GLP-1 Medications for Weight Loss: Complete Guide to All Options

Understanding GLP-1 Medications for Weight Loss

GLP-1 receptor agonists represent a paradigm shift in weight loss treatment. Unlike older weight loss medications that were marginally effective and often came with concerning side effects, GLP-1 medications produce dramatic weight loss—15-22% of body weight on average—in a significant proportion of users. What once seemed impossible for many people with obesity (losing 40-60+ pounds) has become achievable with modern GLP-1 therapy.

The story of GLP-1 medications began with diabetes treatment. Semaglutide (Ozempic) was developed for type 2 diabetes and launched in 2017. Doctors quickly noticed that diabetic patients taking semaglutide weren\'t just controlling their blood sugar—they were losing substantial weight. This led to the development of Wegovy, a higher-dose formulation of semaglutide specifically for weight management, approved by the FDA in 2021. Since then, tirzepatide (Mounjaro/Zepbound), which acts on both GLP-1 and GIP receptors, has shown even more impressive weight loss results.

This guide provides everything you need to understand GLP-1 medications: how they work, which medications are available, how they compare to each other, eligibility criteria, side effects, costs, and practical guidance for getting started.

How GLP-1 Agonists Work for Weight Loss

GLP-1 (glucagon-like peptide-1) is a hormone your body naturally produces that regulates appetite, blood sugar, and metabolic processes. GLP-1 receptor agonists are medications that mimic or enhance GLP-1 signaling, amplifying the body\'s natural appetite-suppression mechanisms.

The Four Primary Mechanisms

1. Appetite Suppression: GLP-1 signals the brain\'s appetite centers (particularly the hypothalamus) to reduce hunger. People on GLP-1 medications consistently report that food cravings almost disappear. Thoughts about food become less intrusive, and the psychological struggle with hunger largely vanishes. This is profoundly different from calorie-restriction dieting, where hunger is constant and requires continuous willpower.

2. Enhanced Satiety: Beyond just suppressing hunger, GLP-1 medications enhance satiety—the feeling of fullness and satisfaction from food. People feel satisfied on much smaller portions than they previously required. What once took a large meal to feel full now feels satisfying with 30-50% less food.

3. Slower Gastric Emptying: GLP-1 slows how quickly food moves from your stomach into the small intestine. This keeps you feeling full longer after eating, extending the time before hunger returns.

4. Improved Blood Sugar Regulation: GLP-1 enhances insulin secretion in response to meals and improves insulin sensitivity. This results in more stable blood sugar, reduced blood sugar spikes after meals, and reduced energy crashes that often trigger hunger and cravings.

The Combined Effect

The combination of these mechanisms produces weight loss that feels almost effortless for many people. Instead of fighting cravings and forcing themselves to eat less, people naturally eat less because their hunger is suppressed, their portions feel larger due to enhanced satiety, and their blood sugar is stable. This is why GLP-1 medications are so effective compared to older weight loss drugs—they work with your body\'s natural systems rather than forcing unnatural changes.

All Available GLP-1 Medications Explained

While GLP-1 is the hormone category, multiple different medications work through GLP-1 pathways. Understanding each option helps you and your doctor choose the best fit for your situation.

Semaglutide (Ozempic, Wegovy, Rybelsus)

Semaglutide is a GLP-1 receptor agonist developed by Novo Nordisk. It comes in three brand names depending on indication and form:

Ozempic (Semaglutide for Diabetes)

Ozempic is labeled for type 2 diabetes at doses up to 1mg weekly. The typical starting dose is 0.25mg weekly, increasing by 0.25mg weekly until reaching the effective dose (usually 0.5-1mg weekly). It comes as a pre-filled injection pen.

• Dosing: 0.25mg to 1mg weekly via subcutaneous injection
• Administration: Self-injected under the skin once weekly
• Insurance coverage: Typically covered for type 2 diabetes; some plans also cover for weight loss
• Cost: $250-400 per month with insurance; $800-1000+ without insurance
• Weight loss: Average 7-12% body weight loss at 1mg dose

Wegovy (Semaglutide for Weight Loss)

Wegovy is identical semaglutide but packaged and marketed specifically for weight loss. FDA approved in 2021. Dosing goes higher than Ozempic—up to 2.4mg weekly. The typical maintenance dose for weight loss is 2.4mg weekly, though some people respond well at lower doses.

• Dosing: 0.25mg to 2.4mg weekly via subcutaneous injection
• Administration: Self-injected under the skin once weekly using a pre-filled pen
• Approval: FDA approved for weight management in adults with BMI ≥ 30 or BMI ≥ 27 with weight-related conditions
• Insurance coverage: Variable; some plans cover, many don\'t for weight loss without diabetes
• Cost: $300-500+ per month with insurance; $1200-1500+ without insurance
• Weight loss: Average 15-17% body weight loss at 2.4mg dose (up to 35-40 pounds for 200-pound person)

Rybelsus (Oral Semaglutide)

Rybelsus is an oral tablet form of semaglutide—the only GLP-1 medication available as a pill. Dosing is lower than injections (3-14mg daily) due to variable absorption. It must be taken on an empty stomach, 30 minutes before food or other medications.

• Dosing: 3mg to 14mg daily as an oral tablet
• Administration: Oral tablet taken daily
• Advantage: No needles; convenient for needle-phobic patients
• Disadvantage: Lower dose limits may mean less weight loss; requires empty stomach; variable absorption
• Insurance coverage: Usually covered for diabetes; less commonly for weight loss
• Cost: Similar to Ozempic and Wegovy
• Weight loss: Typically less than injected semaglutide; average 5-10% body weight loss

Semaglutide Dosing Schedule

Semaglutide is dosed weekly, with a typical titration schedule:

• Weeks 1-4: 0.25mg once weekly
• Weeks 5-8: 0.5mg once weekly
• Weeks 9-12: 1mg once weekly
• Week 13+: 1.5mg once weekly (if using Wegovy) or 2.4mg at week 16+ (if using Wegovy at highest dose)

The slow titration reduces side effects in early weeks. Most of the weight loss occurs at higher doses (1.5-2.4mg), though some people see benefits at lower doses.

Tirzepatide (Mounjaro, Zepbound)

Tirzepatide is a newer dual GLP-1/GIP receptor agonist from Eli Lilly. It activates both GLP-1 receptors (like semaglutide) and GIP receptors (glucose-dependent insulinotropic peptide), providing dual appetite suppression and metabolic improvement. In clinical trials, tirzepatide produced superior weight loss compared to semaglutide.

Mounjaro (Tirzepatide for Diabetes)

Mounjaro is labeled for type 2 diabetes. Dosing ranges from 2.5mg to 15mg weekly. It comes as a pre-filled injection pen.

• Dosing: 2.5mg to 15mg weekly via subcutaneous injection
• Administration: Self-injected under the skin once weekly
• Insurance coverage: Usually covered for type 2 diabetes; increasingly for weight loss
• Cost: $250-400 per month with insurance; $800-1200+ without insurance
• Weight loss at 15mg: Average 19-21% body weight loss

Zepbound (Tirzepatide for Weight Loss)

Zepbound is FDA-approved specifically for weight management in adults with BMI ≥ 30 or BMI ≥ 27 with weight-related conditions. It uses identical tirzepatide as Mounjaro but is marketed for weight loss. Dosing goes up to 15mg weekly.

• Dosing: 2.5mg to 15mg weekly via subcutaneous injection
• Administration: Self-injected under the skin once weekly using a pre-filled pen
• Approval: FDA approved for weight management in 2023
• Insurance coverage: Growing; more plans cover Zepbound for weight loss than Wegovy currently
• Cost: Similar to Mounjaro; variable with insurance
• Weight loss: Average 21-22% body weight loss at 15mg dose (roughly 42-44 pounds for a 200-pound person)

Tirzepatide Dosing Schedule

Tirzepatide is dosed weekly with a typical titration:

• Weeks 1-4: 2.5mg once weekly
• Weeks 5-8: 5mg once weekly
• Weeks 9-12: 7.5mg once weekly
• Weeks 13-16: 10mg once weekly
• Week 17+: 12.5mg to 15mg once weekly

Maximum weight loss often occurs at 10-15mg doses. Like semaglutide, most people maintain their dose rather than continuing to increase indefinitely.

Why Tirzepatide Might Be Superior

Tirzepatide\'s dual GLP-1/GIP action appears to produce greater appetite suppression and potentially better metabolic improvement than semaglutide alone. Clinical trials show tirzepatide produces 20-22% average weight loss versus 17-18% for semaglutide. However, tirzepatide is newer, so long-term safety data is still accumulating compared to semaglutide, which has been used for diabetes since 2017.

Other GLP-1 Options (Saxenda, Dulaglutide, Liraglutide)

While semaglutide and tirzepatide dominate current discussions, several other GLP-1 medications exist and may be appropriate in certain situations.

Saxenda (Liraglutide for Weight Loss)

Saxenda is an older GLP-1 medication (liraglutide) approved for weight loss. It was used before semaglutide and tirzepatide became available. Unlike the newer medications injected weekly, Saxenda is injected daily.

• Dosing: 0.6mg to 3mg daily via subcutaneous injection
• Administration: Daily self-injection (vs. weekly for semaglutide/tirzepatide)
• Weight loss: Average 5-10% body weight loss
• Why less popular: Less effective than semaglutide/tirzepatide; requires daily injections instead of weekly
• When considered: Occasionally when other options fail or aren\'t tolerated; historical option no longer preferred

Victoza (Liraglutide for Diabetes)

Victoza is liraglutide labeled for type 2 diabetes. Similar to Saxenda, it requires daily injections. Less commonly used now that weekly semaglutide and tirzepatide are available.

Dulaglutide (Trulicity)

Dulaglutide is another GLP-1 medication approved for type 2 diabetes. Weekly injection, but produces less weight loss than semaglutide or tirzepatide (typically 2-4% weight loss). Sometimes used off-label for weight loss but not preferred compared to semaglutide/tirzepatide.

Medication Comparison: Which Is Right for You?

Eligibility Criteria and Who Should Consider GLP-1s

GLP-1 medications are not appropriate for everyone, but eligibility has expanded significantly in recent years. Understanding who is a good candidate helps you assess whether these medications might be right for you.

FDA Approval Criteria

Wegovy and Zepbound (the weight loss formulations) are FDA-approved for adults with:

• BMI ≥ 30 (obese), OR
• BMI ≥ 27 with at least one weight-related condition (hypertension, type 2 diabetes, sleep apnea, high cholesterol, etc.)

For reference: BMI 25-29.9 is overweight, BMI 30+ is obese. A person who weighs 200 pounds would need to be approximately 5\'7" or shorter to qualify based on BMI alone.

Beyond Official Eligibility

Doctors increasingly prescribe GLP-1 medications off-label even for people outside these criteria, particularly:

• People with BMI 27-30 who have struggled with weight loss despite best efforts
• People with metabolic syndrome or prediabetes
• People with a strong family history of type 2 diabetes or obesity
• People whose previous weight loss attempts ended in rapid regain
• People with binge eating disorder or significant food addiction

Side Effects, Risks, and Safety Considerations

While GLP-1 medications are generally well-tolerated and produce weight loss that justifies side effects for most people, understanding potential adverse effects helps you make an informed decision.

Most Common Side Effects

Nausea (30-40% of users): Most common side effect. Usually appears in the first 2-4 weeks as your body adjusts, then improves. Severity ranges from mild queasiness (rarely bothersome) to severe nausea (occasionally requires medication). Managing nausea through small frequent meals, bland foods, ginger supplements, and staying well-hydrated usually helps. Dramamine or prescription anti-nausea medications are occasionally needed.

Vomiting (10-20%): Follows nausea; some people experience occasional vomiting, particularly if they eat too much or too quickly. More common with faster dose titration. Usually resolves within 1-2 months.

Constipation (20-25%): Decreased appetite means decreased food intake, which reduces bowel movements. Mitigated by increased fiber intake, hydration, and sometimes stool softeners. Tends to improve as body adjusts.

Diarrhea (20%): Conversely, some people experience diarrhea, particularly if they consume high-fat or high-sugar foods. Usually resolves with dietary adjustment.

Fatigue (10-15%): Some people experience low energy in early weeks, particularly if eating too little. Ensures adequate protein intake and gradually increasing calories if needed helps.

Less Common But More Serious Side Effects

Acute Kidney Injury: Documented but rare (less than 0.1%). Usually occurs in people who become severely dehydrated from vomiting or insufficient fluid intake. Always stay well-hydrated and contact your doctor if unable to keep fluids down.

Pancreatitis: Very rare (approximately 0.1%). Characterized by severe upper abdominal pain, often radiating to the back. Seek immediate medical attention if you develop this.

Gallbladder Issues: Rapid weight loss increases gallstone risk (happens with any rapid weight loss, not specific to GLP-1s). Some people develop gallbladder problems requiring surgery. Risk is roughly 0.5-2% depending on baseline risk factors.

Muscle Loss: Weight loss includes roughly 20-30% muscle along with fat loss. Without resistance training and adequate protein, you may lose more muscle than desired. Mitigation: strength train 2-3 times weekly and consume 1.6-2.2g protein per kg body weight daily.

Absolute Contraindications

Do not use GLP-1 medications if you have:

• Personal history of medullary thyroid cancer (GLP-1s may increase risk)
• Multiple endocrine neoplasia syndrome type 2 (MEN2) (absolute contraindication)
• Severe pancreatitis or chronic pancreatitis (with some exceptions)
• Pregnant or planning pregnancy (GLP-1s haven\'t been adequately studied in pregnancy)

Cost, Insurance Coverage, and Access Options

Cost is one of the most significant barriers to GLP-1 medications. While effective, they are expensive, and insurance coverage varies dramatically.

Insurance Coverage Landscape

Ozempic (semaglutide for diabetes): Usually covered by insurance for type 2 diabetes. Copay ranges from $0-50 with good insurance. Without insurance, $800-1000+ monthly.

Wegovy (semaglutide for weight loss): Historically excluded by most insurance plans, viewing weight loss as cosmetic rather than medical. This is changing; more plans now cover Wegovy, particularly if BMI criteria are met. Coverage varies from 0-100% cost sharing depending on plan. Out of pocket: $300-500 with insurance; $1200-1500+ without.

Mounjaro (tirzepatide for diabetes): Usually covered for type 2 diabetes. Similar copay structure to Ozempic. Without insurance: $800-1200+ monthly.

Zepbound (tirzepatide for weight loss): Newer drug; insurance coverage is still evolving but growing. More plans cover Zepbound for weight loss than Wegovy currently. Out of pocket similar to Wegovy.

Manufacturer Assistance Programs

Both Novo Nordisk (Ozempic/Wegovy) and Eli Lilly (Mounjaro/Zepbound) offer patient assistance programs for uninsured or underinsured patients. Those who qualify can receive medication free or at significantly reduced cost ($50-250/month). Eligibility is based on income and insurance status.

Compounded Medications

Semaglutide and tirzepatide can be compounded (created by pharmacies) rather than using brand-name versions. Compounded versions cost $100-400/month, significantly less than brand versions. However, compounded medications are not FDA-regulated with the same standards as brand versions, creating potential quality and safety concerns. The exact dose and purity might vary. Some prefer the certainty of brand-name medications; others find compounded versions acceptable given the cost savings.

Telehealth and Online Prescribing

Many telehealth platforms now offer online assessments and GLP-1 prescriptions, often with access to compounded medications at lower cost ($150-400/month). This has made GLP-1 medications more accessible, though quality and oversight varies. Ensure you use reputable telehealth providers with licensed doctors who actually evaluate you (not just automatic prescribing).

How to Get Prescribed: Getting Started with Your Doctor

If you think a GLP-1 medication might be appropriate for you, here\'s how to move forward.

Step 1: Assess Your Eligibility

Calculate your BMI: BMI = weight (pounds) × 703 ÷ height (inches)². If your BMI is ≥ 30, you likely qualify. If BMI is 27-30, you\'d need a weight-related condition (high blood pressure, diabetes, high cholesterol, sleep apnea, etc.). Even if you don\'t meet strict criteria, GLP-1s are increasingly prescribed off-label.

Step 2: Discuss with Your Doctor

Schedule an appointment with your primary care doctor or a weight loss specialist. Bring information about GLP-1 medications and your interest in exploring them. Come prepared to discuss:

• Your weight loss history: previous attempts, what worked/didn\'t
• Your current health conditions (diabetes, hypertension, sleep apnea, etc.)
• Any medications you take
• Your family history (obesity, diabetes, thyroid cancer)
• Your goals and what results you\'re hoping for

Step 3: Screening and Evaluation

Your doctor should screen for contraindications, particularly:

• Personal or family history of medullary thyroid cancer
• History of pancreatitis
• Current thyroid issues
• Pregnancy or plans to become pregnant

Your doctor may order bloodwork: kidney function, liver function, and blood sugar levels to ensure GLP-1 medications are safe for you.

Step 4: Prescription and Starting

If you\'re approved, your doctor will write a prescription for either Ozempic, Wegovy, Mounjaro, Zepbound, or another GLP-1. Your doctor will discuss:

• Which medication to start (often based on insurance coverage)
• The dosing schedule (typically starting low and increasing gradually)
• How to self-inject (if needed; some doctors do the first injection in office)
• What side effects to expect and how to manage them
• Follow-up appointments to monitor progress

Step 5: Managing Your Prescription

Once prescribed, you\'ll need to:

• Pick up your prescription (from pharmacy or specialty pharmacy)
• Store properly: refrigerate unused pens; opened pens can sit at room temperature for 30 days
• Inject on the same day each week (many choose Sundays)
• Keep track of how you feel: nausea, appetite changes, weight loss, side effects
• Attend follow-up appointments to monitor progress and adjust dose if needed

Alternative: Telehealth Providers

If your primary care doctor is unwilling to prescribe GLP-1 or you don\'t have a doctor, telehealth platforms specializing in weight loss often provide GLP-1 prescriptions. Reputable options include providers who require online consultations with licensed doctors who evaluate your specific situation. Avoid platforms that prescribe automatically without proper evaluation.