Your first month on a GLP-1

You start low on purpose

GLP-1 medications start at a low dose that isn't meant to be your long-term dose. The approved brands start at semaglutide 0.25 mg or tirzepatide 2.5 mg once a week for 4 weeks, then step up every 4 weeks as tolerated. Starting low gives your stomach time to adjust.

Weekly injections are taken on the same day each week, at any time of day, with or without food. Your clinician and pharmacy label set your exact dose and schedule, including what to do if you miss one.

What the first weeks often feel like

Many people notice they get full sooner and think about food less. The most common side effects are digestive: nausea, diarrhea, constipation, indigestion and stomach pain. They're usually most noticeable in the first weeks and after each dose increase, and often ease as your body adjusts.

Results vary from person to person, and the early weeks are about settling in, not about the number on the scale.

What many people find helps

None of this replaces your clinician's advice, but these are the habits people most often say make the first month easier:

• Eat smaller meals, slowly, and stop when you feel full
• Go easy on greasy, fried or very rich food, especially on injection day
• Drink water through the day, particularly if you have vomiting or diarrhea
• Keep protein in your meals so you're eating well even with a smaller appetite
• Tell your clinician if side effects make it hard to eat or drink. Doses can be adjusted

Warning signs to take seriously

Contact your clinician, or get medical care right away, if you have:

• Severe stomach pain that won't go away, with or without vomiting, which can be a sign of pancreatitis
• Pain in the upper right belly, fever, or yellowing of the skin or eyes, which can be gallbladder problems
• Signs of dehydration, like dizziness, very little urine or a racing heart, after vomiting or diarrhea
• Shakiness, sweating or confusion if you also take insulin or other diabetes medication, which can be low blood sugar

Two things to mention to others

If you're having surgery or a procedure with anesthesia or deep sedation, tell the team you take a GLP-1 medication. The labels warn about a risk of breathing food into the lungs during sedation.

If you take birth control pills and start tirzepatide, the Zepbound label advises switching to a non-oral method, or adding a barrier method, for 4 weeks after you start and for 4 weeks after each dose increase.

On Vitascend

Your clinician picks your starting plan, including a microdose plan if you'd rather go gently, and checks in every 90 days to decide whether to step up. Compounded semaglutide and tirzepatide are not FDA-approved; the dosing and warnings above come from the labels of the FDA-approved brands, Wegovy and Zepbound.