Your first 90 days on a GLP-1
Week by week: what the starter dose actually feels like, when appetite changes show up, when your provider will titrate, and the three weeks most people find hardest.
Weight Loss · GLP-1
Semaglutide
The most studied GLP-1 for weight management, available as a weekly injection or a daily tablet. For most patients this is where treatment starts.
Starting at$169/ month
Your consult is free. We will not prescribe this — or anything — before a clinician has spoken with you and reviewed your bloodwork. Final cost depends on the form and dose prescribed.
Compounded · Rx only
Mechanism
Quieting the food noise.
Semaglutide mimics GLP-1, a hormone your gut releases after eating. It slows how fast the stomach empties and signals fullness to the brain earlier and for longer.
Patients most often describe the effect as the mental chatter about food going quiet. Portions shrink without white-knuckle effort, and snacking between meals stops feeling automatic.
Because the effect depends on continued dosing, semaglutide works best paired with the eating and training habits that keep results once the dose stabilises.
Protocol
How treatment usually runs.
A typical schedule. Yours is set by your clinician after your labs come back.
TitrationMaintenance doseRelative dose by phase — the table below has the exact figures
Start
1–4
Step up
5–8
Build
9–16
Maintenance
17+
| Phase | Weeks | Typical | Purpose |
|---|---|---|---|
| Start | 1–4 | 0.25 mg weekly | Tolerance only. Not a weight-loss dose. |
| Step up | 5–8 | 0.5 mg weekly | First therapeutic dose for most patients. |
| Build | 9–16 | 1.0–1.7 mg weekly | Raised only if side effects are manageable. |
| Maintenance | 17+ | 1.7–2.4 mg weekly | Lowest dose that maintains steady progress. |
What to expect
Honestly, over time.
Week 1–2
Appetite softens
Meals feel bigger than they are. Mild nausea is common early.
Week 4–8
Visible change
Weight begins moving measurably as you reach a therapeutic dose.
Month 3–6
Consistent loss
The most reliable window. Protein and resistance work protect muscle.
Month 12+
Maintenance
Loss plateaus. Your provider sets a maintenance dose rather than stopping abruptly.
Evidence
What the research shows.
In the STEP-1 trial, adults with overweight or obesity taking semaglutide 2.4 mg lost an average of roughly 15% of body weight over 68 weeks, against about 2.4% on placebo.
Participants also received lifestyle counselling. Results in practice depend heavily on whether that support is actually delivered — which is why coaching is built into this program.
Safety and eligibility
Your consult and labs screen for all of the following.
- Do not take with a personal or family history of medullary thyroid carcinoma or MEN 2.
- Do not take if pregnant, breastfeeding, or trying to conceive.
- Tell your provider about pancreatitis, gallbladder disease, kidney disease or diabetic retinopathy.
- Common side effects are nausea, constipation, diarrhoea, reflux and fatigue, worst after dose increases.
- Seek care immediately for severe persistent abdominal pain.
FAQ
Semaglutide questions.
In the STEP-1 trial, adults lost an average of about 15% of body weight over 68 weeks on the 2.4 mg dose. Individual results vary widely with dose, adherence, diet and activity.
Generally no. Oral semaglutide produces smaller average weight reduction than the weekly injection, but adherence is often better for patients who will not use needles. Your provider will weigh both.
Appetite usually changes within one to two weeks of a therapeutic dose. Measurable weight change typically appears around week four to eight and continues as the dose increases.
If it has been fewer than five days, take it when you remember. If longer, skip it and resume your normal schedule. Never double up. Message your care team if you miss more than one week.
Compounded medications are prepared by state-licensed compounding pharmacies and have not been evaluated by the FDA for safety, efficacy or quality. Your provider recommends compounded only when clinically appropriate.
We will not prescribe before we understand you.
Book a one-to-one consult with the clinical team. We talk through your goals, order the bloodwork that matters, and build a plan from what we find.