Getting Started with Weight Loss Peptides

Ready to start your weight loss journey with GLP-1 peptides? This comprehensive guide walks you through every step, from determining eligibility to managing side effects and achieving your goals.

Whether you're considering Semaglutide (Ozempic/Wegovy), Tirzepatide (Mounjaro/Zepbound), or Liraglutide (Saxenda), this guide provides everything you need to know.

Step 1: Determine Your Eligibility

FDA-Approved Criteria

GLP-1 agonists for weight loss are FDA-approved for adults who meet these criteria:

✓ You Qualify If:

  • BMI ≥30 (obesity), OR
  • BMI ≥27 (overweight) with at least one weight-related condition:
    • Type 2 diabetes
    • High blood pressure
    • High cholesterol
    • Sleep apnea
    • Cardiovascular disease
  • Age 18 or older (some peptides approved for 12+)
  • No contraindications (see below)

⚠️ You Do NOT Qualify If:

  • Personal or family history of medullary thyroid cancer (MTC)
  • Multiple endocrine neoplasia syndrome type 2 (MEN 2)
  • History of pancreatitis
  • Severe gastrointestinal disease (gastroparesis, IBD)
  • Pregnant, breastfeeding, or planning pregnancy within 2 months
  • History of suicidal thoughts or severe depression (requires careful monitoring)
  • Diabetic retinopathy (requires ophthalmology clearance)

💡 Calculate Your BMI

BMI Formula: Weight (kg) ÷ Height (m)² or Weight (lbs) ÷ Height (inches)² × 703

Example: 200 lbs, 5'6" (66 inches) = 200 ÷ (66 × 66) × 703 = 32.3 BMI (qualifies)

Step 2: Choose Your Provider

Provider Options

A Traditional Healthcare Providers

Primary care physicians, endocrinologists, or obesity medicine specialists can prescribe GLP-1 agonists. Best for patients with insurance coverage or complex medical histories.

  • Pros: Insurance coverage, comprehensive care, established relationship
  • Cons: May require multiple appointments, longer wait times, may not specialize in weight loss
  • Cost: $25-250/month with insurance, $900-1,500/month without
B Telehealth Weight Loss Clinics

Online platforms specializing in weight loss medications (Ro, Hims/Hers, Calibrate, Found, Sequence). Convenient but typically don't accept insurance.

  • Pros: Fast appointments, specialized in weight loss, convenient
  • Cons: No insurance coverage, compounded versions (not FDA-approved), variable quality
  • Cost: $200-500/month (compounded) or $900-1,500/month (brand name)
C Medical Spas & Wellness Clinics

Local clinics offering weight loss programs with GLP-1 peptides. Variable quality and oversight.

  • Pros: In-person care, often include additional services
  • Cons: No insurance coverage, may use compounded versions, variable medical oversight
  • Cost: $300-600/month typically

⚠️ Beware of Compounded Versions

Due to shortages, many providers offer compounded semaglutide or tirzepatide at lower costs ($200-400/month). However:

  • Not FDA-approved (made under 503B compounding exemption)
  • Quality and purity vary significantly between pharmacies
  • No guarantee of sterility or accurate dosing
  • FDA has issued warnings about adverse events
  • May contain different salt forms (semaglutide sodium vs base)

Recommendation: Use FDA-approved brand name versions when possible, especially if you have insurance coverage.

Step 3: Initial Consultation

What to Expect

Your provider will conduct a comprehensive evaluation including:

✓ Medical History Review

  • Current medications and supplements
  • Previous weight loss attempts
  • Family history of thyroid cancer or MEN 2
  • History of pancreatitis or gallbladder disease
  • Mental health history
  • Pregnancy plans

✓ Physical Examination

  • Height, weight, BMI calculation
  • Blood pressure
  • Abdominal examination
  • Thyroid examination

✓ Laboratory Tests (Usually Required)

  • Comprehensive metabolic panel (kidney/liver function)
  • Lipid panel (cholesterol)
  • HbA1c (blood sugar control)
  • Thyroid function (TSH)
  • Pregnancy test (if applicable)

Questions to Ask Your Provider

Step 4: Starting Your Medication

Prescription & Pharmacy

Once prescribed, you'll need to fill your prescription at a pharmacy. Options include:

Pharmacy Type Pros Cons
Local Retail Pharmacy Immediate pickup, insurance accepted May not stock specialty medications, higher copays
Specialty Pharmacy Better insurance coverage, patient support programs Mail order only, 3-7 day wait
Compounding Pharmacy Lower cost ($200-400/month) Not FDA-approved, variable quality, no insurance

First Injection

Your first dose will be the lowest starting dose to minimize side effects:

💡 Injection Tips

  • Choose injection site: Abdomen (2 inches from belly button), front of thigh, or back of upper arm
  • Rotate sites: Don't inject in the same spot twice in a row
  • Room temperature: Let pen sit out for 30 minutes before injecting
  • Same day/time: Pick a consistent schedule (e.g., Sunday mornings)
  • Pinch skin: Insert needle at 90-degree angle, inject slowly
  • Don't rub: Simply apply pressure with gauze after injection

Step 5: Dose Titration Schedule

Why Gradual Titration Matters

Rapid dose increases cause severe nausea and vomiting. All GLP-1 agonists require gradual dose escalation over 16-20 weeks to allow your body to adapt.

Weeks 1-4: Starting Dose

Expect: Mild nausea (30-40% of patients), reduced appetite, possible constipation

Weight Loss: 2-5 lbs (mostly water weight)

Tips: Eat smaller meals, avoid fatty foods, stay hydrated

Weeks 5-8: First Increase

Expect: Nausea may return for 3-5 days, then improve

Weight Loss: 1-2 lbs per week

Tips: If nausea is severe, stay at previous dose for 4 more weeks

Weeks 9-16: Continued Titration

Expect: Side effects become more tolerable, appetite significantly reduced

Weight Loss: 1-2 lbs per week consistently

Tips: Focus on protein intake (80-100g daily) to preserve muscle

Weeks 17-68: Maintenance Dose

Expect: Minimal side effects, stable appetite suppression

Weight Loss: 0.5-1.5 lbs per week until plateau

Tips: Add resistance training to preserve muscle mass

Calculate Your Exact Dosing Schedule →

Step 6: Managing Side Effects

Common Side Effects (30-45% of patients)

Side Effect Frequency Management Strategies
Nausea 30-40% Eat smaller meals, avoid fatty/spicy foods, ginger tea, stay at lower dose longer
Vomiting 10-15% Eat slowly, stop when satisfied (not full), anti-nausea medication if severe
Diarrhea 15-20% Increase fiber gradually, probiotics, avoid dairy if lactose intolerant
Constipation 20-25% Increase water (64+ oz daily), fiber supplement, magnesium, exercise
Abdominal Pain 10-15% Smaller meals, avoid overeating, heating pad. If severe, rule out pancreatitis
Fatigue 10-15% Ensure adequate calories (1200+ daily), check for nutrient deficiencies
Heartburn/GERD 5-10% Avoid eating 3 hours before bed, elevate head of bed, antacids as needed

⚠️ Seek Immediate Medical Attention If:

  • Severe abdominal pain (especially upper abdomen radiating to back) - possible pancreatitis
  • Persistent vomiting (unable to keep down fluids for 24 hours) - risk of dehydration
  • Signs of gallbladder disease (right upper abdominal pain, especially after eating)
  • Vision changes (especially if diabetic) - possible diabetic retinopathy worsening
  • Severe allergic reaction (difficulty breathing, swelling of face/throat)
  • Suicidal thoughts or severe depression
  • Lump in neck or difficulty swallowing - possible thyroid tumor

Minimizing Side Effects

✓ Best Practices

  • Eat slowly and stop when satisfied (not full)
  • Choose bland, low-fat foods during first 8 weeks
  • Avoid alcohol (increases nausea and slows weight loss)
  • Stay hydrated (64+ oz water daily)
  • Don't skip doses (causes side effects to return)
  • Take anti-nausea medication 30 minutes before injection if needed
  • Inject in evening if nausea is problematic (sleep through worst of it)

Step 7: Maximizing Results

Nutrition Guidelines

While GLP-1 agonists dramatically reduce appetite, proper nutrition is essential for optimal results and muscle preservation.

✓ Daily Nutrition Targets

  • Calories: 1200-1500 (women), 1500-1800 (men) - don't go too low
  • Protein: 80-120g daily (0.8-1.0g per lb of goal weight)
  • Fiber: 25-35g daily (prevents constipation)
  • Water: 64+ oz daily (prevents dehydration)
  • Vitamins: Daily multivitamin recommended

Exercise Recommendations

💡 Why Exercise Matters

GLP-1 agonists cause weight loss from both fat AND muscle (typically 25-30% muscle loss). Resistance training can reduce muscle loss to 10-15%, preserving strength and metabolism.

Expected Timeline

Timeframe Expected Weight Loss What to Expect
Weeks 1-4 2-5 lbs Initial water weight, mild side effects, appetite reduction begins
Weeks 5-12 8-15 lbs Consistent 1-2 lbs/week loss, side effects improve, energy stabilizes
Weeks 13-24 15-25 lbs Steady progress, reaching maintenance dose, minimal side effects
Weeks 25-52 25-40 lbs Continued loss at 0.5-1.5 lbs/week, approaching plateau
Weeks 53-68 30-50+ lbs Final weight loss phase, preparing for maintenance

Step 8: Long-Term Maintenance

How Long Should You Stay On?

Clinical trials show optimal results with 68-72 weeks of treatment. However, many patients require longer-term or indefinite use to maintain weight loss.

💡 What Happens When You Stop?

Weight regain is common: Studies show patients regain 50-70% of lost weight within 1 year of stopping GLP-1 agonists. This is because:

  • Appetite returns to baseline (or higher)
  • Metabolic rate decreases with weight loss
  • Hormonal changes favor weight regain
  • Lifestyle habits may not be fully established

Many patients choose to stay on a maintenance dose indefinitely, similar to how blood pressure or cholesterol medications are used long-term.

Maintenance Strategies

⚠️ Realistic Expectations

GLP-1 agonists are not a cure for obesity. They are a tool that makes weight loss significantly easier, but long-term success requires:

  • Permanent lifestyle changes (nutrition, exercise, sleep, stress)
  • Ongoing medical supervision
  • Realistic expectations about weight regain risk
  • Financial planning for long-term medication costs
  • Commitment to maintenance strategies
Calculate Your Dosing Schedule → Compare Peptides →

⚠️ Medical Disclaimer

This guide provides educational information only and should not replace consultation with a qualified healthcare provider. GLP-1 agonists are prescription medications that require medical supervision. Individual results vary based on starting weight, adherence, lifestyle factors, and medical history.