If you’re not losing weight on semaglutide, the situation is usually solvable—but it requires a structured review rather than guesswork. Weight loss can stall for reasons that have nothing to do with “willpower.”
If you’re stalled, a clinician can evaluate whether the plan needs adjustment and screen for issues that require medical attention. Avoid self-adjusting dosing.
Nausea is one of the most common early side effects people report on semaglutide-based therapy. The good news: for many patients, it improves as the body adjusts—especially when you use a few practical habits.
Eat smaller meals, slow down, and stop at “comfortably satisfied.” Overeating can feel worse when digestion is slower.
Dehydration can worsen nausea and fatigue. Sip water throughout the day. If your clinician recommends electrolytes, use them strategically.
Many people tolerate bland, protein-forward foods better during the adjustment phase: yogurt, eggs, soups, cooked vegetables, toast, rice, or smoothies (if tolerated).
Very fatty meals, fried foods, and heavy desserts can worsen nausea in some people. If symptoms spike after certain foods, reduce them temporarily.
Some patients find nausea is more noticeable in a predictable window after dosing. Keep meals lighter during that window and avoid large, rich meals.
Severe or persistent vomiting, inability to keep fluids down, or signs of dehydration require medical attention. Don’t self-adjust treatment without clinician input.
Tirzepatide-based therapy may be used in clinician-guided programs for chronic weight management in appropriate patients, alongside nutrition and physical activity changes.
A clinician must screen for contraindications and risk factors. Patients should disclose current medications, past adverse reactions, pregnancy status, and relevant family history.
Patients must know what symptoms require immediate medical attention (severe or persistent vomiting, dehydration signs, severe abdominal pain, allergic reactions), and how to reach your clinical support.
If compounded: state clearly that compounded drugs are not FDA-approved and are not evaluated by the FDA for safety, effectiveness, or quality prior to marketing.
If medication is provided in a vial, dosing errors are a known risk when patients measure doses themselves. Provide a step-by-step injection basics guide, measurement safety reminders, and “contact your clinician if unsure” instructions.
If your GLP-1 or GLP-1/GIP medication is provided in a vial (rather than a prefilled pen), accurate measurement is critical. Many injection-related problems are not “medication failures,” but simple measurement errors that can increase side effects and risk.
This guide is not a substitute for your prescription label. Always follow your clinician’s specific dosing instructions.
Know the three measurement concepts
Your prescription and pharmacy label should connect these safely (for example, dose in mg + the corresponding syringe units for your specific concentration). If you don’t see that mapping, stop and contact your clinician or pharmacy before injecting.
(covered above via prescription + pharmacy label connection)
If you miss a dose, do not “double” to catch up. Contact your care team for instructions based on your prescription.
Severe or persistent vomiting, signs of dehydration, severe abdominal pain, or any symptom that feels abnormal warrants medical attention.
