and they are usually manageable with slower titration, smaller meals and hydration. Persistent vomiting, severe abdominal pain that spreads to the back, pain in the upper right abdomen, or signs of dehydration need prompt medical attention.
Labs are repeated at intervals your provider sets, typically including HbA1c, kidney function and lipids. If you take diabetes medication, blood sugar is monitored more closely because doses of other drugs may need to come down. Loss of muscle along with fat is a recognized concern with rapid weight loss, so protein intake and resistance training are part of every plan. A body-composition scan at baseline and during maintenance helps show whether the weight lost is mostly fat.
For compounded vials specifically, the clinic records the pharmacy, lot, concentration and beyond-use date, and checks at each refill that you are still drawing the right volume. A 2023 poison-control case series described patients drawing up to ten times their intended dose from compounded vials, and a 2026 analysis of FDA adverse event reports found compounded GLP-1 reports were more often linked to preparation errors and product-quality issues than brand products. FDA also advises discarding multi-dose vials within 28 days of first use.
Regulatory status
Regulatory status: Semaglutide is FDA-approved as Wegovy for chronic weight management and cardiovascular risk reduction in eligible adults, and as Ozempic and Rybelsus for type 2 diabetes; these products carry a boxed warning about thyroid C-cell tumors. The S5 vial on this page, and BHRC's other semaglutide vials, are compounded preparations. Compounded drugs are not FDA-approved, and FDA does not review them for safety, effectiveness or quality. FDA advises that compounded drugs should only be used when a patient's medical need cannot be met by an FDA-approved drug, and has reported adverse events linked to dosing errors with compounded semaglutide. Semaglutide is prescribed at BHRC only after a consultation and labs with a licensed provider. Prepared by the BHRC team from FDA and PubMed sources.
Before you book
BHRC's West Hollywood and West Los Angeles clinics serve patients from Beverly Hills and the Westside, and Valencia and Westlake Village serve the northern and western suburbs. Each starts with a consultation and labs. BHRC also has clinics in Nevada, Arizona and Texas that follow the same process.
S5 is shorthand for a 5mg semaglutide vial used during the starting weeks. People sometimes search for it as SM5 or call it the SM5 peptide; it is the same compounded semaglutide, just a smaller vial. Later vials hold more semaglutide so that higher maintenance doses do not run out quickly.
It contains the same active ingredient but it is not the same product. Wegovy and Ozempic are made by the manufacturer under FDA approval, in prefilled pens with fixed dose steps. Compounded semaglutide is prepared by a pharmacy, is not FDA-approved, and is drawn up with a syringe. FDA states that compounded drugs should only be used when a patient's medical need cannot be met by an FDA-approved drug.
Your provider writes your schedule at the consult. For an educational overview of how semaglutide doses are usually stepped up, see our Semaglutide Dosage Chart. Please do not use it to change your own dose.
Cost depends on whether brand or compounded medication is appropriate, which vial strength you need at each stage, how often you are seen and which labs are repeated. Prices are not listed on this page; the clinic gives an itemized quote after the consultation. Brand products may be partly covered by insurance for approved uses, while compounded vials generally are not.
The approved product's label uses BMI and weight-related conditions as the main criteria, and BHRC starts from the same framework. Your provider also considers your medical history, medications and goals. Some people who ask turn out to be better served by a different medication or a lifestyle program first. If you do not meet the criteria, the provider will tell you directly and explain the alternatives.
Nausea, vomiting, diarrhea, constipation and reduced appetite are most common, especially after dose increases. Less common but more serious risks listed on the approved label include pancreatitis, gallbladder problems, kidney injury from dehydration, and a boxed warning about thyroid C-cell tumors seen in rodents.
In the SELECT trial of more than 17,000 adults with existing cardiovascular disease and overweight or obesity but no diabetes, the approved 2.4mg weekly dose reduced the combined risk of cardiovascular death, heart attack or stroke by about 20% compared with placebo. Wegovy is FDA-approved for that use in eligible adults. Those results come from the brand product, not from compounded vials.
Weight usually comes back. In the STEP 4 trial, people who switched to placebo after 20 weeks regained weight while those who continued kept losing. BHRC discusses a long-term plan from the start, including what maintenance might look like.
Yes, with your provider's guidance. Doses are converted carefully because the measuring method is different, and the first injection after a switch is usually reviewed with the clinic. Never switch between products, or between pharmacies, without telling the clinic, because concentrations can differ from one vial to another.
Selected research
The literature below is peer-reviewed background on Semaglutide and the mechanisms discussed on this page, so you can read the primary sources yourself. It is not evidence of any particular outcome at BHRC, and some of it is preclinical work in animals or cells. Your provider will discuss what the evidence does and does not support for your situation.
Related peptide therapies
Questions
S5, S10, and S20 refer to the total milligrams of semaglutide per vial (5mg, 10mg, and 20mg). S5 is typically used during initial titration when doses are lower (0.25–0.5mg weekly). S10 is most common during active treatment at therapeutic doses (1.0–1.7mg). S20 is for patients on maximum dose (2.4mg) or those preferring extended supply with fewer refills. Your physician will recommend the appropriate formulation based on your treatment phase.
Semaglutide is administered as a once-weekly subcutaneous injection. Our clinical team will teach you proper technique during your initial visit. Most patients find the injections quick and relatively painless after a short learning curve.
In the STEP 1 trial of brand semaglutide 2.4mg, participants lost an average of 15% of their body weight over 68 weeks. Individual results vary based on starting weight, diet, exercise, and adherence to the program. Most patients begin noticing reduced appetite within the first few weeks, with significant weight loss typically occurring during months 3–6 at therapeutic doses.
The most common side effects are gastrointestinal: nausea, vomiting, diarrhea, and constipation. These typically occur during dose increases and improve over time. Starting at a low dose (S5) and gradually increasing helps minimize these effects. Our team monitors you throughout treatment to manage any side effects.
Semaglutide is not recommended for individuals with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2. It should not be used during pregnancy or breastfeeding. Our physicians will review your complete health history during consultation to ensure this treatment is appropriate for you.
Semaglutide is typically prescribed as a long-term treatment. Studies show that weight regain is common when the medication is discontinued without sustained lifestyle changes. Our team works with you to develop habits that support your results, whether you continue on maintenance doses (often S10 or S20) or eventually transition off therapy.
Most patients progress through formulations as their treatment advances. You'll likely start with S5 during the titration period (first 4–8 weeks), then move to S10 once at therapeutic doses. Some patients transition to S20 when on maximum dose or for the convenience of extended supply. Your physician guides these transitions based on your progress and needs.
Get Started
Schedule a consultation with our medical team to learn which semaglutide formulation is right for your health goals.
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Or call us directly: +1 213-325-3373
*Brand-name semaglutide (Wegovy) is FDA-approved, and BHRC's S5, S10 and S20 vials are compounded and not FDA-approved, for chronic weight management in adults with a BMI ≥30, or ≥27 with at least one weight-related condition. Individual results may vary. Common side effects include nausea, vomiting, diarrhea, and constipation. Not recommended for individuals with a personal or family history of medullary thyroid carcinoma or MEN 2 syndrome. A consultation with our medical team is required to determine if this therapy is appropriate for you.
