How to Lose Weight on Ozempic (and Other GLP-1s) the Right Way

The success of GLP-1 medications has made drugs like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) seem like a magic bullet for weight loss. But using these injectable drugs doesn't mean you can throw healthy lifestyle habits out the window.

"When I meet with patients beginning GLP-1 therapy, I emphasize that this is not just a medication journey,” says Jasdeep Saluja, MD, the chair of the American College of Lifestyle Medicine's GLP-1 task force. “It's a chance to reset our relationship with food and health."

If you want to lose weight on these drugs — and develop the tools you need to keep it off for good — it’s well worth taking these steps to maximize your chance of success.

"Our baseline health evaluation is extremely comprehensive,” says Katherine Saunders, MD, an obesity medicine specialist with FlyteHealth and Weill Cornell Medicine in New York City. “I explain to my patients that it's like establishing a relationship with a new primary care provider with extra emphasis on everything related to weight and weight-related health complications.”

Dr. Saunders notes that FlyteHealth won’t prescribe anti-obesity medications without a large panel of labs, a series of health questionnaires, and a one-hour initial visit.

You're unlikely to get this level of care from med spas, online weight loss programs, or compounding pharmacies, which often bill themselves as a quick and easy way to access GLP-1s without the hassle of an office visit. Saunders warns if a provider offers GLP-1s without a comprehensive checkup and counseling, you should steer clear.

"We discourage arbitrary weight goals, and we celebrate health improvements," Saunders says.

Together, you and your doctor can discuss what optimal health looks like for you and figure out how to make it happen with a weight-focused plan. Saunders says that might mean addressing weight-related health complications or staving off new ones, like high cholesterol, high blood pressure, or high blood sugar.

Saunders says new negative feelings about food could be enough to make people give up on their GLP-1, which could cause them to regain their lost weight. But you can sidestep that issue and enjoy what you’re eating again by sharing any concerning shifts in food preferences with your care team.

"At each follow-up appointment, we ask about the relationship with food and other factors that could limit a patient's ability to stay on medications," Saunders says.

"Exercise isn’t just about the number on the scale — it’s about muscle preservation, metabolic resilience, mental health, and longevity," Saluja says.

Staying focused on your “why” can make it easier. "I also find that anchoring exercise in purpose — better energy, stronger bones, improved glucose regulation — helps shift it from a 'should' to a 'want,'” says Saluja.

Regular strengthening exercises like lifting weights or using resistance bands are key to combatting this problem, says Stephen Finney, MD, an obesity medicine physician in Dartmouth, Massachusetts, and a diplomate of the American Board of Obesity Medicine. "I'll demonstrate resistance band and body weight exercises at patients' initial weight loss appointments," he says.

"We shift the focus from volume to value, prioritizing nutrient density over caloric density," Saluja says.

"I often use the term 'high water, high fiber, high value' plates,” says Saluja. “Think soups, stews, and stir-fries packed with vegetables and legumes." He also points out that smoothies are another easy way to boost nutrition — think spinach, chia seeds, and unsweetened plant milks — when you're not overly hungry. And if you're having trouble remembering to eat, set reminder alarms to nudge you.

Saunders says your care team should be checking your bloodwork regularly to make sure you're not at risk for any vitamin or mineral deficiencies. But if getting enough wholesome food feels like a struggle, a registered dietitian can help you come up with a meal plan that feels both appealing and doable.

"The most common adverse effects I hear from my patients are increased satiety, fatigue, nausea, potentially vomiting, 'sulfur burps' or acid reflux, abdominal cramps, constipation, and diarrhea,” Dr. Finney says.

Habit shifts and lifestyle changes can help you cope, too. Finney encourages his patients to eat small meals slowly and avoid heavy or greasy foods to minimize nausea, and to pick fiber-rich foods and drink plenty of water to reduce constipation. If the nausea won't ease up, medications that help prevent and treat nausea and vomiting, known as antiemetics, are another good option, he adds.

"GLP-1s help regulate appetite, but stress and sleep deprivation can still trigger cravings, fatigue, and metabolic dysfunction," Finney says. He encourages his patients to aim for seven to eight hours of sleep and explore stress-reduction practices such as meditation, journaling, or therapy.

If you're having trouble sleeping or feel overwhelmed, your doctor has tools that can help.

"We'll refer to behavioral sleep specialists and use mindfulness or cognitive behavioral strategies for stress," Saluja says. "GLP-1s open a door, but lasting health comes from how we walk through it — guided by sleep, calm, purpose, and connection."

The Takeaway

• Although weight loss medications like Ozempic, Wegovy, and other GLP-1 agonists seem like miracle drugs, it’s still important to follow healthy lifestyle habits while you’re on them.
• Prioritize your health rather than just weight loss. People who want to take these drugs should get a baseline exam before they start. They also should exercise regularly to keep weight off and prevent bone and muscle loss, and eat nutritious foods.
• Stress and sleep play a big role in effective weight loss. Practice self-care and get enough sleep every night to optimize your weight loss journey.