How long will it take to notice weight loss?

Weight loss can vary among patients. Some notice weight loss right away, others can take one month or more. Consistency is important. Continue to take as directed and your provider will titrate your dose as needed to promote optimal weight loss tailored to your clinical needs. On average, 1-2 pounds per week (or 6-8 pounds per month) of weight loss is typically considered safe. That said, individual targets may vary and should be discussed with your weight management clinician. Please note that prior to every visit, you will need an updated weight, blood pressure and heart rate measurement.

What is a branded GLP-1 medication?

Branded GLP-1s, renowned for their groundbreaking applications in diabetes management, have emerged as a promising and innovative solution for individuals seeking effective and sustainable weight loss. Engineered by leading pharmaceutical companies, these GLP-1 receptor agonists harness the power of Glucagon-Like Peptide-1 to not only regulate blood sugar levels but also to address the intricate interplay between metabolism and body weight.

The distinct feature that sets these branded GLP-1s apart in the realm of weight management is their ability to influence satiety and reduce appetite. The drugs work by mimicking GLP-1, a gut hormone produced naturally by your body that is involved in insulin release and appetite regulation. GLP-1 medications have been shown to encourage insulin release after you eat, while also inhibiting glucagon production and slowing down digestion. Together, these effects help to control blood sugar, reduce appetite, and lead to weight loss.

What is a compounded GLP-1 medication?

Drug compounding is often regarded as the process of combining, mixing or altering ingredients to create a medication tailored to the needs of an individual patient. Compounding includes the combining of two or more drugs. Compounded drugs are not FDA-approved. That said -

We ensure that the ingredients used in the prescribed GLP-1 compounds are pharmaceutical grade and NOT research grade.

We ensure that the GLP-1 medication is compounded using its base form and NOT its salt form.

The compounding pharmacy conducts third-party quality testing to check for potency, sterility and the presence of toxins.

We ensure complete due diligence of the compounding pharmacy, including but not limited to accreditations, licensures, and manufacturing/storage/tracking processes.

What are the most common side effects of GLP-1?

GI side effects are most common when initiating GLP-1 therapy. Nausea, diarrhea, constipation and lack of appetite are among the most common. Your provider may be able to prescribe medication to help manage these side effects. Often these side effects resolve over time.

How does GLP-1 therapy work?

GLP-1 therapy can help with weight loss by making you feel full and reducing appetite. GLP-1 is a hormone that our bodies naturally produce. When we eat food, GLP-1 is released and tells our brains that we're full. With GLP-1 therapy, doctors give you a medicine called a GLP-1 agonist. This medicine works like the natural GLP-1 in your body. It tells your brain that you're full even if you haven't eaten as much food. This can help you eat less and make healthier food choices. When you eat less and make healthier choices, you can lose weight over time.

How is GLP-1 therapy administered?

There are two ways GLP-1 medications are administered: orally and via injection. The injectable method is currently more common and is administered with a small insulin needle. You can inject this below the level of the skin in your abdomen, the outside of your thigh, or the outside of your upper arm. Check out this helpful guide on giving a subcutaneous injection from the University of Michigan.

Injecting using a pre-filled pen (typically a branded GLP-1):

Video: Ozempic® (semaglutide) injection 0.5 mg, 1 mg, or 2 mg Pen Instructions for Use | novoMEDLINK™

Injecting using a vial/needle/syringe (typically a compounded GLP-1):

How to inject compounded tirzepatide.

Can GLP-1 therapy be combined with other chronic medications?

Yes, GLP-1 therapy can be combined with many other chronic medications such as those used for diabetes, blood pressure and high cholesterol. That said, there are certain medications and conditions which are not a good fit for GLP-1 therapy. It is important to notify both your PCP and your weight management clinician of any medications added or removed so they can continue to follow your progress and make other medication adjustments as needed.

What lifestyle changes should I make while on GLP-1 therapy?

When you're on GLP-1 therapy, there are some simple lifestyle changes that can help you stay healthy and get the best results from the medicine. These include eating healthy foods, drinking plenty of water, listening to your healthcare provider, and sleeping well. Remember, GLP-1 therapy can be helpful, but it's just one part of taking care of yourself. Making healthy choices with food, exercise and sleep will make you feel strong and happy. And don't forget to have fun and enjoy life with your friends and family!

Are there any interactions with other medications or medical conditions?

Yes, there may be interactions with your current medications. This is why it is important to list ALL of your medications AND supplements for your weight loss provider to review. Additionally, it is important to notify your in-person healthcare providers of any GLP-1 added so they do not start you on a medication that is contraindicated while on GLP-1 therapy.

What can I expect from my initial level of medication in terms of weight loss?

Please note that the initial level of medication is usually intended to be a starter dose to help your body get used to to the mechanism and effects of the medicine in association with a balanced diet and lifestyle program. It is common to not see significant weight loss on this level, but it is important for the reasons mentioned above. At your subsequent visit, your provider will evaluate your progress and increase the level of your medication if appropriate.

Why haven't I lost weight on my medication?

Some patients will notice an immediate weight loss and others will require higher doses of medication to achieve weight loss. Continue to use your medication as prescribed and your provider will titrate as necessary to promote weight loss.

When can I expect my side effects to resolve?

Most people find that side effects decrease over time. If you are finding it hard to manage side effects, please mention this to your provider.

How can I maintain my weight loss? 

Exercise 3-5 days a week, drink plenty of water and eat a well balanced diet. Smaller portion sizes can help reduce excess calorie consumption. 

As far as healthy eating goes, patients are not required to follow a specific diet, but it is important that you implement a reduced-caloric diet. Here are some recommendations:

Decrease calories and work up to a ~500 kcal daily energy deficit.

Consider intermittent fasting (IF), including time-restricted eating (TRE) and intermittent calorie restriction (ICR).

Eating plans such as the DASH (Dietary Approaches to Stop Hypertension) diet, Therapeutic Lifestyle Changes diet, the Mediterranean Diet, or following the American Heart Association (AHA) 2021 Dietary Guidance to Improve Cardiovascular Health are all worth considering.

If you need assistance with meal planning or have special dietary needs, it may be helpful to seek guidance from a registered dietitian.

Include a wide variety of nutrient-dense foods, such as fruits, vegetables, lean meats, low-fat dairy, seafood, nuts, seeds, legumes and whole grains.

Replace foods that are high in cholesterol, saturated fat (animal fats) and trans fats (fried, processed foods) with foods that are high in monounsaturated and polyunsaturated fats like olive oil, nuts, seeds and avocado.

Minimize refined carbohydrates, sweets and sugar-sweetened beverages.

If you cannot eat at least 1,200 calories each day, a multivitamin may be needed to ensure you’re meeting your nutritional needs.

After you reach your weight loss goal, it’s important to continue a healthy eating pattern to avoid weight regain.

What happens if I miss more than two doses of my medication? 

If you miss more than 2 weeks of a GLP-1 medication, we suggest reinitiating the dosing schedule to reduce the chance of GI side effects. For example, if you are on level 3 of Ozempic, but have missed 3 weeks due to shortage or being out of town, we would restart you on level 1. 

What do I do if there is a shortage of my brand medication?

Due to high demand of GLP-1 medications, some branded medications may be out of stock or short on supply. If your prescribed dosage is out of stock, we may not be able to fill a higher dose of your medication. Options include having our team complete and submit a Prior Authorization on other GLP-1 medications that your insurance might cover, discussing starting a compound medication, or your provider refilling your current dose of medication if it is available. 

What is a compound medication? 

Compounding is the process of customizing a medication by combining, mixing, or adjusting ingredients to meet a patient’s unique needs. These formulations are not FDA-approved, but we carefully vet every compounding partner through rigorous due diligence to ensure quality and safety.

We ensure that the product being used is:

Pharma grade (not research grade).

Base form (not salt form).

Passed through third party quality / sterility testing.

Here is some more information on this directly from the FDA.

What happens when I reach my goal BMI?

Once you reach a BMI of 25, your weight management clinician will start to de-escalate your dose. Once your BMI is between 22-24, you should ideally be at the lowest dose of medication. If you start to regain weight, your weight management clinician can begin to escalate the dose. It is recommended that you continue living a healthy lifestyle to maintain your weight loss. 

Do I have to have a follow up every month?

For GLP-1 medications, follow ups are recommended at 1 month intervals until you have reached a steady state, at which time you will meet with your provider every 3 months.

How do I administer the medication my provider ordered today?

Injecting using a pre-filled pen (typically a branded GLP-1):

Video: Ozempic® (semaglutide) injection 0.5 mg, 1 mg, or 2 mg Pen Instructions for Use | novoMEDLINK™

Injecting using a vial/needle/syringe (typically a compounded GLP-1):

How to inject compounded tirzepatide.