Starting a GLP-1 for Weight Loss? Here’s Advice From Other Patients

If you want insight into any treatment regimen, the best people to ask are other patients. There’s just no substitute for first-hand experience with a medication (or a surgical procedure, or any other form of treatment).

With the value of the patient perspective in mind, we asked patients to pay forward what they’ve learned about taking different GLP-1 medications, such as Wegovy, Saxenda and compounded semaglutide. 

We combed through the tips, hacks and lessons we’ve received to come up with this curated list of need-to-know advice, broken down by topic. (Some advice relates to multiple topics — the categorization isn’t perfect.)

For each tip, we note which GLP-1 medication the patient (advice-giver) is taking. When it comes to GLP-1s, some advice is broadly applicable, while other advice might only apply to GLP-1s that share the same active ingredient. For your reference, here are the GLP-1s grouped by active ingredient:

• Semaglutide: Ozempic, Wegovy and compounded semaglutide
• Liraglutide: Saxenda
• Tirzepatide: Mounjaro and Zepbound, which was recently FDA-approved for weight loss but isn’t available to patients yet

Want to contribute your own GLP-1 treatment advice? Just fill out this Google form. We’ll update this article periodically as tips roll in.

Side effects‍

Tips for avoiding nausea and other common complaints      

Focus on protein during meals to avoid nausea (and starvation). (Wegovy)

‍Definitely take anti-nausea medication (Zofran/ondansetron). Within a few days you won’t really need it, but have it handy. (Saxenda)

Make sure you eat something that isn’t too harsh on your stomach about an hour or two before your injection. I also take Zofran (anti-nausea medication) about 30 minutes beforehand. (Wegovy)

When you first start taking your medication, try a little bit of everything and take note of how it makes you feel. I started by having bread and it did not upset my stomach. But when I ate any sort of junk food, it would make me vomit. (Wegovy)

Limiting fatty and spicy foods helps your stomach. (compounded semaglutide)

I get headaches, but it helps to drink an electrolyte pack, like a Liquid I.V. (Mounjaro)

Diet decisions‍‍

What, how and when to eat (and/or drink) to get the most out of treatment

Eat a high-protein diet and drink electrolytes. (Mounjaro)

Try to eat three meals a day but make them small. I rarely have an appetite for "healthy" food, so I have to make myself choose that first and focus on having a green vegetable or salad, and one lean healthy protein, every day. (Wegovy)

Eat small meals, and don’t eat anything before bed. (Wegovy)

The healthier you can be prior to taking medication, the easier it is to keep it up after you start. (compounded semaglutide) 

Start changing your eating habits right away when you start your medication. It takes time to adjust to a new eating style, so take advantage of the medication’s effects to help make diet changes. (Saxenda)

Just don’t drink, but if you need to, [I’d recommend] vodka or gin, with tonic or soda. (Saxenda)

Remember to take a multivitamin. (Saxenda)

Exercising

‍How to prepare your body for exercise and build a sustainable workout routine

‍Try anything you want and pay attention to how it makes you feel. I love cardio kickboxing, but I know I can’t do it the day of or after an injection. (Wegovy)

Definitely exercise to firm up as you lose weight. Be sure to eat enough protein to support a robust workout, including (lifting) weights and strength conditioning. (Wegovy)

Eat more protein each day than you typically would, and exercise at least four times a week. (compounded semaglutide)

Questions for your doctor 

What to ask your provider before you start a GLP-1 

"What's the strategy for tapering off my medication?” (Wegovy)

“Are there any non-obvious medication reactions?” I found out that there were certain antibiotics I couldn’t take with Zofran, my anti-nausea medication, so I was able to flag that with any urgent care doctors I saw. (Wegovy)

“I’m allergic to Zofran — do you prescribe any other anti-nausea meds?” (Wegovy)

“I have [this big event or milestone] [this long] from now. Will I need to modify my treatment plan in any way?” (unspecified)

Administration

Where, when and how to take a GLP-1

I typically inject my medication in my upper thigh and switch legs every month. (Saxenda)

Know your body. If you tend to have more side effects for things in the morning or at night, plan your injections for the opposite time of day. (compounded semaglutide)

Plan to have an easy day on the day of or after your injection, just so you’re not mentally stressed about needing to be 100% in case you have any side effects. (Wegovy)

I inject in my stomach and I think it’s the least painful place. I get alcohol pads (like the ones doctors use to sterilize vaccine injection sites). I  wipe my stomach with the pad, then I smell the alcohol pad, then I inject myself, and then I smell the pad again. I find that the alcohol scent prevents me from feeling nauseous or dizzy. The injection doesn’t actually hurt. If there’s any pain at all, it comes from me punching my stomach too hard to hold it taught for the injection. (Wegovy)

It sounds like most people do one of two things: 1) Take the injection on Friday night or Saturday morning, so that if you do feel ill, it’s mostly over the weekend. 2) Take it on Sunday night or Monday morning, if you want to feel a little hungrier on the weekends when you might be more social. The medication levels off by the end of the seven-day cycle, so you can stomach a little more food toward the end, typically. I ended up going for Monday mornings for social reasons, but I’ve definitely had a few rough Mondays since I started. (Wegovy)

Grab bag

Uncategorized tips and big-picture wisdom to guide your GLP-1 experience

Physical cravings are only a portion of the battle. If you have bad eating habits, or you’re used to force-feeding yourself when you’re already full (i.e., a “clean plate” mentality), you may still struggle even on the meds. This is something I've found myself absent-mindedly doing. (Wegovy)

Consider keeping a journal and tracking all of the benefits and changes you experience. (Wegovy)

Be prepared for a lot of people to comment on your weight loss and ask questions. Decide what you feel comfortable sharing ahead of time if possible. (Wegovy)

Be patient. I didn’t really see or feel different until the end of month three. I broke down crying for the first two months because I felt like the medication wasn’t working. The number on the scale was going down, but my measurements weren’t. I realized that, during those months, I was losing weight from places I wasn’t measuring (like my face, neck and arms). (Wegovy)

Do not let other people’s opinions influence your success. Just because people don’t seem to notice, it doesn’t mean treatment isn’t working. I had many people “not notice,” when they really just didn’t want to say anything to me in case the weight loss was caused by something tragic (like a break-up or a loss). (Wegovy)