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1. What are GLP-1 medications?
14. Can I drink alcohol?
2. How do they work?
15. What about pregnancy?
3. How much weight will I lose?
16. Do they affect mental health?
4. Semaglutide vs tirzepatide?
17. Can teens take them?
5. What are the side effects?
18. What labs should I get?
6. What does it cost?
19. Any drug interactions?
7. What is compounded GLP-1?
20. Can I travel with them?
8. Is compounded legal?
21. What’s “Ozempic face”?
9. 503A vs 503B?
22. Will I regain weight?
10. How do I choose a provider?
23. What should I eat?
11. Does insurance cover it?
24. Do I need to exercise?
12. How long do I take it?
25. What’s coming next?
13. Is there an oral option?
1. What are GLP-1 medications?
GLP-1 receptor agonists are a class of medications that mimic the naturally occurring hormone glucagon-like peptide-1. They were originally developed for type 2 diabetes but are now widely used for weight management. The main medications are semaglutide (brand names Ozempic and Wegovy) and tirzepatide (Mounjaro and Zepbound). They are administered as weekly injections, though oral versions are also available.
2. How do GLP-1 medications work?
They work through multiple mechanisms: suppressing appetite by acting on hunger centers in the brain, slowing gastric emptying (so you feel full longer), improving insulin sensitivity, and reducing “food noise”—the constant background thinking about food. Tirzepatide is a dual agonist that targets both GLP-1 and GIP receptors, which may explain its slightly stronger weight loss effect.
3. How much weight will I lose?
Clinical trial averages: semaglutide 2.4mg produces about 15% body weight loss at 68 weeks. Wegovy HD 7.2mg achieves about 20.7%. Tirzepatide at maximum dose produces about 22.5%. Individual results vary significantly—some patients lose more, some less. Most weight loss occurs in the first 12–18 months, after which weight stabilizes. See our month-by-month timeline →
4. What’s the difference between semaglutide and tirzepatide?
Semaglutide targets only GLP-1 receptors. Tirzepatide targets both GLP-1 and GIP receptors. Tirzepatide generally produces slightly more weight loss and may have lower nausea rates. Semaglutide has more proven benefits beyond weight loss (cardiovascular, kidney, liver). Both are excellent options. Full head-to-head comparison →
5. What are the most common side effects?
Gastrointestinal effects are most common: nausea (30–44%), diarrhea (23–30%), vomiting (13–24%), and constipation (17–24%). These are typically worst during dose increases and improve within 1–2 weeks. Eating smaller meals, staying hydrated, and following a slow titration schedule helps significantly. Rare but serious risks include pancreatitis and gallbladder issues.
6. How much do GLP-1 medications cost?
Brand-name (without insurance): $1,000–$1,600/month. With insurance copay: $25–$250/month (if covered). Compounded versions: $150–$450/month. Manufacturer savings programs can reduce brand-name costs for eligible patients. Complete cost guide →
7. What is compounded semaglutide/tirzepatide?
Compounded versions are custom-prepared by licensed pharmacies using the same active pharmaceutical ingredient as the brand-name product. They are not FDA-approved but are legal when prepared under Section 503A or 503B of the FD&C Act. They typically cost 70–85% less than brand-name versions.
8. Are compounded GLP-1 medications legal?
The legal status is nuanced and evolving. The FDA’s shortage exceptions ended (semaglutide: Feb 2025, tirzepatide: Oct 2024), but some compounding continues under alternative legal frameworks including different salt forms and 503B outsourcing facility provisions. The situation varies by pharmacy and formulation. Full legal status update →
9. What’s the difference between 503A and 503B pharmacies?
503A pharmacies are traditional state-licensed compounding pharmacies that fill individual prescriptions. 503B pharmacies are FDA-registered outsourcing facilities that can produce larger batches and are subject to federal inspections and cGMP (current Good Manufacturing Practice) standards. 503B facilities generally offer a higher level of quality assurance. Detailed comparison →
10. How do I choose a good GLP-1 provider?
Look for three things: (1) a licensed pharmacy with LegitScript certification, (2) a real medical evaluation before prescribing (not just a quick questionnaire), and (3) transparent pricing with no hidden fees or subscription traps. Also check for ongoing support—dose adjustments, side effect management, and accessible customer service. Full vetting checklist →
11. Does insurance cover GLP-1 medications for weight loss?
Coverage varies widely. About 43% of large employers now cover GLP-1s for weight management. Medicare began covering GLP-1s for obesity under a 2025 demo program. Many private plans cover Ozempic/Mounjaro for diabetes but not Wegovy/Zepbound for weight loss specifically. Prior authorization is almost always required. Insurance coverage guide →
12. How long do I need to take GLP-1 medications?
Current evidence suggests that obesity, like diabetes or hypertension, is a chronic condition requiring ongoing treatment. The STEP 1 extension trial showed that patients who stopped semaglutide regained about two-thirds of lost weight within a year. Most experts recommend planning for long-term or indefinite use, with maintenance dosing potentially lower than the active weight-loss dose. Weight regain data →
13. Is there a pill version (oral GLP-1)?
Yes. Rybelsus (oral semaglutide 14mg) is available for diabetes. Wegovy’s oral formulation (25mg) has been approved for weight management. Orforglipron, a next-generation oral GLP-1 from Eli Lilly that doesn’t require fasting before taking, is in late-stage clinical trials. All oral GLP-1 options →
14. Can I drink alcohol on GLP-1 medications?
You can, but with caution. Most patients report significantly reduced alcohol tolerance and decreased desire to drink. Alcohol combined with GLP-1s increases risks of low blood sugar, dehydration, and worsened GI side effects. If you drink, start with less than usual and see how your body responds. Full alcohol guide →
15. What about pregnancy and GLP-1 medications?
GLP-1 medications are not safe during pregnancy (animal studies showed fetal harm). Stop semaglutide at least 2 months before planned conception and tirzepatide at least 1 month before. Importantly, GLP-1 medications can restore fertility by reversing obesity-related anovulation, and may reduce oral contraceptive effectiveness—so unplanned pregnancies (“Ozempic babies”) do occur. Pregnancy & fertility guide →
16. Do GLP-1 medications affect mental health?
The FDA investigated reports of suicidal ideation and found no causal link in the clinical trial data. In fact, large-scale real-world studies suggest GLP-1 users may have lower rates of depression and anxiety than matched controls—likely due to improvements in quality of life, self-esteem, and metabolic health. However, any significant mood changes should be reported to your provider. Mental health research →
17. Can teenagers take GLP-1 medications?
Yes—Wegovy is FDA-approved for patients aged 12+ with obesity. The STEP TEENS trial showed a 16.1% BMI reduction in adolescents, which was actually stronger than adult results. Guidelines recommend trying lifestyle interventions first, then adding medication for severe cases. Pediatric research →
18. What lab tests should I get on GLP-1s?
Baseline labs before starting, then retest at 3 months, 6 months, and annually. Core panel: HbA1C, fasting glucose, lipid panel, CMP (kidney/liver), TSH (thyroid), vitamin B12, vitamin D, and iron. These track both progress (improving metabolic health) and potential issues (B12 depletion, kidney stress from dehydration). Full lab guide →
19. Are there important drug interactions?
The main concern is that GLP-1 medications slow gastric emptying, which can affect absorption of oral medications. High-priority interactions include insulin/sulfonylureas (hypoglycemia risk), oral contraceptives (reduced effectiveness), and warfarin (unpredictable INR). Levothyroxine and blood pressure meds may need monitoring. Drug interaction guide →
20. Can I travel with GLP-1 medications?
Yes. TSA allows injectable medications, syringes, and ice packs in carry-on bags. Always carry medication with you (not in checked luggage) to avoid temperature extremes. Bring a prescription or provider letter for international travel. Keep medication cool but never frozen. Travel guide →
21. What is “Ozempic face”?
A colloquial term for facial volume loss that can occur with significant weight loss (from any cause, not just GLP-1s). The face loses subcutaneous fat, which can create a gaunt or aged appearance. It’s more common with rapid weight loss, in older patients, and in those who lose 15%+ of body weight. Slower weight loss, adequate protein, and hydration may help. Full article →
22. Will I regain weight if I stop?
Likely yes. The STEP 1 extension trial showed patients regained about two-thirds of lost weight within one year of stopping semaglutide. This is consistent with obesity being a chronic condition where the underlying biology doesn’t change even when symptoms (excess weight) are managed. Planning for long-term, affordable treatment is the best approach. Regain timeline →
23. What should I eat on GLP-1 medications?
Prioritize protein (80–120g/day) to preserve muscle mass. Eat protein first at every meal. Hydrate aggressively (64+ oz water daily). Eat smaller, more frequent meals to reduce nausea. Limit fried, greasy, and sugary foods (they tend to worsen GI side effects). Avoid high-calorie liquid calories (smoothies, juices) since they bypass the satiety mechanism. Diet guide →
24. Do I need to exercise on GLP-1 medications?
You don’t need to, but you absolutely should. Strength training (resistance exercise) is the single most important complement to GLP-1 therapy because it preserves lean muscle mass during weight loss. Without it, 25–40% of weight lost can be muscle. Even 2–3 strength sessions per week makes a significant difference in body composition and metabolic health. Exercise guide →
25. What new GLP-1 medications are coming?
The pipeline is packed. Key drugs to watch: Retatrutide (triple agonist, 28.7% weight loss in trials), Amycretin (Novo Nordisk’s GLP-1/amylin combo), Orforglipron (Eli Lilly’s oral pill with no fasting requirement), Danuglipron (Pfizer’s once-monthly oral pill), and CagriSema (semaglutide + cagrilintide combo). Canadian generic semaglutide is expected in 2026. Full pipeline guide →