Inclusion Criteria:  BMI greater than or equal to 27 kg/m2 Of Amish Descent  Exclusion Criteria:  Woman of childbearing age who is sexually active History of diabetes (HbA1c > 6.5% or random glucose >200 mg/dL) Known allergy to semaglutide Medical issues, which in the judgment of the research physician or PIs might increase the risk associated with participation in the study eGFR < 60 mL/min/1.73 sq. m. Hematocrit < 35% TSH < 0.4 o4 > 5.5 AST or ALT in excess of 2X the upper limit of normal Unable to discontinue a drug, vitamin, or nutritional supplement, which in the judgment of the research physician or PIs might alter the response to semaglutide Personal or family history of medullary carcinoma of the thyroid or multiple endocrine neoplasia, type 2