What Really Happens in Month 1 on GLP-1 Meds, According to an Obesity Doctor

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.

The Rebound Effect Is Real

Research confirms what many fear - weight often returns after stopping GLP-1 medications. In an Eli Lilly study, patients who discontinued Mounjaro regained about 14% of their body weight after 36 weeks. With Ozempic, two-thirds of the total weight loss was eventually regained. "Most of the folks that regained weren't doing it the right way," says Dr. Decotiis, who emphasizes that proper monitoring makes all the difference in maintaining results.

Focus on Body Fat, Not Just Weight

The scale doesn't tell the whole story when it comes to healthy weight loss. "We make sure they're actually losing fat, okay? And their muscle is staying the same," explains Dr. Decotiis in her post. She monitors patients using body composition scales to track exactly what they're losing. "Most of the doctors prescribing this medication are not even putting people on a body composition scale," she points out, suggesting this oversight might contribute to weight regain after stopping medication.

Don't Stop Your Medication Abruptly

If you want to maintain your results, a gradual approach to ending treatment is crucial. "The worst thing someone can do is stop the drug abruptly," warns Dr. Decotiis. Instead, she recommends a careful tapering process: "I titrate the drug up and I taper it down. That makes such a difference." This methodical approach gives your body time to adjust and may significantly improve your chances of maintaining weight loss.

Proper Hydration Is Non-Negotiable

You might be surprised by how important water intake is for sustainable weight management. "People on these medications need to drink a tremendous amount of water. Up to maybe a gallon or more a day," Dr. Decotiis advises. She explains the science behind this requirement: "For every ounce of fat that you burn, you're losing water. It's very easy to get dehydrated." Proper hydration supports your metabolism and helps prevent weight regain.

Build Muscle Through Strength Training

Your exercise routine needs to focus on building and preserving muscle mass. "We don't encourage heavy aerobics, but we want them to build muscle," says Dr. Decotiis. Strength training helps maintain your metabolic rate, which is crucial for preventing weight regain. Even moderate resistance training several times per week can make a significant difference in your body composition and ability to maintain weight loss.

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Prioritize Protein and Vegetables

What you eat becomes even more important after stopping medication. "We want them to eat a lot of protein and vegetables, we measure the fiber in their diet," Dr. Decotiis explains. Protein helps preserve muscle mass while keeping you full, and fiber-rich vegetables provide essential nutrients with minimal calories. This nutritional approach supports sustainable weight management even as your body adjusts to life without medication.

Understand How Your Hormones Affect Results

Your hormonal profile may influence how your body responds to both the medication and its discontinuation. "Estrogen is really a positive modulator," says Dr. Decotiis, noting that "women do very, very well on this medication" due to this hormonal interaction. Understanding your unique hormonal situation can help you create a more effective maintenance plan after stopping medication.

Regular Monitoring Makes The Difference

Consistent check-ins are essential for maintaining results. "We follow patients very carefully, and we put them on a body composition scale every week, every other week," explains Dr. Decotiis. This regular monitoring allows for quick adjustments to your maintenance plan. Many of her patients who maintain this vigilance "have gotten off this drug and they've been able to maintain their weight," demonstrating that success is possible with the right approach.

Consider Which Medication You Used

Not all GLP-1 medications are created equal when it comes to maintenance potential. "People have lost a lot more weight on Mounjaro and Terzepatide than they did on Ozempic," Dr. Decotiis shares from her clinical experience. She adds that "there are also fewer side effects, and I feel that people are more easily tapered off that drug." The specific medication you used may influence your maintenance strategy.

Adjust Your Approach Based On Your Metabolism

Your unique metabolic profile should guide your maintenance plan. "It really depends on their metabolism," Dr. Decotiis explains when discussing how long patients typically need medication. She emphasizes personalization: "Some people can get off it pretty easily, okay? When I'm following your body composition scale, I'm seeing what's happening with your body fat as I'm taking the drug down." Your individual metabolic response will determine the best approach for maintaining your results.

Success Is Possible With The Right Strategy

Despite concerning statistics about weight regain, maintaining your results is achievable. "Many of my patients have gotten off this drug and they've been able to maintain their weight," Dr. Decotiis affirms. The key difference is comprehensive care: tracking body composition, proper tapering, adequate hydration, appropriate exercise, and nutrition tailored to your needs. With this holistic approach, you can beat the odds and keep the weight off for good. And if you enjoyed this article, don't miss20 Incredible Ozempic Success Stories of All Time.