How to Talk to Your Doctor About GLP-1 Weight Loss Drugs

Talking to your doctor is an essential step in determining if GLP-1 receptor agonists (GLP-1s) can help you manage your weight. In addition to treating type 2 diabetes, these medications can help people lose weight by lowering appetite, slowing digestion, and helping the body regulate blood sugar more effectively. But these drugs aren’t appropriate for everyone, and you’ll have more success if you and your clinician are on the same page.

To make the best decision, it’s important to understand how to approach the conversation with your doctor and what to expect from it. Knowing what questions or concerns to discuss about the medications will ensure that you leave the appointment with the information you need to take the next step.

First, be clear about what you want to achieve. In addition to giving context, sharing goals helps your doctor decide if medication is appropriate for you or if other approaches might be a better fit.

“Meaningful weight loss, better blood sugar control, and reduced cardiovascular risk are common goals for people who seek GLP-1 therapy,” says Fatima Cody Stanford, MD, MPH, an obesity medicine specialist at Massachusetts General Hospital and Harvard Medical School, both in Boston.

Other common goals include wanting to feel better physically and mentally as well as improving stamina, mobility, or longevity, says Allison Rhodes, MD, a physician at the Ohio State University Wexner Medical Center in Columbus who is certified in internal medicine and obesity medicine.

But don’t expect it all to happen at once, Dr. Stanford says.

“Unrealistic goals include rapid or extreme weight loss, cure of obesity, or permanent results without ongoing therapy,” she says.

Based on what you share, your doctor may help you manage expectations and set realistic goals, even if GLP-1s are not a fit for you.

Your doctor will want to know how you’ve tried to lose weight and the results. This helps tailor a plan that makes sense for your body, habits, and health history.

A detailed history of past diets, exercise regimens, medications, and even weight loss surgery attempts helps your doctor spot patterns. Your doctor may ask:

• Did you lose weight but then regain it?
• Did certain approaches trigger side effects or affect your mood?
• Did you maintain lifestyle changes for a time, and if so, what helped?

This information helps tailor therapy, set realistic expectations, and identify potential barriers to adherence and success, Stanford says.

In addition to discussing your weight history, your doctor will likely take a complete medical history, Dr. Bartfield says. This may include:

• Previous and current medical issues
• Medications you are taking
• Family medical history
• Sleep patterns
• Eating patterns
• Activity patterns
• Stressors
• Stress-coping mechanisms

Your doctor also will talk to you about your diet and exercise habits. Be prepared to share more information about what you eat, when you eat, when you exercise, and what kind of physical activity you do regularly.

In addition to being crucial to losing weight, a healthy diet and regular physical activity help GLP-1s work effectively, Stanford says. Your doctor may focus on those first before prescribing medications. You also may receive diet recommendations while you are taking GLP-1s.

Dr. Rhodes, for instance, encourages all her patients to eat a whole-food, plant-focused diet while minimizing processed foods and boosting fiber intake. This can keep your digestive tract moving smoothly while attempting to minimize the side effects of GLP-1s. You also should consume enough protein to combat the muscle loss that can happen alongside weight loss, Rhodes says.

GLP-1s may cause side effects early on and throughout treatment. Ask your doctor about what you can expect, how to address them, and any interactions GLP-1s may have with your current medications.

• Acid reflux
• Constipation
• Diarrhea
• Headache
• Indigestion
• Loss of appetite
• Nausea
• Vomiting

GLP-1s slow the digestive process, so it’s also wise to ask about diet strategies that can minimize side effects. Eating small meals and easy-to-digest foods can help in the first few days after an injection, Rhodes says.

In addition to common side effects, it is also important to discuss the potential for depression, says Zhaoping Li, MD, professor of medicine and chief of clinical nutrition at UCLA in California.

“Some patients may experience mood changes or struggle with expectations if weight loss is slower than hoped,” Dr. Li says.

Losing weight also may result in saggy skin and muscle loss. Ask your doctor about ways to monitor this, including through body-composition testing. Bartfield says that you may also be referred to a registered dietitian and exercise physiologists.

Starting a GLP-1 is not a one-and-done decision. Talk to your doctor about how often you should visit for follow-ups, including regular monitoring and medication adjustments.

Follow-up visits are the time to evaluate progress, manage side effects, and fine-tune diet and exercise. Stanford recommends scheduling the first follow-up appointment within four to six weeks of starting treatment.

You may start with the lowest dose of a GLP-1 after your first visit and gradually increase as tolerated, based on follow-up visits.

If you experience side effects like vomiting or constipation that lasts more than a few days, contact your doctor right away, Rhodes says. You may need a medication change or strategy revision.

Regular follow-ups with your healthcare team can help you manage this process and adjust medications where necessary.

“The people who are most successful at keeping the weight off after stopping are at a time and stage in their life where they are able to make significant, lasting changes in their nutrition, activity, stress management, and sleep habits,” Rhodes says.

• Talking openly with your doctor about your goals, past weight loss attempts, and lifestyle helps determine if a GLP-1 medication is right for you.
• GLP-1s work best when paired with diet changes and regular physical activity.
• Side effects like reflux, nausea, and constipation are common but often manageable with your healthcare team’s guidance.
• Work with your doctor to determine a plan for follow-up visits to ensure you are taking the right dosage and experiencing results.