You've got your prescription. Your medication has arrived. You're holding that pen in your hand, maybe feeling a mix of hope and nervousness. What happens now?
The first month on GLP-1 medication is an adjustment period. Your body is encountering a new hormone signal, your eating patterns are shifting, and you're learning what works for you. It's rarely a smooth, linear experience—there are ups and downs, days that feel great and days that feel rough.
This guide will walk you through what to expect week by week, what's normal (even when it doesn't feel normal), and practical strategies to make this transition as smooth as possible. Remember: everyone's experience is different, but having a general roadmap helps you know you're on track.
Before Your First Injection
Set yourself up for success before you even take your first dose:
Prepare Your Supplies
- Medication storage: Most GLP-1 pens need refrigeration. Clear a spot where they won't freeze (back of the fridge is coldest—avoid it).
- Injection supplies: Alcohol swabs for cleaning the injection site. Your pen should come with needles.
- Sharps container: For safe needle disposal. You can buy one at any pharmacy or use a thick plastic container like a laundry detergent bottle.
Choose Your Injection Day
GLP-1 medications are taken once weekly. Pick a day that works for your schedule, and ideally one where you can take it easy the next day in case you experience side effects. Many people choose Friday evening or Saturday morning so any nausea happens over the weekend.
Stock Your Kitchen
In case of nausea or appetite changes, have gentle foods on hand:
- Crackers, toast, plain rice
- Ginger tea, ginger candies, or ginger ale
- Broth-based soups
- Bananas, applesauce
- Protein shakes (for when solid food doesn't appeal)
- Plenty of water and electrolyte drinks
Pro tip: Take a "before" photo and record your starting weight, measurements, and how you're feeling. You'll appreciate having this baseline later—it's easy to forget where you started when you're in the middle of the journey.
The Week-by-Week Experience
1 Week 1: The Beginning
What's Happening in Your Body
You're starting at the lowest dose—this is intentional. Your body is being introduced to a new hormone signal gradually. The medication begins working on GLP-1 receptors in your brain (affecting appetite) and gut (slowing digestion), but the effects are subtle at this dose for most people.
What You Might Experience
- Mild appetite reduction: Some people notice eating slightly less, feeling satisfied sooner. Others notice nothing yet—both are normal.
- Possible nausea: Usually mild if present. Often described as "queasiness" rather than severe nausea.
- Injection site reaction: Slight redness or tenderness is common and typically resolves quickly.
- Fatigue: Some people feel a bit tired as their body adjusts.
What's Normal
Feeling very little at this dose is completely normal. Don't be discouraged if you don't notice dramatic appetite changes—the starting dose is primarily about getting your body accustomed to the medication, not maximum effect.
What's Not Normal (Contact Your Provider)
- Severe vomiting that prevents keeping fluids down
- Severe abdominal pain
- Signs of allergic reaction (hives, difficulty breathing, swelling)
💡 Week 1 Tips
Stay well hydrated. Eat slowly and stop when satisfied, even if it's sooner than expected. Don't force yourself to finish meals. Keep a simple journal of how you feel—it helps identify patterns.
2 Week 2: Finding Your Rhythm
What's Happening in Your Body
The medication is building up in your system. GLP-1 agonists have a long half-life, meaning each dose adds to the circulating levels from the previous dose. By week 2, you have more consistent medication levels.
What You Might Experience
- More noticeable appetite changes: Food may feel less urgent. You might catch yourself forgetting to eat or feeling full faster.
- Continued or new GI symptoms: Nausea may increase, decrease, or stay the same. Constipation or diarrhea can appear.
- Food preferences shifting: Some people find certain foods (often greasy or very sweet foods) less appealing.
- Minor weight change: You might see a small drop on the scale, often 1-3 pounds. Much of this is reduced food volume and water.
What's Normal
Experiencing different side effects than week 1, or having symptoms come and go. Your body is calibrating. It's also normal to still not feel much—response varies widely between individuals.
💡 Week 2 Tips
If nausea is bothersome, try eating smaller meals more frequently. Avoid lying down right after eating. Ginger in any form (tea, candies, supplements) can help. Stay consistent with your injection day and time.
3 Week 3: Adapting
What's Happening in Your Body
For many people, week 3 is when the medication starts feeling more integrated. Your body is adapting to the new normal, and you're developing awareness of how the medication affects your hunger and eating patterns.
What You Might Experience
- More predictable appetite: You're starting to understand your new hunger signals.
- Side effects may be peaking or improving: For most people, initial side effects are worst in the first few weeks and then improve.
- Possible early weight loss: Some people see 2-5 pounds down by now, though significant loss usually comes later at higher doses.
- Emotional adjustment: The changing relationship with food can bring up feelings—relief, sadness, confusion. All normal.
What's Normal
Having a "bad day" where nausea returns even though it had improved. Feeling frustrated that results aren't more dramatic yet. Questioning whether it's working. All of this is part of the process.
💡 Week 3 Tips
Focus on protein at each meal—it helps preserve muscle and keeps you satisfied. Don't skip meals entirely, but eat smaller portions if needed. This is a good time to start or continue gentle exercise like walking.
4 Week 4: Approaching Your First Dose Increase
What's Happening in Your Body
You've completed one month on the starting dose. Your body has had time to adjust, and you're likely approaching your first dose increase (titration). This is when the therapeutic effects start to strengthen.
What You Might Experience
- Established pattern: You know what to expect from the medication, for better or worse.
- Plateau feeling: Effects from the starting dose may feel like they've maxed out.
- Weight change: Typical first-month loss is 2-6 pounds, but ranges widely from nothing to 10+ pounds.
- Anticipation about dose increase: You may be looking forward to (or nervous about) moving to the next level.
What's Normal
Feeling like "not much is happening" at this low dose. The starting dose is intentionally gentle. Real momentum typically builds as you titrate up. Also normal: some people respond strongly even to the lowest dose.
💡 Week 4 Tips
Before your dose increase, reflect on how the first month went. What helped with side effects? What foods worked best? This knowledge helps as you increase the dose and potentially experience stronger effects.
Common First-Month Challenges (and Solutions)
Challenge: Nausea Won't Quit
For some people, nausea is persistent and really impacts quality of life. Strategies that help:
- Eat very small portions—think appetizer-sized, not entrée-sized
- Avoid greasy, fried, and very rich foods (these are harder to digest)
- Stay upright after eating for at least an hour
- Try ginger in various forms: tea, candies, supplements
- Consider taking your injection at bedtime so you sleep through the initial surge
- Talk to your provider about anti-nausea medication if it's severe
Challenge: Constipation
GLP-1 medications slow gut motility, which can lead to constipation. Solutions:
- Drink more water than you think you need
- Include fiber-rich foods (vegetables, fruits, whole grains) even if portions are small
- Stay active—movement helps gut motility
- Consider a gentle fiber supplement like psyllium
- Magnesium supplements can help (check with your provider)
- If severe, your provider may recommend a stool softener or laxative
Challenge: Not Feeling Any Different
Some people don't notice much at the starting dose. This doesn't mean the medication isn't working or won't work.
- Give it time—effects often become more apparent at higher doses
- Track your food intake; you might be eating less without consciously noticing
- Stay patient and follow the titration schedule
- Discuss with your provider if effects remain minimal even at higher doses
Challenge: Energy Feels Low
Eating less means fewer calories, which can initially affect energy. To manage:
- Prioritize protein—it's essential for maintaining energy and muscle
- Don't cut calories dramatically just because you can; aim for adequate nutrition
- Ensure you're sleeping enough—your body is doing a lot of adjusting
- Light exercise like walking can actually boost energy
- Consider a multivitamin to fill nutritional gaps
When to Contact Your Provider: Severe or persistent vomiting, severe abdominal pain, signs of dehydration (dark urine, dizziness, confusion), inability to eat or drink anything for more than a day, or any symptoms that feel concerning. It's always better to ask than to suffer unnecessarily.
What About Weight Loss?
Let's set realistic expectations. During the first month, on the starting dose, typical weight loss is modest: 2-6 pounds for most people, though some lose more and some lose nothing.
Several factors affect early weight loss:
- Starting weight: People with more to lose often lose more initially
- Individual response: Some people are highly responsive even to low doses
- Dietary choices: Even with reduced appetite, food choices matter
- Water retention: Weight can fluctuate several pounds just from water
- Where you are in your cycle: Hormonal fluctuations affect water weight
The real weight loss momentum typically builds in months 2-4 as you titrate to therapeutic doses. The first month is about adjustment and laying groundwork—not dramatic results.
Emotional Aspects of the First Month
Starting GLP-1 medication isn't just a physical experience. You might encounter unexpected emotions:
Relief
"Finally, something is working." "I'm not constantly thinking about food." "I feel normal around food for the first time." These feelings of relief are common and valid.
Grief or Loss
This might surprise you, but some people feel a sense of loss when food becomes less important. If eating was comfort, stress relief, or social connection, having that shift can feel disorienting. It's okay to acknowledge this.
Anxiety
"What if this stops working?" "Am I doing this right?" "Will I regain the weight?" These worries are normal. Try to stay present rather than catastrophizing about the future.
Impatience
"Why isn't this working faster?" The cultural narrative of dramatic quick weight loss creates unrealistic expectations. Real, sustainable change takes time—months, not weeks.
Give yourself grace. You're making a significant change. It's okay if it feels complicated. Consider talking to a therapist, especially one who specializes in eating/weight issues, if emotions feel overwhelming.
End of Month 1: Taking Stock
As you complete your first month, reflect on:
- What went well? What strategies helped with side effects? What foods worked for you?
- What was challenging? What do you want to handle differently going forward?
- Physical changes: Weight, measurements, how clothes fit, energy levels
- Appetite/eating changes: How has your relationship with food shifted?
- Questions for your provider: What do you want to ask at your next check-in?
Document this, either by writing it down or noting it in your phone. This reflection helps you see progress that the day-to-day grind can obscure, and it gives you valuable information to share with your healthcare provider.
Looking Ahead: What Comes Next
Month 1 is foundation-building. Here's what's coming:
- Dose increases: Most protocols increase your dose monthly until you reach the maintenance level
- Stronger effects: Both the appetite suppression and potential side effects intensify at higher doses
- More significant weight loss: Months 2-6 are typically when you see the most dramatic changes
- Routine: What feels new and strange now will become your normal
You've made it through the hardest part in some ways—starting. Keep going. The first month is just the beginning of a longer journey that, for many people, leads to meaningful, lasting change.
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