Medical Weight Loss in North Carolina

How GLP-1 medicines work

After you eat, your gut releases a hormone called GLP-1. It slows how fast your stomach empties and tells your brain you are full. GLP-1 medicines act like that hormone, but they last much longer. Most people feel less hungry and get full on smaller meals.

Tirzepatide also acts on a second gut hormone, GIP. Both medicines are a shot you give yourself under the skin once a week.

The medicines

• Semaglutide (Wegovy). FDA-approved for chronic weight management in 2021. It starts at a low dose that goes up every four weeks, reaching the full dose after about 16 weeks.
• Tirzepatide (Zepbound). FDA-approved for chronic weight management in 2023. It also starts low and goes up in steps, usually every four weeks, until you reach the dose that works for you.

Going up slowly gives your body time to adjust, which keeps side effects down. Your provider decides which medicine and dose fit you.

Who these medicines are for

The FDA approved them for adults with a BMI of 30 or higher, or 27 or higher with at least one weight-related health problem, such as high blood pressure, type 2 diabetes or high cholesterol. They are meant to be used with a lower-calorie diet and more physical activity, not instead of them.

Who should not take them

• People who are pregnant or trying to become pregnant. Semaglutide should be stopped at least two months before a planned pregnancy.
• People with a personal or family history of medullary thyroid cancer, or of multiple endocrine neoplasia type 2 (MEN 2).
• People who have had a serious allergic reaction to the medicine.

Your provider will also ask about pancreatitis, gallbladder disease, kidney problems and diabetic eye disease, which need extra care. If you take birth control pills, tirzepatide can make them less effective for a while after you start and after each dose increase; your provider will explain backup options. Tell any surgeon or anesthesia team that you take one of these medicines.

Side effects

The most common side effects are nausea, diarrhea, vomiting, constipation and stomach pain. They are most likely in the first weeks and right after a dose increase, and they often ease over time. Eating smaller meals, stopping when you feel full and going easy on greasy food can help.

Get medical care right away for severe stomach pain that does not go away (with or without vomiting), signs of a serious allergic reaction, or pain in the upper right belly with fever or yellow skin.

What happens at your visits

Your first online visit covers your health history, weight history, current medicines and goals. Your provider may order lab work before you start. If a medicine is right for you, the prescription goes to a pharmacy and you get a food and activity plan. Follow-up visits check your progress, side effects and dose.

Planning for the long run

These medicines work while you take them. When people stop, the weight often comes back: in one large study, people regained about two-thirds of the weight they had lost within a year of stopping semaglutide. Your provider will plan with you for the long term, including what to do if you want to lower the dose or stop.

Sources

1. FDA: Wegovy (semaglutide) label at its June 2021 approval for chronic weight management
2. FDA: approval of Zepbound (tirzepatide) for chronic weight management, November 2023
3. Wilding et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). New England Journal of Medicine, 2021
4. Jastreboff et al. Tirzepatide once weekly for the treatment of obesity (SURMOUNT-1). New England Journal of Medicine, 2022
5. Wilding et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide (STEP 1 extension). Diabetes, Obesity and Metabolism, 2022
6. Wegovy prescribing information (Novo Nordisk)
7. Zepbound prescribing information (Eli Lilly)

This page is general information, not medical advice. Talk with a licensed provider about your own health.