Top 5 Tips for Success with GLP-1 Weight Loss Medications

While tirzepatide (Zepbound / Mounjaro) and semaglutide (Wegovy / Ozempic) are incredibly powerful GLP-1 weight loss medications, recent news reports have highlighted that many people who start treatment discontinue. In this article, I will review 5 tips to improve your success getting started on a GLP-1 for weight loss.

1. GLP-1 weight loss medications are for long-term use

GLP-1 weight loss medications only help you control your weight if they are in your body. If you lose weight with a GLP-1 and then stop the medication, studies show very high odds of regaining the weight. This is no different than any other medical problem – if you have diabetes and use a GLP-1 to lower your blood sugar, then stop it, the blood sugar will go back to where it was previously. For this reason, make sure you understand the costs of the GLP-1 weight loss medication, insurance coverage and expected results before starting it.

2. Preventing GI Side effects from GLP-1 weight loss medications

GLP-1 weight loss medications can cause nausea, vomiting, diarrhea, constipation, burping and heartburn. For this reason, we start them at a very low, non-therapeutic dose, and gradually increase the dose as the body gets used to them. Oftentimes, these side effects are worse a day or two after the injection. To avoid nausea, try not to let your stomach be empty those first few days – wake up and have an Optifast or Numetra high quality protein drink. Our patients report that this one tip alone can prevent a lot of nausea! Through the day, eat frequent small portions of plants and proteins, and avoid fattier foods. Also, try not to have larger meals.

We also recommend avoiding eating out the first few days after you start your GLP-1 as you lose control of what is in your foods at restaurants.

For diarrhea, immodium is highly effective. For constipation, skip the fiber and go straight to a stool softener like Surfac or Colace, or even straight to Miralax. For heartburn or burping, pepcid, prilosec, or nexium are highly effective.

3. The day of the GLP-1 injection matters

Semaglutide and Tirzepatide are given just once a week, and side effects are most common the day or two after the dose. While many people think they will start on Friday so that they don’t have side effects at work, we have found that Sunday or Monday dosing tends to work better for lots of reasons. First, people tend to eat out less on Monday and Tuesday vs. on Friday or Saturday. Second, for people who travel, oftentimes a Sunday or Monday dose means you can travel and not have to bring your medication with you. And third, if you have side effects or need to talk to your healthcare team, they will be at the office Monday through Friday, but not typically on weekends.

4. Watch out for muscle loss

Studies have shown that one-third of the weight lost with GLP-1 weight loss medications will be muscle loss. To prevent this, we have two recommendations. First, eat plenty of protein – 90 grams or more. To achieve this, we strongly recommend protein supplementation with high-quality protein drinks, such as Optifast or Numetra (as mentioned above).

Second, it is imperative that you are doing strength training a minimum of 20 minutes twice a week to sustain your muscle mass. This should be full-body, head to toe, with a focus on higher load sets (sets where you can do 6-7 repetitions with 1-2 in reserve). Be sure to talk to the providers and dietitians at CNC for individualized recommendations.

5. GLP-1 Weight Loss Medications do NOT cure obesity

While they are a powerful tool, GLP-1 weight loss medications do not cure obesity. They are recommended to be used in conjunction with a structured weight management program that includes comprehensive medical management, individualized food and activity plan, and lifestyle counseling to identify causes of weight gain and barriers to weight loss. We encourage all of our patients on a GLP-1 weight loss medication to enroll in one of our treatment plans designed from the ground up to give you the best result and improve your odds of success.

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