What to expect on a GLP-1 medication

Lillian Yang, RDN

How does a GLP-1 medication work?

GLP-1 receptor agonists are a class of medications that can be very effective for the treatment of obesity and type 2 diabetes. These medications mimic a hormone that you already produce in your body called glucagon-like peptide-1. This hormone works by targeting areas of the brain that regulate appetite and food intake, which reduces cravings, lowers your blood sugar, and slows the digestion of food. In other words, you may experience:

  • Reduced hunger and appetite
  • Feeling full more quickly with smaller food portions 
  • Decreased cravings
  • A reduction in food-focused thoughts

When used in conjunction with good nutrition and healthy habits, GLP-1 medications can be a powerful tool on your weight loss journey.

How much weight should I expect to lose?

It depends on a few things: the type of GLP-1 medication, the dosage, and individual factors. The ideal rate of weight loss is 0.5-1% per week of your initial weight (on average). For a 200-pound person, that’s 1 to 2 pounds per week; for a 300-pound person, that’s 1.5 to 3 pounds per week. In clinical trials, the majority of people on liraglutide lost >5% of their body weight over 56 weeks. For semaglutide, there was an average weight loss of almost 15% over 68 weeks. The newest in the field is tirzepatide, which had an average weight loss of 15% to 20.9% over 72 weeks. 

Do I start to lose weight right away?

This also depends! Weight loss happens more quickly for people who experience appetite suppression right away on the starting dose. For others who are not as sensitive to the medication, weight loss may not start until they reach higher doses. It is also common to see faster weight loss in the initial few weeks, followed by a few weeks of slower weight loss. Some people experience greater changes in inches and clothing sizes than in numbers on the scale. Everyone’s weight journey looks different.

What it feels like on a GLP-1

You can expect to feel less hungry throughout the day, feel full and satisfied eating smaller portions, fewer cravings, or less “food-focused” thoughts —or any combination of these.

Some people experience changes in food preferences and say that certain foods or alcohol don’t appeal to them like they used to. 

Will I still feel hungry and have cravings?

Hunger levels will vary from person to person. The goal of the medication is to reduce your appetite to a more manageable level — not to completely eliminate your hunger. Hunger is a very normal part of human biology, and hunger cues are actually very important. Paying attention to when you are hungry and when you are full is a great healthy habit that can help guide the way to more intuitive eating (with the help of this medication). Cravings are also very normal to experience, so if the medication does not eliminate cravings completely for you, that’s usually okay. People report more manageable cravings and find the cravings more easily satisfied (e.g. by a few bites of ice cream as opposed to the whole pint). 

If I’m on an appetite-suppressing medication, do I need to change my diet?

These medications are incredibly powerful tools, and we are blessed to have access to them. Relying on medication alone often doesn’t work, though. Losing weight doesn’t automatically translate to improved health. To really maximize the benefits of medication, it’s important to incorporate healthy habits related to food, nutrition, fitness, mental health, and sleep. With Sequence, you will have a personalized nutrition plan with lessons, and access to one-on-one sessions with our team of Registered Dietitians.

What if my weight stalls or plateaus?

Weight plateaus are very common during a weight loss journey, no matter which program or diet philosophy you follow. Typically, stalls will happen:

  • After a period of rapid weight loss (for example, losing a lot of weight during month 1 and then plateauing for month 2)
  • After a few months of continuous weight loss, as your metabolism adjusts
  • When you initiate a new exercise routine

Or they can be unpredictable – your metabolism and your body are always adapting to changes in eating/moving patterns and hormone shifts. 

While it can be confusing and/or frustrating, we encourage you to not stress about it unless the plateau lasts longer than 4-6 weeks. In that case, it’s a good idea to check in with your prescribing physician. 

I’m super excited and eager for this weight to come off! 

We are just as excited as you are, which is why we do our best to streamline the process! Clinicians will prescribe your dose based on the recommended titration schedule and use their best judgment on whether to increase the dose or keep you on the same dose. This is to minimize side effects and discomfort and ensure you’re losing weight at a healthy, sustainable rate. Our overall goal is to have you use the least amount of medication that is still effective. 

Will I be on medication forever? 

These weight-loss medications are intended for long-term use. Obesity is a chronic condition, similar to hypertension and heart disease, and therefore can require medication maintenance to manage it. On the Sequence program, your Clinician will help you to find the appropriate maintenance dose when the time is right. However, you can always tell your Clinician that you’d like to try a lower dose or that you’d like to try to manage your weight without the medication. The Sequence program is comprehensive, meaning our fitness and nutrition teams support your Clinician and provide you the tools you need to also make lasting lifestyle changes.

How do I get a prescription for a GLP-1 medication with Sequence?

Your Sequence weight management treatment plan will vary depending on your medical history, goals, and insurance coverage. 

If you’re looking to get evaluated for an obesity treatment prescription, we’ll need a bit more information. Every member must match recommended medical criteria, meet with a Clinician, and discuss their medical needs to make sure pharmacological treatment is appropriate.

Here’s how to begin:

  1. Submit a short, 5-minute assessment to see if you qualify for our program 
  2. Fill out your medical history questionnaire and book your consultation
  3. Get a custom weight management plan from one of our board-certified clinicians

With Sequence, you’ll have access to a variety of resources that support lasting, comprehensive weight management, including our team of fitness coaches and Registered Dietitians. If you qualify for membership, you also get access to an expert Care Team, who will provide ongoing support for your weight loss journey. 

Lillian Yang, RDN

About the Author

Lillian Yang is a Registered Dietitian and Certified Diabetes Educator. She completed her BS at New York University and currently lives in Brooklyn, NY. For the last 8 years, she has helped people achieve their health goals by making realistic, easy, and sustainable changes in their habits and daily lives.

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