What are the average weight loss results for patients taking semaglutide with cyanocobalamin?

1. The best direct evidence: short‑term, real‑world results

A published retrospective analysis of 94 patients treated in a commercial wellness program with compounded semaglutide plus cyanocobalamin reported mean weight loss of 4.11 (±2.77) kg — about 4.57% (±2.96%) of baseline weight — at the 3‑month primary endpoint, and documented fat‑mass loss of 2.67 (±2.37) kg with smaller absolute lean‑mass losses ^{[1] [6]}. That study used once‑weekly injections starting at low doses and titrating to a maximum semaglutide dose of 2.4 mg (with cyanocobalamin included in the compound) and concluded that meaningful weight loss is achievable outside tightly controlled trials, while noting the real‑world context of the data ^{[6] [1]}.

2. What the randomized trials say — and what they don’t

Large randomized trials of semaglutide used for weight management (e.g., the STEP programme) have shown average weight reductions near ~15% of baseline after longer treatment durations (around 68 weeks), but those pivotal trials tested semaglutide itself (branded formulations such as Wegovy) rather than routinely co‑formulating it with cyanocobalamin, so direct attribution of those percentage losses to a semaglutide+B12 combination is unsupported by the trial data ^{[5] [7]}. Industry and clinic marketing often cite the STEP‑era magnitude of semaglutide’s effect when promoting compounded semaglutide+B12, creating an impression that the combination provides the same long‑term percentages — a claim not tested in randomized trials according to available reporting ^{[2] [3] [4] [5]}.

3. The role of cyanocobalamin — physiology vs. evidence

Cyanocobalamin (vitamin B12) is sometimes added by providers for perceived benefits to energy, metabolic support, or to reduce nausea, and many clinics compound weekly semaglutide+B12 formulations or administer B12 alongside semaglutide injections ^{[8] [6]}. However, authoritative summaries and reviews note that B12 is not itself a weight‑loss agent and that there is no robust clinical evidence showing that adding B12 to semaglutide enhances weight loss; some reviews explicitly state semaglutide has not been studied in combination with B12 in trials, and that adding B12 offers benefit mainly for patients with documented deficiency ^{[5] [8]}.

4. How to read the varied claims and commercial incentives

Clinic and medspa webpages frequently report larger average poundages or percentages (for example, “15–20 lb over 26–30 weeks” or “12–15% over 68 weeks”) and present compounding semaglutide+B12 as superior, but these sources are promotional and do not substitute for randomized data; several pieces explicitly acknowledge that clinical studies of semaglutide alone show large weight loss while noting the combination has not been formally studied in trials ^{[3] [2] [4] [5]}. The commercial incentive to advertise enhanced or faster results is a plausible hidden agenda across many clinic sites and should temper acceptance of their numeric claims without peer‑reviewed evidence ^{[3] [4]}.

5. Bottom line and reporting limitations

The clearest, peer‑reviewed estimate specifically for compounded semaglutide with cyanocobalamin in a real‑world clinic cohort is ~4.11 kg (4.57%) weight loss at three months, with preferential fat loss ^[1]. Larger percentages commonly cited reflect semaglutide’s established long‑term effects when used alone in randomized trials or come from promotional materials rather than trials of the combination, and available sources acknowledge that semaglutide+B12 has not been rigorously compared to semaglutide alone in controlled studies ^{[5] [2]}. Reporting is limited by small real‑world sample sizes, short follow‑up in the combination study, and the promotional nature of many clinic claims, so definitive conclusions about added benefit from cyanocobalamin cannot be drawn from the sources reviewed ^{[1] [3] [5]}.