Starting a GLP-1 medication is a significant step in your health journey. This comprehensive guide will walk you through everything you need to know, from determining if you're a candidate to preparing for your first injection.
Step 1: Determine If You're a Candidate
GLP-1 medications are FDA-approved for specific conditions. You may be a candidate if you meet certain criteria:
For Weight Management (Wegovy, Zepbound)
- BMI of 30 or greater (obesity), OR
- BMI of 27 or greater with at least one weight-related condition (high blood pressure, type 2 diabetes, high cholesterol, sleep apnea, heart disease)
For Type 2 Diabetes (Ozempic, Mounjaro)
- Diagnosed with type 2 diabetes
- Need additional blood sugar control beyond current treatment
- May also benefit from weight loss
Who Should NOT Take GLP-1 Medications
- Personal or family history of medullary thyroid carcinoma (MTC)
- Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- History of pancreatitis
- Pregnant or planning to become pregnant
- Breastfeeding
- Type 1 diabetes
Step 2: Talk to Your Healthcare Provider
Your healthcare provider will help determine if a GLP-1 medication is right for you. Here's how to prepare for that conversation:
Information to Bring
- Your complete medical history
- List of all current medications and supplements
- History of weight loss attempts (diets, programs, medications)
- Family history of thyroid cancer or MEN 2
- Any history of pancreatitis or gallbladder disease
- Recent lab work (A1C, lipid panel, kidney function)
Questions to Ask
- Which GLP-1 medication do you recommend for me and why?
- What side effects should I expect?
- How will this interact with my current medications?
- What is the dosing schedule?
- How often will I need follow-up appointments?
- Will my insurance cover this medication?
- What happens if I need to stop the medication?
Step 3: Understand Your Medication Options
There are several GLP-1 medications available. Your provider will help you choose based on your specific needs:
Semaglutide OptionsGLP-1
- Ozempic: FDA-approved for type 2 diabetes. Weekly injection. Max dose 2mg.
- Wegovy: FDA-approved for chronic weight management. Weekly injection. Max dose 2.4mg.
- Rybelsus: Oral semaglutide for type 2 diabetes. Daily tablet. Max dose 14mg.
Tirzepatide OptionsGLP-1 + GIP
- Mounjaro: FDA-approved for type 2 diabetes. Weekly injection. Max dose 15mg.
- Zepbound: FDA-approved for chronic weight management. Weekly injection. Max dose 15mg.
Step 4: Navigate Insurance and Cost
These medications can be expensive without insurance. Here's what to do:
- Check your insurance formulary: Call your insurance company or check their website to see if GLP-1 medications are covered.
- Ask about prior authorization: Most plans require prior authorization. Your provider's office typically handles this.
- Explore manufacturer savings programs: Novo Nordisk and Eli Lilly offer savings cards that can reduce copays to as low as $25/month for eligible patients with commercial insurance.
- Consider patient assistance programs: If you're uninsured or underinsured, manufacturers offer programs based on income.
- Use FSA/HSA funds: These medications are eligible expenses for flexible spending and health savings accounts.
Step 5: Prepare for Your First Injection
Once you have your prescription filled, it's time to prepare for your first dose:
What You'll Need
- Your medication pen
- Pen needles (usually provided separately)
- Alcohol swabs
- Sharps container for needle disposal
- Your injection instructions
Choosing Your Injection Day
Pick a day of the week that works for your schedule. Consider:
- Some people prefer to inject on Friday evening in case side effects occur over the weekend
- Choose a day you'll consistently remember
- Set a recurring reminder on your phone
- The exact time of day doesn't matter for weekly injections
Step 6: What to Expect in the First Weeks
Week 1-2
- Side effects: Mild nausea is common. Usually manageable.
- Appetite: May notice slight reduction in hunger.
- Weight: Some people lose 1-3 lbs; others don't see change yet.
- Tip: Eat smaller portions and avoid fatty foods.
Week 3-4
- Side effects: Often improving as body adjusts.
- Appetite: More noticeable appetite suppression.
- Weight: Typically 2-5 lbs lost by end of month 1.
- Note: Prepare for first dose increase at week 4.
Step 7: Set Yourself Up for Success
Medication works best when combined with lifestyle changes:
Nutrition
- Prioritize protein at every meal (25-40g per meal)
- Eat slowly and stop when satisfied, not full
- Stay hydrated with 64+ oz of water daily
- Limit fried, fatty, and very sweet foods
Exercise
- Aim for 150+ minutes of activity per week
- Include strength training 2-3x weekly to preserve muscle
- Start slow if you're new to exercise
- Walking counts—any movement is beneficial
Mindset
- Set realistic expectations—weight loss takes time
- Track progress beyond the scale (energy, clothing fit)
- Build a support system
- Be patient through the dose escalation process
Checklist: Before Your First Dose
- Confirmed you meet eligibility criteria
- Discussed options with healthcare provider
- Prescription filled and medication in hand
- Have pen needles and alcohol swabs
- Sharps container for disposal
- Reviewed injection instructions
- Chosen your injection day
- Set phone reminder
- Stocked up on protein-rich, easy-to-digest foods
- Have ginger tea or ginger chews on hand for nausea
You're ready to begin your GLP-1 journey. Remember, this is a marathon, not a sprint. The gradual dose escalation process takes months, but it sets you up for the best long-term results with manageable side effects.