What Should New Patients Expect in Their First 90 Days on GLP-1 Medications for Weight Loss?
Starting GLP-1 medications for weight loss is a transformative journey. In the first 90 days, most patients experience appetite changes, weight loss, and sometimes side effects that typically improve over time. Understanding the timeline, expected results, and how to manage challenges can help you maximize your success and build healthy habits for the long term. This guideline applies to injectable GLP-1 medications. Oral GLP-1 medication results may differ.
Why Do the First 90 Days on GLP-1 Medications Matter?
The first three months on GLP-1 medications set the foundation for your weight loss journey. This is when your body adapts, appetite patterns shift, and early weight loss begins. Some side effects may appear and subside during this time, making it crucial for fine-tuning your approach and building sustainable habits.
How Do GLP-1 Medications Work for Weight Loss?
GLP-1 medications, such as semaglutide and tirzepatide, mimic the hormone glucagon-like peptide-1. This hormone helps regulate appetite, digestion, and blood sugar. By slowing gastric emptying and enhancing satiety, these medications reduce hunger and cravings, making it easier to eat less and lose weight. They also support insulin sensitivity and metabolic health, which can benefit patients with or without diabetes.
What Happens During the First Month on GLP-1 Medications?
The first month is all about adjustment.
As you begin GLP-1 therapy, your body needs time to adapt to the medication. This period is focused on finding the right dose, noticing early appetite changes, and learning how your body responds.
What to expect:
Patients start on a low dose to allow the body to adapt.
Appetite changes are common, many notice reduced hunger and smaller meal sizes within the first two weeks.
Early side effects may include nausea, constipation, diarrhea, or mild fatigue.
Tips:
Begin or increase physical activity, including both cardiovascular activity and resistance training, for metabolic and cardiovascular benefits.
Eat smaller, balanced meals to minimize digestive discomfort.
Avoid high-fat or heavy meals during dose escalation.
Stay hydrated and include fiber to reduce constipation risk.
What Results and Changes Can You Expect in the Second Month?
The second month is when progress becomes visible.
By now, your body is more accustomed to the medication, and you may start to see steady weight loss and improved appetite control. This is a motivating phase for many patients.
What to expect:
Dose may be increased if needed.
Appetite control becomes more consistent; cravings are less frequent.
Noticeable weight loss occurs- We recommend targeting no more than 0.5-2 pounds per week to prevent adverse side effects Many published studies demonstrate that rapid weight loss exceeding approximately 2 pounds per week is associated with greater loss of lean muscle and bone mass, leading to detriments such as reduced metabolic rate, strength, and long-term health outcomes.
Improved metabolic markers: better blood sugar, blood pressure, and cholesterol.
Clothes may fit more comfortably; energy and confidence often improve.
Tips
Track both scale and non-scale victories, such as improved sleep or mobility.
Maintain regular check-ins with your provider.
Utilize body composition analysis to accurately track changes beyond your weight.
How Do You Build Momentum and Healthy Habits in the Third Month?
The third month is about building momentum and setting long-term habits.
With most side effects behind you and weight loss underway, this is the time to focus on sustainable routines and plan for continued success.
What to expect:
Dose may be increased as needed.
Sustained satiety, feeling satisfied with smaller portions.
Better portion awareness and less emotional eating.
Continued weight loss occurs.
Improved body composition, energy, and lifestyle habits.
Tips:
Continue focusing on both cardiovascular exercise and resistance training to maintain muscle mass.
Prioritize high-protein, nutrient-dense meals.
What Are the Most Common Side Effects of GLP-1 Medications and How Can You Manage Them?
Most side effects are temporary and improve as your body adjusts.
Common issues include:
Nausea
Constipation or diarrhea
Heartburn/reflux
Mild fatigue
Occasional dizziness
How to manage side effects:
Start with a low dose and increase gradually.
Eat smaller, more frequent meals.
Stay hydrated and avoid high-fat foods.
Focus on fiber intake.
Contact your provider if you experience severe or persistent symptoms, such as:
Severe nausea or vomiting
Unexplained abdominal pain
Signs of dehydration (dizziness, dark urine)
Rapid, unsustainable weight loss
What Are the Best Tips for Maximizing Success in the First 90 Days on GLP-1?
Follow your dose schedule: Don’t skip doses or increase too quickly.
Adopt a balanced eating plan: Include lean protein, whole grains, vegetables, and healthy fats.
Stay active: Even light daily movement helps.
Track your progress: Weigh yourself weekly, and come into our clinic for a free InBody composition analysis every few months.
Build a support system: Friends, family, or online groups can help maintain momentum.
Communicate with your provider: Regular check-ins with your Patient Care Coordinator to ensure your plan is working.
Frequently Asked Questions
How much weight can I expect to lose in the first 90 days on GLP-1?
In the first 90 days, you can expect an average weight loss of 4-10% of starting body weight. This varies significantly by the specific drug, dose, your initial weight, medication adherence, diet/exercise habits, and individual factors like age, sex, and metabolism.
What are the most common side effects of GLP-1 medications?
The most common side effects are mild nausea, constipation, diarrhea, and fatigue, which usually improve after the first few weeks.
How soon will I notice results from GLP-1 weight loss medications?
Many patients notice reduced appetite and smaller meal sizes within the first two weeks, with weight loss often starting by the end of the first month.
What should I do if I’m not losing weight on GLP-1 after 90 days?
If you’re not seeing results, review your eating and activity habits, ensure you’re taking the medication as prescribed, and consult your provider for possible dose adjustments.
Can I switch to a different GLP-1 medication if I have side effects?
Yes, your healthcare provider can help you transition to another GLP-1 medication if you experience persistent or severe side effects.