Obesity Medicine & Weight Loss
GLP-1 Medication Guide:
What to Expect on Wegovy or Zepbound
GLP-1 medications like Wegovy (semaglutide) and Zepbound (tirzepatide) are powerful tools for long-term weight loss and metabolic health. The more you understand about how they work — and how to support them — the better your results will be. This guide summarizes what we discuss in the office so you have a clear reference at every stage of treatment.
What These Medications Do
GLP-1 receptor agonists mimic a hormone your body naturally produces after eating. When you take Wegovy or Zepbound, several things happen simultaneously:
- Reduce appetite and cravings by signaling fullness to your brain
- Slow stomach emptying so you feel full longer after meals
- Improve blood sugar regulation and insulin sensitivity
- Reconnect hunger and satiety cues in your gut and brain for sustainable weight loss
Dosing Instructions
Both medications are weekly subcutaneous injections following a gradual titration schedule. Slow titration is intentional — it allows your body to adjust and minimizes side effects.
| Week | Dose |
|---|---|
| 1–4 | 0.25 mg |
| 5–8 | 0.5 mg |
| 9–12 | 1 mg |
| 13–16 | 1.7 mg |
| Week 17+ | 2.4 mg (full dose) |
Titrate up every 4 weeks unless otherwise instructed. If side effects occur, your provider may hold or slow titration.
| Month | Dose |
|---|---|
| 1 | 2.5 mg |
| 2 | 5 mg |
| 3 | 7.5 mg |
| 4 | 10 mg |
| 5 | 12.5 mg |
| Month 6+ | 15 mg (full dose) |
Titrate every 4 weeks. Not everyone needs the highest dose.
Common Side Effects
Most side effects are GI-related and improve over time as your body adjusts to each dose level:
- Nausea
- Constipation or diarrhea
- Bloating or gas
- Fullness or early satiety
- Heartburn or reflux
To minimize side effects: eat slowly, avoid high-fat meals, and stop eating when full. Try a 10-minute walk after each meal. Avoid eating at least 3 hours before bed.
How Much Weight Can I Lose?
Average total body weight loss with lifestyle support. Keep in mind this occurs gradually — usually over 6 months. Individual results vary:
Wegovy
~15%
avg. total body weight loss
Zepbound
15–22%
avg. total body weight loss
Combining the medication with healthy eating and regular exercise is key to long-term success. These numbers reflect what's possible when treatment is paired with lifestyle change — not the medication alone.
Lifestyle = Medication Success
GLP-1s are tools, not magic pills. The patients who see the best outcomes use the reduced appetite as an opportunity to build better habits. Four habits that make the biggest difference:
- Track meals & protein intake
Knowing what you're eating keeps you accountable and helps identify patterns that work for your body. - Get daily movement
Aim for 150 minutes per week. Consistent walking, strength training, or whatever you'll actually sustain all count. - Prioritize sleep & stress management
Poor sleep and chronic stress elevate hunger hormones — directly working against the medication. - Stay hydrated
Many patients on GLP-1s underdrink, especially early on. Aim for adequate fluid intake throughout the day.
Nutrition Tips for Best Results
What you eat matters as much as how much when you're on a GLP-1. Here's how to make your reduced appetite work in your favor:
-
Prioritize Protein
Aim for around 120g per day to preserve muscle and reduce hunger. 30g per meal is a good general rule. Lean meats, eggs, Greek yogurt, cottage cheese, and legumes are all excellent sources. -
Low-Carb Focus
Reduce processed carbs and sugar; choose fiber-rich whole grains when needed. Whenever eating carbs, pair them with a protein to slow absorption and reduce blood sugar spikes. -
High Fiber
Include vegetables, chia/flax seeds, and legumes to help digestion and fullness — and to counteract the constipation some patients experience early on. -
Avoid Large Meals
Eat small, frequent meals and stop eating when 80% full. Large meals are much harder to tolerate on these medications. -
Last Meal 3 Hours Before Bed
With slowed gastric emptying, late eating reliably triggers nighttime reflux. This one habit change significantly improves sleep quality.
Final Reminders
- Always inject on the same day of the week
- Rotate injection sites — abdomen, thigh, back of arm
- Do not stop the medication abruptly; let us know if you'd like to come off and we'll titrate down slowly
- These medications are chronic — weight regain is highly likely if treatment is stopped
Contraception & Pregnancy
For women on oral birth control pills: GLP-1 medications may reduce their effectiveness. We recommend a back-up method such as condoms while on treatment, or an alternative method such as an IUD or NuvaRing. Medication should be stopped at least 2 months before planning pregnancy.
Planned Surgeries or Procedures
Please let us know if any procedures are planned. Medication should be stopped at least 1 week prior to any surgery due to the risk of aspiration from delayed gastric emptying.
Questions? We're Here.
Our team at Los Angeles Primary Care is here to support you through every dose adjustment and help you build the habits that make these medications work long-term.
Schedule a Visit