Preparing for your first GLP1 shot

So, you finally receive your prescription for a GLP1 agonist, Ozempic, Wegovy, Zepbound or Mounjaro, and you’re feeling a little nervous about it.  First thing to know, most people are okay! The studies showed about 10-30% of patients will experience side effects with these medications. From what I’ve seen, possibly, the number is higher than that, but for most patients, the side effects are mild, tolerable and improve over time. We have some strategies to minimize the side effects.

I recommend taking the first shot over a weekend or a day you won’t be busy.  If you are going to experience side effects, the first and maybe second shot will be the worst ones. Since the medications do slow transit through the gut, a lot of side effects are stomach related. Especially in the beginning, you may experience nausea or heartburn. Some of this is related to how you eat. Greasy, fatty, rich foods will trigger more symptoms. Also, overeating. Sometimes, patients are not used to eating smaller portions yet, may go out to eat and eat a larger portion that sits heavy. So I do recommend paying attention to how you eat, and when you have symptoms. Patients are often able to pinpoint which foods seem to trigger symptoms for them. I warn people, pizza is a common culprit. For most people, the nausea is mild, and they can power through it. If somebody is having more discomfort, I do sometimes give antiacids or nausea medicine. My policy with these meds is if you just need a pill occasionally while getting used to the medication, I think that’s fine, however, if you need nausea medicine every day, it’s likely not the right medication for you. You should not be too sick to eat, you just shouldn’t feel like eating as much.

Constipation is another possibility. The most important strategy here is to remember to drink water. GLP1 agonists can reduce thirst along with hunger and patients often forget their water. Make it proactive, get a large bottle of water and leave it in your sight line so you remember. Fiber also makes a difference, aim for at least 25g of fiber daily, this will often include a supplement. A Probiotic can also help keep you regular. If needed, Miralax works when things get too slow.

Some patients will experience fatigue in the beginning. Again, I remind people to take their first shot on a day they can rest. Remember to stay well hydrated. And remember to get adequate nutrition! Sometimes these medications are so potent that patients are not eating enough. Focus on quality, not quantity make sure you get enough protein. Eating the right way can make a big difference!

I also recommend Tirzepatide (Mounjaro or Zepbound) over Semaglutide (Ozempic, Wegovy), as it is typically better tolerated and I have very few patients that want to stop it. While that first shot can be nerve wracking, most people really are fine! Talk to your doctor about your concerns, and congratulations on taking this important step towards improving your health!