By Gabriel Alizaidy, MD, MS, and Starling Krentz, MS
What are GLP-1 medications?
GLP-1 receptor agonists (like semaglutide and tirzepatide) are injectable medications that mimic a natural hormone involved in controlling blood sugar, slowing digestion, and reducing appetite. They were first used for type 2 diabetes but are now also prescribed for chronic weight management in people with obesity or those who are overweight with related conditions such as high blood pressure, high cholesterol, or diabetes.
In addition to supporting weight loss and metabolic health, some GLP-1s are used to reduce cardiovascular risk in people with type 2 diabetes and heart disease, and studies are exploring potential benefits in fatty liver disease and kidney health.
How do GLP-1s help with weight loss?
GLP-1s help with weight loss by acting on areas of the brain that regulate appetite and satiety, while also slowing the rate at which food leaves the stomach. This combination makes people feel full sooner, stay satisfied longer, and naturally reduce how much they eat.
Many describe the effect as similar to having an internal “gastric band,” since portions shrink and cravings, especially for calorie-dense foods, become less intense. Over time, that consistent reduction in intake leads to meaningful weight loss without the same constant struggle against hunger.
How soon will I notice the results?
Some people feel appetite suppression within hours of the first injection, but for most it takes a few weeks. The medication usually builds to steady levels around week four or five. Early weight loss in the first month is often water, but the steady, sustainable fat loss tends to be about one to two pounds per week.
It's important to note that your starting weight matters. Those with higher initial body weight often see faster and more dramatic weight loss, while those closer to their goal weight may experience more gradual changes.
What are the most common side effects?
The most frequent ones are nausea, constipation, diarrhea, burping, and low energy on injection days. These are usually mild and fade as the body adapts.
Can I split doses to reduce side effects?
Absolutely! Some people divide their weekly dose into two or three smaller injections (or more if they prefer). Splitting the dose lowers the risk of side effects by smoothing the drug’s effect and significantly reducing nausea or stomach issues.
Semaglutide vs Tirzepatide: Which is more effective?
Clinical trials lasting one year show that semaglutide produces about 16 percent average weight loss, while tirzepatide at 15 mg weekly reaches around 22.5 percent. In our client population, we’ve seen semaglutide averaging 16.5 percent weight loss and tirzepatide holding steady at 20.8 percent.
Tirzepatide’s dual GIP/GLP-1 receptor action gives it an edge, but both medications deliver impressive results. Individual response varies, and factors such as side effect tolerance, cost, and availability all play a role in choosing the best option.
Do I have to stay on GLP-1s forever?
The choice is yours. GLP-1s can serve as a powerful complement to better lifestyle habits. If you combine them with strength training, protein intake, and sustainable dietary routines, the lifestyle changes you make during your weight loss journey can carry you forward after stopping.
Some people prefer to stay on a maintenance dose to keep appetite suppressed, while others switch to a microdose to continue enjoying the metabolic benefits without affecting hunger. The risk of regaining weight after stopping is no greater than with other weight loss methods when you've built solid habits.
Are compounded GLP-1s safe?
Compounded GLP-1s are considered safe when they come from trusted pharmacies that follow strict regulations set by the FDA and state boards of pharmacy. These pharmacies have to meet high standards for sourcing raw ingredients, preparing medications in controlled environments, and testing for quality, purity, and consistency.
The partners we work with go through additional layers of oversight, which means their processes are built around safety and reliability rather than shortcuts. It’s worth pointing out that while “compounded” might sound like something experimental, in reality it’s a well-established practice in medicine that ensures patients get access to treatments made carefully and responsibly.
What’s the difference between Ozempic, Wegovy, Mounjaro, and Zepbound?
The main differences are indication and insurance coverage. Efficacy is strong across all of them.
Do oral GLP-1s work at all?
Oral versions sound convenient, but the reality is that they require extremely high doses to have any effect. With semaglutide, for example, you would need around 25 milligrams to approach the same impact as a tiny injection. At those levels the stomach side effects are intense, far worse than what people sometimes notice with injections, and the price is usually much higher.
Compounded oral products add another problem since they have not been shown to work at all. In fact, we ran clinical trials with both oral semaglutide and oral tirzepatide, and the results looked no better than placebo for weight loss. By contrast, injections are simple, nearly painless, and only needed once or twice a week. In practice, it makes far more sense to use the form that is proven to work.
Can I drink alcohol while on GLP-1s?
There is no dangerous interaction between GLP-1s and alcohol, but here's the reality: alcohol adds empty calories that directly work against your weight loss goals. While some advocate for "moderation," the truth is that moderation can be antithetical to weight loss success. Make good choices that align with your goals.
Are there risks with long-term use?
GLP-1 medications have been studied for decades, with millions of people around the world using them safely. Most side effects are mild and often linked to dose. Rare issues like pancreatitis and gallbladder problems have been reported, but the good news is that there are simple ways to lower those risks.
For example, steady and balanced weight loss, staying well hydrated, and avoiding crash diets all help protect your gallbladder. If stomach pain ever feels unusual or more intense than expected, the safe approach is to check in with your provider right away, just to be sure.
As for the thyroid cancer warning you may have heard about, that comes from studies in rodents. Despite decades of human use, those cancers haven’t been seen in people. Doctors only recommend avoiding GLP-1 medications if you or a family member has a very rare condition called medullary thyroid carcinoma or MEN2. For everyone else, the overall safety record in humans has been very reassuring.
And of course, regular follow-ups with your provider are the best way to keep things on track.
What about about ozempic butt/face/feet?
These nicknames are a bit exaggerated, but they usually come from dramatic or too-quick weight loss, especially when muscle is lost along with fat. That is not unique to GLP-1s since it can happen with any rapid change in weight. A steadier pace, regular strength training, and enough protein all help protect muscle and keep the body’s shape looking balanced.
Do GLP-1s affect sex hormones or muscle?
Yes, and this is something we take seriously. Rapid weight loss can tank your testosterone (or estrogen/progesterone in women) and put your hard-earned muscle at risk. Nobody wants to lose weight only to feel weak, tired, or see their gains disappear.
That's why we strongly encourage pairing GLP-1s with resistance training and high protein intake, and for some people, hormone support makes all the difference. With the right approach, you're not just preserving muscle while losing fat, many of our patients actually build muscle during their transformation. It's about being smart with your protocol, not just watching the scale drop.
What’s the difference between GLP-1 and GIP?
GLP-1 reduces appetite and slows digestion: it's your primary hunger and satiety regulator. GIP enhances insulin response and improves nutrient absorption, adding metabolic benefits. Tirzepatide activates both pathways, which explains its enhanced effectiveness for both weight loss and metabolic health improvements.
What about the next generation of GLP-1 medications (triple agonists)?
The future is incredibly exciting! Retatrutide adds a third pathway (glucagon receptor agonism) and has shown more than 24 percent body weight loss in clinical trials. This triple-action approach could revolutionize obesity treatment. While it's still under study and not yet approved, the early data is remarkably promising.
Can patients switch between semaglutide and tirzepatide (or vice-versa)?
Yes, most patients transition between these medications without any issues. The protocols for transitioning are well-established, with equivalent dosing strategies that make the switch smooth. Whether moving from semaglutide to tirzepatide for enhanced effects, or from tirzepatide to semaglutide for better tolerability or cost reasons, the transition is typically seamless.
How do patients describe the difference between the two GLP-1s?
Patients often report a qualitative difference between the medications. With semaglutide, many describe it as consequence-driven appetite control: you avoid overeating because you'd feel unwell if you did.
Tirzepatide users often report something more profound: the inherent desire to overeat simply disappears. Once they've had enough food, there's genuinely no psychological pull to continue eating. It's not about willpower or avoiding discomfort; the compulsion itself is gone.
Are there any supplements I should take with GLP-1s to help with the experience?
When using a GLP-1, focus on supporting digestion and covering nutrient needs: increase fiber intake, consider magnesium in well-absorbed forms such as glycinate, threonate, or sucrosomal (avoid citrate if sensitive to its laxative effect), take a high-quality or even prescription strength multivitamin (Building Blocks) since reduced appetite can limit micronutrient intake, and maintain hydration with electrolytes rather than plain water alone to improve absorption and fluid balance.
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Disclaimer: The contents of this article, including, but not limited to, text, graphics, images, and other information, is for information purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. The content is not meant to be complete or exhaustive or to be applicable to any specific individual's medical condition. You should consult a licensed healthcare professional before starting any health protocol and seek the advice of your physician or other medical professional if you have questions or concerns about a medical condition. Always talk to your doctor about the risks and benefits of any treatment. Never disregard or delay seeking professional medical advice or treatment because of something you have read on this site. Maximus does not recommend, endorse, or make any representation about the efficacy, appropriateness, or suitability of any specific test, products, procedures, treatments, services, opinions, healthcare providers or other information contained herein. Maximus is not responsible for, nor will they bear any liability for, the content provided herein or any actions or outcomes resulting from or related to its use.
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