Medically reviewed by Dr. Payman Joseph, MD · Updated November 2026
Starting a GLP-1 program like semaglutide or tirzepatide is exciting, and it helps to know what’s normal. Here’s what most of our patients experience in the first four weeks.
Before your first dose
Your first visit is a medical consultation. We review your health history, current medications and goals, and confirm the treatment is a safe fit. If it is, you can often start the same day. Medication is dispensed in our office, and we’ll show you how to inject at home if you’d rather not come in each week.
Week 1: getting started
- You’ll start at a low dose so your body can adjust.
- Many people notice they feel full sooner and think about food less.
- Mild nausea is common in the first few days. Eating smaller meals and stopping when you feel satisfied helps.
Weeks 2–3: finding your rhythm
- Appetite changes usually become more noticeable.
- Some patients see the scale start to move; others take a little longer, and that’s normal.
- Heavy, greasy or very sugary meals are more likely to cause stomach upset, so many patients naturally shift toward lighter foods.
Week 4: your first check-in
Around the end of the first month, we review how you’re feeling, any side effects and your progress. If things are going well, we may increase your dose. Doses are raised gradually, usually about every four weeks, to keep side effects manageable.
Tips that make the first month easier
- Eat slowly and stop at the first sign of fullness.
- Prioritize protein and vegetables at each meal.
- Drink plenty of water throughout the day.
- Limit alcohol, which can worsen nausea.
- Keep a simple log of your weight and how you feel to share at check-ins.
When to call us
Call us if nausea or vomiting keeps you from eating or drinking, or if you have severe or persistent stomach pain. Seek emergency care for symptoms like severe abdominal pain that spreads to your back, signs of an allergic reaction, or trouble breathing.
Ready to talk it through? Book a consultation at our Van Nuys or Canoga Park office, or call (877) 991-1191. Telehealth visits are available anywhere in California.
This article is for general education and isn’t a substitute for medical advice. Compounded medications are prepared by licensed pharmacies for individual patients. They are not FDA-approved and have not been reviewed by the FDA for safety or effectiveness.
