GLP-1 Starter Guide

GLP-1 Starter Guide: Eligibility, Baseline Checks, and Ongoing Monitoring (DMV)

What GLP-1 medications are—plain and simple

GLP-1 medicines help regulate appetite, fullness, and blood sugar. Some are approved for type 2 diabetes, others for chronic weight management. In a medical weight-loss program, they’re one tool—used with nutrition, activity, sleep, and coaching—not a stand-alone fix.

Common options include weekly injections such as semaglutide and tirzepatide. Your clinician will decide whether a GLP-1 is appropriate and which formulation makes sense for you.

Who may be eligible

You may be a candidate if you’re an adult who:

• Has BMI ≥30, or BMI ≥27 with a weight-related condition (e.g., prediabetes, type 2 diabetes, high blood pressure, high cholesterol, sleep apnea).
• Is ready to pair medication with nutrition and activity changes.
• Can attend regular follow-ups and monitoring visits.

Eligibility also depends on your medical history, current medicines, and lab results. Some people start with lifestyle care only; others combine both from day one.

Who should use caution—or avoid GLP-1s

Tell your clinician if you have or have had:

• Personal or family history of medullary thyroid carcinoma (MTC) or MEN2 (a genetic condition).
• Pancreatitis, significant gallbladder disease, or severe GI disease (e.g., gastroparesis).
• Pregnancy or breastfeeding (not recommended); planning pregnancy soon.
• Kidney disease (dehydration can worsen kidney function).
• Diabetic retinopathy (if you have diabetes—closer eye monitoring may be needed).
• Use of insulin or sulfonylureas (risk of low blood sugar—doses may need adjustment).

Your clinician will weigh risks and benefits and may suggest a different plan if GLP-1s aren’t a fit.

Baseline checks before you start

A good start is a safe start. Expect:

• History & exam: weight, waist, BP, heart rate, medication/supplement list, past GI issues, pancreatitis/gallbladder history.
• Labs (as appropriate): A1c or fasting glucose, lipids, kidney and liver function; pregnancy test when relevant.
• Goal setting: fat-loss goals, sleep and stress plan, preferred foods, and movement you’ll actually do.
• Education: how to inject, rotate sites, store pens, travel with medication, handle missed doses, and when to call.

How dosing and titration usually work

GLP-1s are typically started low and increased slowly to improve tolerance. A common pattern (exact brands and steps vary):

• Semaglutide: start low for 4 weeks, then step up every 4+ weeks toward a target dose if tolerated.
• Tirzepatide: similar stepwise increases, beginning with a low weekly dose and advancing in 4-week intervals.

Your schedule may pause or slow if you have side effects. Do not jump doses on your own.

What to expect in the first 12 weeks

Weeks 1–4: learning the pen, smaller appetite, sometimes nausea or fullness sooner than expected.
Weeks 5–8: dose may increase; focus on protein, fiber, and hydration.
Weeks 9–12: appetite signals feel more predictable; steady behavior beats perfection.

Plan on check-ins at about 4, 8, and 12 weeks to track weight, waist, food patterns, step count, and any side effects.

Common side effects—and simple fixes

Typical: nausea, constipation, diarrhea, bloating, heartburn, fatigue, injection-site tenderness. These often ease with time and dose adjustments.

Practical tips

• Smaller meals, eat slowly, stop at “satisfied,” not stuffed.
• Protein target: aim ~25–35g per meal; include lean meats, fish, eggs, Greek yogurt, tofu, beans.
• Fiber & fluids: vegetables, berries, oats/beans; sip water through the day; consider an oral electrolyte if you’re queasy.
• For constipation: fluids, fiber, daily walk; talk to your clinician about short-term stool softeners if needed.
• Avoid heavy, greasy foods on dose-increase weeks.

Red flags—call promptly or seek care

• Severe, persistent abdominal pain (especially to back), repeated vomiting, signs of dehydration.
• Yellowing of skin/eyes, clay-colored stools, fever with abdominal pain.
• Vision changes, severe low blood sugar if you use insulin/secretagogues.
• Signs of an allergic reaction (trouble breathing, swelling, hives).

Food: a simple plan you can follow

Think “balanced plate”:

• ½ non-starchy vegetables, ¼ protein, ¼ smart carbs (whole grains, fruit, beans), plus a thumb of healthy fat.
• Breakfast ideas: Greek yogurt + berries + oats; eggs + spinach + whole-grain toast.
• Lunch/dinner: grilled chicken or tofu bowl (veggies, quinoa, olive-oil drizzle); salmon + roasted veg + brown rice.
• Snacks: string cheese, hummus + carrots, protein shake, apple + peanut butter.

Hydration: target pale-yellow urine; add electrolytes if you’ve had nausea.

Activity: protect muscle, support loss

• Walking goal: build toward 7–10k steps/day (start where you are).
• Strength: 2–3 short sessions/week (push, pull, legs, core) to preserve lean mass.
• Recovery: 7–9 hours sleep; manage stress (brief walks, breath work, consistent schedule).

Sample week on a GLP-1 (DMV-friendly)

• Mon: injection day; small, protein-forward meals; 20-minute walk after dinner.
• Tue: strength 25 minutes + 6k steps; 2L water across the day.
• Wed: review food log; add veggies at lunch; evening stretch.
• Thu: 7k steps; fiber boost (beans or oats).
• Fri: light strength 20 minutes; plan weekend meals.
• Sat: longer walk on the Mall or a local trail; pack water/electrolyte.
• Sun: rest, grocery list, prep proteins/veggies; early bedtime.

Plateaus happen—here’s how to respond

1. Reality check: are you hitting protein, steps, sleep?
2. Food audit (3–5 days): log portions; watch liquid calories and grazing.
3. Add resistance training or increase intensity slightly.
4. Review dose and timing with your clinician; sometimes you hold or adjust.
5. Stress & schedule: tighten your sleep window; plan easy, repeatable meals.

Follow-ups and monitoring long-term

Expect visits every 4–12 weeks to review weight, waist, vitals, side effects, and adherence. Labs are often rechecked at 3–6 months and then periodically. If you have diabetes, glucose and medication doses may need adjustments.

When you reach a stable routine, you and your clinician can discuss maintenance: continuing the medication, tapering, or transitioning to a non-medication plan.

Costs, coverage, and access

Coverage varies. Many insurers require BMI criteria and prior authorization. Out-of-pocket options exist. Use only FDA-approved medications from licensed pharmacies; avoid unverified sources. We can provide estimates and, when applicable, a superbill.

FAQs

How fast will I lose weight?
Rates vary. Steady, sustainable loss is the target. The best results come from pairing the medicine with food, activity, sleep, and stress routines you can keep.

Do I have to change how I eat?
Yes—medication lowers appetite, but what you eat still matters. Protein, fiber, and hydration protect muscle, reduce side effects, and keep energy stable.

Will I regain if I stop?
Without a maintenance plan, regain is common. We’ll build habits and a long-term strategy—medication or not—to protect your progress.

Can I drink alcohol?
In moderation, if your clinician agrees. Alcohol can worsen nausea and add calories; avoid on dose-increase days.

Can I travel with it?
Yes. Keep pens within the labeled temperature range; use a small cooler if needed. Pack needles in your carry-on and bring your prescription label.

Bottom line: GLP-1s can be a useful tool for the right person when paired with food, movement, sleep, and regular follow-ups. Start safely, go slow, and personalize the plan.

Ready to talk options? Schedule a consultation in DC/MD/VA. Call our clinic or request an appointment online.
This information is educational and not a substitute for in-person care.