GLP-1 medication: what the first 90 days actually look like

Weeks 1–2: evaluation before anything is prescribed

Care starts with a full intake, not a prescription. Your provider reviews your weight and health history, current medications and supplements, prior attempts at weight management, personal and family history, and any symptoms that need attention on their own. Lab work is ordered when it is clinically appropriate.

This is also the step where a GLP-1 may be ruled out. Certain histories make these medications inappropriate, and some symptoms point somewhere else entirely — thyroid issues, sleep apnea, or a medication you are already taking that promotes weight gain. A consultation is an evaluation; it is not a guarantee of a prescription.

Weeks 3–6: the starting dose is deliberately low

GLP-1 therapy is titrated. The opening dose is not intended to produce dramatic change — it is intended to let your body adjust with the fewest side effects possible. Nausea, fullness, constipation, reflux, and fatigue are the common complaints, and they are usually worst in the days after a dose increase.

Most of that is manageable with the boring fixes: smaller meals, stopping at comfortably satisfied rather than full, water throughout the day, fiber, and easing off very fatty or very large meals. Tell your provider what you are feeling instead of waiting it out — holding a dose longer is a legitimate clinical decision, not a failure.

• Eat protein first at every meal, then vegetables, then starch
• Keep meals smaller and more frequent while appetite signals change
• Hydrate deliberately — appetite suppression usually suppresses thirst cues too
• Report severe or persistent vomiting, dehydration, or intense abdominal pain right away

Weeks 6–12: dose adjustments and protecting muscle

By the second and third month, the question shifts from tolerability to whether the plan is working. Your provider looks at trend, not any single week: appetite control, energy, side effects, lab results when applicable, and whether a dose increase is warranted or the current dose is doing enough.

Rapid weight loss without resistance training and adequate protein costs you lean mass, and lean mass is what keeps your metabolic rate up after the medication phase ends. Two or three strength sessions a week and a protein target you actually hit are not optional extras — they are the difference between weight loss and body-composition change.

What follow-up looks like after that

Follow-ups are more frequent early on and typically space out once you are stable on a dose. Each visit is $75; a first-time consultation is $150. Labs and medication are billed separately because they are paid to the lab and the pharmacy rather than to us.

The long view matters here. GLP-1 therapy is not a 12-week event, and the plan for maintenance — what happens at your goal, how you taper or continue, what habits carry the result — should be part of the conversation well before you get there.