Starting a new medication can be both exciting and nerve-wracking, especially when it comes to weight management treatments that have received so much media attention. Dr. Meghan Garcia-Webb, a Boston-based physician board-certified in Internal Medicine, Lifestyle Medicine, and Obesity Medicine, has guided patients through their GLP-1 weight loss journeys. "I've helped hundreds of patients lose weight, and I'm here to help you too," says Dr. Meghan, who prescribes FDA-approved medications like semaglutide, tirzepatide, and liraglutide daily. Her frontline experience offers invaluable insights about what actually happens during that crucial first month on GLP-1 medications—information that can help set realistic expectations for your own weight loss journey.
Everyone's Experience Is Different
The first thing Dr. Meghan wants you to understand is that reactions to GLP-1 medications vary dramatically from person to person. "For the GLP-1 medications, I find that it's very hard to predict. People are all over the map," she explains. Unlike some medications that produce relatively consistent side effects across patients, GLP-1 medications affect each person uniquely. Dr. Meghan notes that she might see one patient with no side effects and the very next patient with numerous challenges, which makes it impossible to predict exactly how you'll respond until you try it yourself.
Some People Experience No Side Effects
Believe it or not, many patients sail through their first month with minimal discomfort. "Some people are just so lucky and they really don't have any of the bad side effects," Dr. Meghan shares from her clinical experience. These fortunate individuals notice decreased appetite and begin losing weight without struggling with nausea or digestive issues. Dr. Meghan has even seen "super responder" patients who lose as much as 10 pounds in their first month. If you're hesitant to start your prescribed medication, remember that you could be among those who experience a smooth transition.
When Side Effects Hit Hard
At the opposite end of the spectrum, a small percentage of patients have severe initial reactions. "I do have a very small percentage of people that will call me after they start it. And they're like, did I get food poisoning?" Dr. Meghan reveals. These individuals might experience intense nausea, vomiting, or diarrhea that can be mistaken for a stomach virus. Though this represents a minority of cases in Dr. Meghan's practice, she recommends starting your first dose on a Friday, giving yourself weekend recovery time if you happen to experience stronger side effects.
Most People Have Manageable Symptoms
The majority of Dr. Meghan's patients fall somewhere in the middle with what she describes as "annoying, but manageable side effects." You might experience mild stomach upset, slight fatigue, or minor bowel issues while simultaneously noticing positive changes in appetite control. "Usually what happens though, is some sort of flavor of, yeah, I didn't feel great. I had a little stomach upset... but their appetite also got better. They weren't eating as much. The food noise really disappeared," Dr. Meghan explains. For most patients, these benefits outweigh the temporary discomfort.
Your Experience May Change With Each Dose
Dr. Meghan has observed that reactions often shift as patients increase their medication doses. "For some reason, the tirzepatide 7.5 seems to be a weird dose for people," she notes, pointing out that patients frequently report plateaus or increased side effects at this specific level. Some find that side effects intensify with dose increases then gradually improve, while others experience fewer issues as their body adapts over time. Dr. Meghan emphasizes that this variability is normal and part of finding your optimal treatment level.
The First Month Is About Adjustment, Not Results
The primary goal during your first month isn't weight loss—it's allowing your body to adapt to the medication. "These first initial doses are really just to get your body used to the medication," Dr. Meghan stresses. While some patients lose significant weight immediately, many don't—and that's completely normal. Dr. Meghan reassures patients that losing just a pound or two in the first month isn't concerning as the medication journey has just begun. She evaluates early success not by pounds lost but by whether the medication is tolerable enough to continue.
Don't Compare Your Journey To Others
Dr. Meghan strongly advises against measuring your progress against other patients, celebrities, or social media success stories. "Don't compare yourself to other people that you know are taking it or that you've heard about on the news or social media," she cautions. The varied response patterns mean someone struggling with side effects might still achieve excellent long-term results. Dr. Meghan emphasizes that different experiences don't necessarily indicate different outcomes—they're simply part of the "regularly irregular" nature of GLP-1 medications that makes each patient's journey unique. And if you enjoyed this article, take advantage of these 15 Quick Ways to Lose Body Fat Percentage in a Week.