Navigating Your First Month With GLP-1 Medication

By
Dr. Rehan Umar
Medical Advisor
February 28, 2024
5 minutes

Semaglutide, a medication initially developed for managing type 2 diabetes, can provide tremendous support in losing weight. If you're considering or have recently started taking semaglutide for weight management, here's a guide to help you navigate the first month of your journey.

Setting the Foundation

  • Begin by gaining a comprehensive understanding of how semaglutide works to promote weight loss. Familiarize yourself with its mechanism of action and its effectiveness in appetite suppression.
  • Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist. It is a mimic of the naturally occurring GLP-1, which is a hormone secreted by the small intestines, and has several roles: 
  • It triggers glucose-dependent insulin release from the pancreas, prompting the body to uptake sugar from your meals and utilize it for energy 
  • It decreases inappropriate glucagon secretion. Glucagon is a hormone that raises blood sugar levels when necessary 
  • It slows gastric, or stomach emptying. When stomach emptying is slowed down, food is digested at a slower pace, and the body releases less sugar from the food you eat. More importantly, slow stomach emptying also means you feel full quicker, and stay full longer. 
  • It acts in the areas of the brain involved in regulation of appetite and caloric intake. It essentially suppresses appetite so you eat less.  

Monitoring Your Body's Response

Most patients will start semaglutide at the lowest 0.25 mg/week dose for 4 weeks. This lower dose helps assess your tolerance and response to the medication. Semaglutide also takes ~4-5 weeks of once-weekly dosing to reach steady state levels in your body. While individual experiences during the first month on semaglutide can vary widely, there are some common observations reported among individuals: 

Appetite Changes

  • Semaglutide is known for its appetite-suppressing effects and this can lead to changes in eating habits and food choices. Pay attention to any changes in your hunger levels, food cravings, and overall eating habits. These insights will be valuable as you work towards establishing a healthier relationship with food.

Gastrointestinal Side Effects:

  • Nausea is frequently reported during the initial weeks. Prevalence of symptoms is higher during the first 4–5 weeks of treatment, when gastric emptying is relatively more delayed, and decreases thereafter. Symptoms are usually moderate and disappear 8 days or less after their onset. While these side effects may be more prominent at the beginning of your treatment journey, they often diminish over time. Some individuals find it helpful to take medication with food to mitigate these effects. 
  • Diarrhea: Diarrhea can initiate during the first four weeks of treatment, after which the incidence notably decreases. Symptoms have been reported to last for about three days
  • Constipation: The onset can be in the first 16 weeks of treatment, particularly during the first 28 days. 
  • GERD: reflux and bloating are also common in the first few weeks of treatment. These symptoms are typically temporary and resolve over time. 

Weight Loss

  • While patients have reported initial weight loss even as early as the first few weeks into treatment, it does take 8-12 weeks to see noticeable changes. This is partly due to the fact that people do not begin taking the 2.4mg dose at once; they start at the 0.25mg/week dosage and gradually increase the dosage every four weeks, until the maximum dose of 2.4mg/week is reached. Once patients reach the maximum tolerated dose that causes appetite suppression to cause a meaningful calorie deficit, weight loss becomes apparent. 

Scheduled Check-Up

  • Most healthcare providers schedule a follow-up appointment within the first month. Share your experiences, discuss any challenges, and provide feedback on your weight loss journey.

Conclusion

  • Embarking on a weight loss journey with semaglutide requires patience, dedication, and collaboration with your healthcare team. Use the first month to understand the medication's effects on your appetite, make sustainable lifestyle changes, and establish a solid foundation for your weight loss goals. Remember, everyone's journey is unique, so stay committed, celebrate small victories, and continue working closely with your healthcare provider for the best possible outcome.

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