GLP-1 Medications 101

GLP-1 Medications 101: How They Work, What They Cost, and What to Ask Your Doctor

If you’re hearing a lot about Ozempic®, Wegovy®, Mounjaro®, Zepbound® or Foundayo, you’re not alone. GLP-1 medications have become a game-changer in weight management. 

Many of my patients are curious about them but understandably have lots of questions. While I’m not a medical doctor and cannot prescribe these medications, I often explain how they work, their benefits and downsides, and how to use them safely. Then I help with the nutrition before, during, and after taking any GLP-1s. 

This blog breaks it all down so that you can have a more informed conversation with your healthcare provider. Buckle up! It’s a long read, but one that should help you better understand your options. 

Understand How GLP-1 Medications Work

GLP‑1 receptor agonists (GLP‑1 RAs), also known as incretin mimetics and anti-obesity medications (AOMs), are drugs originally developed to treat type 2 diabetes.  Today, their use has expanded to include weight management, conditions like heart disease, chronic kidney disease (CKD), fatty liver, sleep apnea, and even some mental health and reward-related disorders (such as alcohol use disorder).

GLP‑1 stands for glucagon-like peptide-1, which is a natural hormone your body makes. These medications work by mimicking that hormone to:

  • Increase feelings of fullness
  • Slow down how quickly food leaves your stomach (so you stay full longer)
  • Reduce appetite
  • Improve blood sugar levels
  • Lessen food cravings

Thanks to these effects, GLP‑1 RAs not only help manage blood sugar but also support long-term weight loss and improve overall metabolic health.

It’s important to understand that the GLP-1 produced naturally by the body is short-lived, with effects lasting only a few minutes to a couple of hours. In contrast, GLP-1 medications are engineered to be much longer-acting, which is why they only need to be injected once a week. 

Compare the GLP-1 Medications Available Today

There are currently four main GLP-1–based medications approved and widely used for weight management: semaglutide, tirzepatide, orforglipron (Foundayo), and liraglutide. Semaglutide and tirzepatide are the most commonly prescribed options, while liraglutide is an older medication that is still used in some cases. Orforglipron (Foundayo) is a newer oral GLP-1 receptor agonist that provides an alternative to injectable treatments. Additional medications are in development and are expected to become available in the coming years.

Semaglutide

Semaglutide is a medication that mimics the GLP-1 hormone to help lower blood sugar and support weight loss.

Brand Names:

  • Wegovy: FDA-approved specifically for weight loss
  • Oral Wegovy: Also approved for weight loss.
  • Ozempic: FDA-approved for type 2 diabetes, but often prescribed off-label for weight loss
Wegovy injection

Generic Versions:

  • There are no generic versions of semaglutide available at this time.

How It’s Taken:

  • Wegovy: A once-weekly injection (there is no oral option approved for weight loss)
  • Oral Wegovy: To maximize absorption, it should be taken first thing in the morning on an empty stomach with no more than 4 ounces (120 mL) of plain water. After taking the tablet, wait at least 30 minutes before eating, drinking, or taking any other medications.

Weight Loss

In clinical trials, participants taking semaglutide lost an average of 15% of their body weight over 68 weeks—that’s a little over a year. This means someone who weighed 200 pounds could lose around 30 pounds. Results varied, of course, but many people experienced steady and meaningful weight loss when the medication was combined with lifestyle changes, such as healthy eating and increased physical activity. 

In a separate trial, at 208 weeks, users of semaglutide maintained a 10.2% weight loss.

In clinical trials, participants taking the oral medication lost approximately 13.6% of their body weight at the higher doses.

Tirzepatide

Tirzepatide also mimics the GLP-1 hormone to support significant weight loss. In addition, it simulates the GIP hormone, which helps regulate blood sugar. 

Brand Names:

  • Zepbound – FDA-approved for weight loss
  • Mounjaro – FDA-approved for type 2 diabetes, but also prescribed off-label for weight loss

Generics:

  • No generic versions of tirzepatide are currently available.

How It’s Taken:

  • A once-weekly injection

Weight Loss

Clinical studies have shown weight loss of ~21% of body weight over a 72-week period, which is among the highest reported for a medication to date.

Orforglipron

Foundayo is the newest GLP-1 medication, and it’s the first approved as a daily pill rather than a weekly shot.

Brand Names:

  • Foundayo – FDA-approved for weight loss, approved in April 2026

Generics:

  • No generic versions of orforglipron are currently available.

How It’s Taken:

  • A once-daily pill, taken with or without food and without water restrictions

Weight Loss

In clinical trials, participants taking Foundayo lost an average of 12.4% of their body weight at the highest dose over 72 weeks.

Decide Which GLP-1 Medication Might Fit You Best

With several options now available, it’s normal to wonder which one makes sense for your situation. While only your healthcare provider can make that call, these questions can help guide your conversation.

Are needles a dealbreaker? If the idea of a weekly injection feels overwhelming, orforglipron (Foundayo) and oral semaglutide (Wegovy pill) are worth asking about since they’re taken as a daily pill instead.

Do you struggle with sleep apnea? Tirzepatide is currently the only GLP-1 medication approved specifically for treating sleep apnea, so this may be a relevant factor if that’s part of your health picture.

How much weight loss are you hoping for? Clinical trials show tirzepatide tends to produce the highest average weight loss, followed by semaglutide injection, with orforglipron and oral semaglutide showing solid but somewhat more modest results. These are population averages though, and your own results may look different.

There’s no single “best” GLP-1 medication. The right one depends on your health history, your goals, and what fits into your life. Bring these questions to your provider, and don’t be afraid to ask why they’re recommending one option over another.

Find Out If You Qualify for GLP-1 Medications

These medications are typically prescribed for:

  • Adults with a BMI ≥ 30 
  • Adults with a BMI ≥ 27 who also have a weight-related health condition, such as:
    • Type 2 diabetes
    • High blood pressure
    • High cholesterol
    • Cardiovascular disease
  • Semaglutide is also approved in children 12 years and older living with obesity.

Important Note: These are prescription medications that must be taken under medical supervision. They’re not suitable for everyone.

Contraindications

While GLP-1 medications can be highly effective for weight loss, they aren’t safe for everyone. Semaglutide and tirzepatide are not recommended for individuals with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia syndrome type 2 (MEN2) and pregnant women. They should also be used cautiously—or avoided altogether—in people with a history of pancreatitis, certain gallbladder conditions, or severe gastrointestinal disorders. 

As with any prescription medication, GLP-1 agonists must be used under the guidance of a qualified healthcare provider.

Understand Compounded GLP-1 Medications

You’ve probably heard about compounded semaglutide, tirzepatide, or orforglipron. These are versions of GLP-1 medications made by specialty pharmacies instead of the original drug companies like Novo Nordisk or Eli Lilly.

The biggest draw is cost. Brand-name GLP-1 medications can run hundreds of dollars a month, and compounded versions have often been a fraction of that price. For many patients without insurance coverage for weight loss medications, compounding has been the only realistic way to afford treatment.

But here’s what you need to know. This option is shrinking. As drug shortages have resolved, the FDA has tightened the rules around what compounding pharmacies are legally allowed to make, and regulators have signaled they want to close this door even further in the future.

No matter which option you choose, only work with a licensed, reputable pharmacy. Compounded medications are not reviewed by the FDA for safety, effectiveness, or quality the same way brand-name drugs are, so that extra layer of caution matters.

GLP-1s Costs

Out-of-pocket costs can range from $25 to $699 per month. Insurance will often cover these medications for diabetes but less often for weight management. Check your coverage ahead of time to avoid surprises.

The good news? 

Eli Lilly, the manufacturer of Mounjaro and Zepbound, now offers the more affordable options through Lilly Direct.

Novo Nordisk is also working on making semaglutide (Ozempic and Wegovy) more affordable. At the time of writing this blog, Novo has a special offer that significantly cuts the price of the first two months of the medication. 

GLPs Benefits 

Semaglutide (Ozempic and Wegovy):

Tirzepatide (Mounjaro and Zepbound)

  • Significant weight loss 
  • Dual-action effect: Targets both GLP-1 and GIP receptors to enhance appetite regulation and glucose control
  • Reduced appetite and improved satiety: Helps you feel full longer and reduces food intake
  • Improved blood sugar control: Particularly beneficial for individuals with type 2 diabetes or insulin resistance
  • Fewer food cravings, especially for high-calorie, highly processed foods
  • May lower risk of obesity-related conditions, such as cardiovascular disease and metabolic syndrome
  • Approved for the treatment of sleep apnea

Orforglipron

Watch for These Side Effects

As with any medication, there are some potential drawbacks:

  • Digestive issues are the most common:
    • Nausea
    • Constipation
    • Diarrhea
      Bloating or burping
  • More serious side effects:
    • Pancreatitis – Inflammation of the pancreas; symptoms include severe abdominal pain, nausea, and vomiting
    • Gallbladder disease – Including gallstones and inflammation (cholecystitis)
    • Thyroid tumors – Including a potential risk of medullary thyroid carcinoma (MTC); not recommended for individuals with a personal or family history of MTC or MEN2 (Multiple Endocrine Neoplasia syndrome type 2)
    • Kidney problems – Worsening of kidney function, especially in those with preexisting kidney issues and during severe nausea/vomiting
    • Severe gastrointestinal issues – Persistent nausea, vomiting, diarrhea, or constipation leading to dehydration
    • Allergic reactions – Rare but possible; signs include rash, itching, swelling (especially of the face/tongue/throat), severe dizziness, or trouble breathing
  • Cost and access: Insurance may not always cover these medications
  • Long-term use may be necessary to maintain weight loss
  • Muscle loss may occur if weight loss is too rapid or if you’re not exercising or eating enough protein

Know What Happens If You Stop Taking GLP-1s

Yes, weight regain is common after stopping GLP-1 meds, especially if lifestyle changes aren’t maintained.

Clinical studies have shown that people can regain a significant portion of the weight they lost—on average, about two-thirds—within a year of stopping the medication.

Read about how to keep weight off after stopping Zepbound.

Support Your Results With Nutrition and Exercise

GLP-1 medications can be powerful tools for weight loss, but they aren’t a cure-all. Healthy lifestyle habits—especially good nutrition and regular exercise—remain essential for long-term success. A balanced diet helps preserve muscle mass during weight loss, prevents nutrient deficiencies, and reduces common side effects like constipation (hello, fiber!). 

Meanwhile, exercise supports muscle strength, boosts metabolism, promotes heart health, and improves energy and mood. These habits not only enhance the effectiveness of the medication but also set the foundation for maintaining your progress—even if you eventually stop taking the medication.

Prepare for Your Doctor Conversation About GLP-1s

Bringing up GLP-1 medications like Ozempic, Wegovy, Mounjaro, Zepbound or orforglipron with your healthcare provider can feel intimidating. But it doesn’t have to be. Your doctor’s goal is to support your health, and having an open, honest conversation is the first step.

Here are a few tips to help guide your discussion:

  • Be clear about your goals. Whether it’s weight loss, managing a health condition, or preventing future issues, sharing your motivation helps your provider understand your priorities.
  • Ask if you meet the criteria. You can say:
    “Do I qualify for GLP-1 medications based on my BMI or health history?”
  • Mention any weight-related conditions. High blood pressure, type 2 diabetes, PCOS, or sleep apnea may affect your eligibility.
  • Discuss your full health history. Be sure to mention any past digestive issues, thyroid problems, family history of thyroid cancer, and history of pancreatitis.
  • Ask about the risks and benefits. For example: “What side effects should I watch for?” or “What labs or follow-up visits would I need?”
  • Be honest about your lifestyle. These medications work best when combined with healthy habits. Talk about your nutrition and activity levels, and ask where to start if you’re not sure.

Remember, your doctor is there to support you. It’s okay to advocate for yourself and ask questions—you’re a partner in your care. However, not all doctors are knowledgeable about or agree with this new generation of weight-loss medication, and it’s fine to seek a physician or other healthcare provider willing to have an open conversation with you.

If possible, seek the advice of an obesity specialist. 

Find Out Where to Get a GLP-1 Prescription

GLP-1 medications require a prescription, so you’ll need to work with a licensed healthcare provider to get started. Here are the most common places patients turn to.

Your primary care doctor. This is often the easiest starting point since they already know your health history. Not all primary care doctors prescribe GLP-1s for weight loss, so it’s worth asking directly if this is something they offer.

An obesity medicine specialist. These are doctors with additional training specifically in weight management. They tend to be especially familiar with GLP-1 medications, dosing, and side effect management.

An endocrinologist. If you have type 2 diabetes or another hormone related condition, an endocrinologist may already be part of your care team and can prescribe GLP-1s as part of your treatment plan.

A telehealth provider. Many telehealth platforms now offer virtual visits specifically for weight loss medications. These can be a convenient option, though it’s important to choose a reputable platform that uses licensed providers and connects you to FDA-approved medications.

A medical weight loss clinic. Some clinics specialize in weight management and offer GLP-1 prescribing alongside other support like nutrition counseling.

No matter where you go, ask whether the provider accepts your insurance and whether they’ll help you navigate prior authorization if your plan requires it. Insurance coverage for weight loss medications varies widely, so this step can save you time and money.

Final Thoughts

GLP-1 medications have become powerful tools in the treatment of excess weight. They can be highly effective, but like any tool, they work best when combined with healthy eating, regular physical activity, and the guidance of a qualified healthcare provider.

As a dietitian who works closely with patients using these medications, I’ve seen how they can truly transform the approach to weight management. Beyond weight loss, GLP-1s are also showing promise for managing other chronic health conditions. That said, they’re still relatively new, and I continue to follow the emerging research closely.

Do I recommend them? I view them as one of many treatment options. When a patient is interested, I provide an overview of the pros and cons and always encourage a conversation with a knowledgeable physician to help determine if it’s the right path.

Want help with nutrition and exercise? Book an appointment with me.

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