Semaglutide and Tirzepatide: What GLP-1 Weight Loss Medications Do, and What to Ask First
Semaglutide and tirzepatide are the two weight loss medications most people have heard of by now. The attention is earned. For the right patient, with a provider watching, they can make appetite far easier to manage.
They also get sold carelessly, and they have trade-offs worth knowing before you start. This post covers both.
What a GLP-1 is
GLP-1 is a hormone your gut releases after you eat. It tells your brain you've had enough, slows how fast your stomach empties, and helps your body manage blood sugar after a meal.
Semaglutide mimics GLP-1. It works on the same signal, for longer than your own hormone does.
Tirzepatide acts on GLP-1 and on a second gut hormone, GIP, which also plays a part in appetite and blood sugar. Acting on both signals is the main difference between the two medications.
Either way, the effect most patients notice first is simple: you get full sooner and stay full longer, and food stops occupying your attention the way it did.
Semaglutide or tirzepatide?
Your provider makes that call with you, based on your history, your goals and how you respond. Neither one is right for everyone, and some patients start on one and change to the other.
At our clinic, each comes paired with a supporting compound:
- Semaglutide + B12: for appetite and steady weight loss, with B12 for energy and mood. $480 a vial, about a 3-month supply.
- Tirzepatide + NAD: for weight loss support, with NAD for energy, metabolism and cellular repair. $680 a vial, about a 3-month supply.
The vial price covers the medication. Lab work is billed separately.
These are compounded preparations from a licensed compounding pharmacy. The brand-name versions of both medications are FDA-approved; compounded preparations like ours are not. Your provider will go through what that means at your consult, and you should ask any clinic the same question.
What side effects to expect
The most common side effects are digestive: nausea, a queasy or overfull feeling, and changes in bowel habits. They tend to show up early and when the dose goes up, and for many patients they ease as the body adjusts. That's one reason your provider starts low and raises the dose gradually.
These medications aren't safe for everyone. Your provider asks about your personal and family history, including certain thyroid cancers and past pancreatitis, and about pregnancy or plans for it. Some of those answers rule a patient out.
If you've been buying semaglutide or tirzepatide online without a prescription, stop and talk to a provider. The same rule from our peptide post applies here: you have no assurance of what's in a vial you didn't get through a pharmacy.
What happens to your muscle
When you lose weight quickly, some of what you lose is muscle, not only fat. That matters, because muscle is what keeps you strong and keeps your metabolism up.
Eating enough protein and doing some strength training while you're on a GLP-1 helps protect it. That's why every patient on our weight loss program gets fitness and nutrition consultations with us, included in the program. We'll work with you on how much protein to eat and what kind of training fits your life, so you're not figuring it out alone.
What happens when you stop
A GLP-1 changes how your appetite works for as long as you take it. When you stop, that effect wears off, and appetite tends to come back. Many people regain weight after stopping, especially if nothing else changed while they were on it.
That isn't a reason to avoid these medications. It is a reason to use your time on one to build habits that last, and that's what the fitness and nutrition consultations in our program are for. Plan with your provider how and when you'd come off, and aim to have those habits in place before you do.
Questions to ask any clinic before you start
- Is this the brand-name medication or a compounded preparation, and where is it compounded?
- What do you screen for before prescribing it?
- How will my dose be increased, and what do I do if the side effects are rough?
- What does the price include, and how long does one vial last?
- What's the plan for when I stop?
Getting started
Weight loss medication isn't the right answer for everyone, and working out whether it's right for you starts with a conversation. The consult is free, it's by video, and it's available to men and women anywhere in Montana.
This article is general health information, not medical advice, and it is not a recommendation to use any specific medication. The compounded preparations described are not FDA-approved. GLP-1 medications aren't appropriate for everyone; treatment decisions are made with a licensed provider based on your individual evaluation.