How-to
The questions to ask before starting a GLP-1 such as Wegovy, Zepbound or Foundayo: what to bring, fit, side effects, results, stopping, muscle and cost, with a printable checklist.
Fact-checked against FDA labels and official sources; not yet reviewed by a licensed clinician. This page is education, not medical advice. Talk to your doctor before starting, stopping or changing any treatment.
Key takeaways
- GLP-1 labels say not to use these medicines with a personal or family history of medullary thyroid carcinoma or MEN 2, so bring your family history.[1]
- Nausea is the most common side effect: 44% vs 16% on placebo in the Wegovy 2.4 mg trials, mostly while the dose is being raised.[1]
- The ADA 2026 Standards recommend checking measurements at least every 3 months during treatment and continuing long-term medicines to keep the benefits.[4]
- Weight tends to return after stopping: in STEP 4, people switched to placebo regained 6.9%.[7]
- Compounded semaglutide and tirzepatide are not FDA approved; fill prescriptions at a state-licensed pharmacy.[10]
In short: Before starting a GLP-1 medicine such as Wegovy, Zepbound or Foundayo, it helps to walk into the appointment with your health history written down and a short list of questions: is it a good fit for you, which form and why, what side effects to expect and when to call, how you will know it is working, what happens if you stop, how to protect muscle, and what it will cost. This page explains why each question matters, using the FDA labels and the American Diabetes Association’s 2026 Standards of Care, and ends with a checklist you can print.
New to these medicines? Our GLP-1 guide explains how they work, and every FDA-approved weight-loss medication compared shows the options side by side. This page does not tell you whether to take one: that is a decision for you and your clinician.
Three stages to plan for
- Before the visitWrite down your history, medicines and goals; check your coverage.
- At the visitAsk about fit, the form, side effects, follow-up and cost.
- After you startTrack side effects, eat enough protein, keep moving and keep follow-up visits.
Before the visit: what to write down
The labels list several conditions that change whether these medicines are used or how carefully they are monitored. Your clinician will ask, but having the answers ready saves time and helps nothing get missed.
- Thyroid cancer in you or your family. The labels say these medicines should not be used by people with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 (MEN 2). This is the subject of their boxed warning.
- Pancreas, gallbladder and stomach history. Past pancreatitis, gallstones or severe gastroparesis (very slow stomach emptying) matter, because the labels warn about pancreatitis and gallbladder disease and say Wegovy is not recommended with severe gastroparesis.
- Kidney problems and diabetic eye disease. Dehydration from vomiting or diarrhea can harm the kidneys, and the Wegovy label asks for monitoring in people with type 2 diabetes who have a history of diabetic retinopathy.
- Every medicine and supplement you take. Insulin and sulfonylureas raise the risk of low blood sugar with a GLP-1, and slower stomach emptying can affect pills taken by mouth. The Zepbound and Foundayo labels say birth control pills may work less well for a time after starting and after each dose increase, and advise a backup method.
- Pregnancy and breastfeeding plans. The Wegovy and Zepbound labels say to stop when pregnancy is recognized; the Wegovy label says to stop at least two months before a planned pregnancy.
- Planned surgeries or procedures. The labels warn about breathing in stomach contents under general anesthesia or deep sedation, so your surgical team needs to know.
- Your weight history and goals. What you have tried, what worked and what did not, and what you want to change, such as blood sugar, blood pressure, sleep apnea, joint pain or simply energy.
Questions about fit
“Is a GLP-1 medicine a reasonable option for me, and why?” The labels for long-term weight medicines describe adults with obesity, or adults with overweight and at least one weight-related condition, which the NIH generally describes as a BMI of 30 or more, or 27 or more with a condition such as high blood pressure or type 2 diabetes. Our BMI calculator gives you the number; your clinician looks at the whole picture.
“What else could I try, alone or alongside it?” The U.S. Preventive Services Task Force recommends that adults with a BMI of 30 or more be offered or referred to intensive, multicomponent behavioral programs. Every GLP-1 label pairs the medicine with a reduced-calorie diet and more activity. Our 40 ways to lose weight compared shows the full range, from eating patterns to surgery.
“Which medicine and which form, and why that one?” Options include weekly injections (Wegovy, Zepbound), daily pills (Wegovy tablets, Foundayo) and a daily injection (Saxenda or generic liraglutide). Some labels add other approved uses: Wegovy also lowers the risk of heart attack and stroke in adults with heart disease and obesity or overweight, and Zepbound also treats moderate to severe sleep apnea in adults with obesity. If you have diabetes, the ADA’s 2026 Standards say semaglutide or tirzepatide should be the preferred obesity medicines because of their larger weight loss and their added benefits.
“Is this the FDA-approved product?” Ozempic and Mounjaro have the same ingredients as Wegovy and Zepbound but are approved for type 2 diabetes. Compounded semaglutide and tirzepatide are not FDA approved, and the FDA has received reports of dosing errors with them. Read compounded GLP-1s before you agree to one.
Questions about side effects
“What side effects should I expect, and how do we manage them?” Digestive effects are the most common, especially while the dose is being increased. In the Wegovy 2.4 mg trials, nausea affected 44% of people vs 16% on placebo. Doses are increased step by step, usually every four weeks for the weekly injections, to help the body adjust; the ADA notes the best dose for a person may not be the highest approved one. Our GLP-1 side effects guide has practical tips.
| Item | Wegovy 2.4 mg | Placebo |
|---|---|---|
| Nausea | 44% | 16% |
| Diarrhea | 30% | 16% |
| Vomiting | 24% | 6% |
| Constipation | 24% | 11% |
| Abdominal pain | 20% | 10% |
Percent of people reporting each effect at any time in the trials. Other GLP-1 medicines have their own label tables.
Source: WEGOVY prescribing information (DailyMed), adverse reactions table (checked on October 6, 2026)
“Which symptoms mean I should call you, or get urgent care?” Ask for this in writing. The labels describe several warning signs.
Questions about results and how long
“How will we judge whether it is working, and when do we check in?” The ADA’s 2026 Standards recommend checking weight-related measurements at least every 3 months during active weight management treatment, and changing the plan if goals are not being reached. Agree on what success means for you: a number on the scale, a waist measurement, blood sugar, blood pressure or how you feel.
“What happens if I stop?” The ADA says long-term obesity medicines should be continued beyond reaching weight goals to keep the health benefits, because stopping often brings weight back. In STEP 4, people switched from semaglutide to placebo regained 6.9% of their weight while those who continued lost a further 7.9%. Our keeping weight off guide covers the habits that help either way.
Numbers worth knowing
- 44% vs 16%had nausea on Wegovy 2.4 mg vs placebo in its weight trialsWegovy label (DailyMed)
- +6.9%weight regained after switching to placebo in STEP 4, while continuers lost a further 7.9%Rubino D et al., JAMA 2021
- 3 monthshow often the ADA recommends checking measurements during active treatmentADA Standards of Care 2026
Checked on October 6, 2026
Questions about food, muscle and movement
“How much protein should I aim for, and should I see a dietitian?” Eating much less can make it harder to get enough protein, fiber and vitamins. The ADA advises paying attention to protein and fiber during weight loss treatment and pairing protein with resistance training to preserve lean mass, and a 2025 joint nutrition advisory from four obesity and nutrition societies makes muscle and bone protection a priority. Our protein calculator gives a starting range to discuss.
“What kind of exercise should I do?” U.S. guidelines suggest 150 to 300 minutes of moderate activity a week plus muscle strengthening on two or more days. Strength training matters most for muscle; our muscle loss guide explains why.
Extra questions if you have type 2 diabetes
“Do my diabetes medicines need to change?” The Wegovy label says that using it with insulin or a medicine that makes the pancreas release insulin, such as a sulfonylurea, can raise the risk of low blood sugar, and that lowering those doses may be necessary. Ask how to recognize low blood sugar and what to do. “Do I need an eye check?” The label asks for monitoring in people with a history of diabetic retinopathy. “Which brand fits: one approved for weight or one approved for diabetes?” Ozempic and Mounjaro are approved for type 2 diabetes, Wegovy and Zepbound for weight management; your clinician and your plan’s coverage rules both shape which one is prescribed. The ADA’s 2026 Standards say weight management should be a primary goal of diabetes treatment alongside blood sugar.
Questions about cost and coverage
“Will my plan cover it, and is prior authorization needed?” Coverage for weight medicines varies widely. Many plans ask for prior authorization, and Medicare Part D cannot cover drugs used only for weight by law, although the CMS Medicare GLP-1 Bridge (July 2026 to December 2027) offers Wegovy, Zepbound KwikPen and Foundayo for a $50 copay to people who meet its criteria. If you pay yourself, makers list monthly self-pay prices, for example Wegovy pens at $349 and Zepbound KwikPen at $299 to $449 as of October 6, 2026. Our insurance guide and cost hub walk through it.
“Where should I fill the prescription?” Use a state-licensed pharmacy. The FDA’s BeSafeRx program lists the signs of a safe online pharmacy, and the agency has warned about counterfeit Ozempic in the U.S. supply chain. If you are looking for a clinician who prescribes and follows these medicines, our find a provider page can help.
Printable checklist
Print this page or copy the list below into your phone’s notes. Tick off each item at your appointment and write the answers next to it.
Before starting a GLP-1: my checklist
Bring with me
- ☐ Personal or family history of medullary thyroid cancer or MEN 2
- ☐ Past pancreatitis, gallstones, severe gastroparesis, kidney or diabetic eye disease
- ☐ List of all medicines and supplements (insulin, sulfonylureas, birth control pills)
- ☐ Pregnancy or breastfeeding plans; any planned surgery
- ☐ My weight history, what I have tried, and my goals
- ☐ My insurance card and plan’s drug list (formulary)
Ask
- ☐ Is a GLP-1 a reasonable option for me, and what are the alternatives?
- ☐ Which medicine and form (weekly shot or daily pill), and why?
- ☐ Is it the FDA-approved product, not a compounded one?
- ☐ How will we raise the dose, and what if side effects are hard?
- ☐ Which symptoms mean I should call or get urgent care?
- ☐ Does it interact with my other medicines or birth control?
- ☐ How and when will we check whether it is working?
- ☐ How long would I take it, and what happens if I stop?
- ☐ How much protein and what exercise should I aim for? Can I see a dietitian?
- ☐ Will my plan cover it? Is prior authorization needed? What is my monthly cost?
- ☐ When is my next follow-up visit?
From instatuck.com, checked against FDA labels and the ADA Standards of Care 2026 on October 6, 2026. Education only; not medical advice.
Want to understand the brand you are offered in more depth? See semaglutide and tirzepatide, or the side-by-side Wegovy vs Zepbound. If you are weighing a program that bundles a prescription with coaching, our telehealth programs comparison shows what each includes.
Records in this article
FDA approved for weight managementPrescriptionPillWegovy Pill (oral semaglutide): status, how it is taken, how it comparesSemaglutide: one ingredient, several brands · Pill (tablet) · Daily
Strength Training for Weight Loss: keep muscle while losing fatModerate · Low impact
FDA approved for weight managementPrescriptionInjectionZepbound (tirzepatide): uses, side effects, cost and FDA statusTirzepatide: how the dual GIP/GLP-1 drug works (Zepbound, Mounjaro) · Injection · WeeklyRelated guides
GLP-1 Medication vs a Diet Program: Results, Costs and Trade-offsGLP-1 medication vs a diet program compared: average weight loss in STEP, SURMOUNT, Look AHEAD and…
Ozempic vs Mounjaro: How the Two Diabetes Drugs DifferOzempic vs Mounjaro compared from the FDA labels and the SURPASS-2 head-to-head trial: approved uses, how…
Does Insurance Cover GLP-1s for Weight Loss? (checked quarterly)Does insurance cover GLP-1s for weight loss? Employer data, Medicare rules and the $50 GLP-1 Bridge,…
Mounjaro Cost: self-pay price, savings card and Medicare (prices checked monthly)What Mounjaro costs, with dates: $499 LillyDirect self-pay at every strength, the $25 savings card and…Questions to ask a professional
- Is a GLP-1 medicine a reasonable option for me, and what are my alternatives?
- Which medicine and form would you suggest for me, and why?
- Which symptoms mean I should call you or seek urgent care?
- How will we judge whether it is working, and when is my next check-in?
- What happens if I stop, and what is our long-term plan?
- Will my insurance cover it, and what will I pay each month?
Frequently asked questions
What should I ask my doctor before starting a GLP-1?
Ask whether it is a good fit for you and what the alternatives are, which medicine and form and why, what side effects to expect and when to call, how you will judge results, what happens if you stop, how to protect muscle, and what it will cost. The printable checklist on this page lists them.
Who should not take a GLP-1?
The labels say people with a personal or family history of medullary thyroid carcinoma or MEN 2, or a serious allergy to the medicine, should not use them. Other conditions, such as past pancreatitis or severe gastroparesis, need a careful discussion with your clinician.
Do I need blood tests before starting?
Your clinician decides which tests fit your health, so ask which ones and why. The Wegovy label, for example, asks clinicians to monitor kidney function in people whose side effects could cause dehydration.
How long will I need to take it?
The ADA says long-term obesity medicines should be continued beyond reaching weight goals to keep the health benefits, because stopping often brings weight back. Talk with your clinician about a long-term plan.
Can I take a GLP-1 if I am planning a pregnancy?
The Wegovy and Zepbound labels say to stop when pregnancy is recognized, and the Wegovy label says to stop at least two months before a planned pregnancy. Tell your clinician about any plans.
References
- WEGOVY (semaglutide) injection and tablets: prescribing information. Novo Nordisk, via DailyMed, 2026. (accessed October 7, 2026) Drug label
- ZEPBOUND (tirzepatide) injection: prescribing information. Eli Lilly and Company, via DailyMed, 2026. (accessed October 7, 2026) Drug label
- FOUNDAYO (orforglipron) tablets: prescribing information. Eli Lilly and Company, via DailyMed, 2026. (accessed October 7, 2026) Drug label
- 8. Obesity and Weight Management for the Prevention and Treatment of Diabetes: Standards of Care in Diabetes, 2026. Diabetes Care; American Diabetes Association Professional Practice Committee, 2026. doi:10.2337/dc26-S008 · PMID 41358882 (accessed October 6, 2026) Guideline
- Weight Loss to Prevent Obesity-Related Morbidity and Mortality in Adults: Behavioral Interventions. U.S. Preventive Services Task Force, 2018. (accessed October 7, 2026) Guideline
- Prescription Medications to Treat Overweight & Obesity. National Institute of Diabetes and Digestive and Kidney Diseases (NIH). (accessed October 7, 2026) Government page
- Rubino D, Abrahamsson N, Davies M, et al.. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance (STEP 4). JAMA, 2021. doi:10.1001/jama.2021.3224 · PMID 33755728 · NCT03548987 (accessed October 7, 2026) Randomized trial
- Mozaffarian D, Agarwal M, Aggarwal M, et al.. Nutritional priorities to support GLP-1 therapy for obesity: a joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society. American Journal of Clinical Nutrition, 2025. doi:10.1016/j.ajcnut.2025.04.023 · PMID 40450457 (accessed October 6, 2026) Society statement
- Physical Activity Guidelines for Americans, 2nd edition: top 10 things to know. U.S. Department of Health and Human Services (ODPHP). (accessed October 7, 2026) Guideline
- FDA’s concerns with unapproved GLP-1 drugs used for weight loss. U.S. Food and Drug Administration, 2026. (accessed October 7, 2026) Government page
- BeSafeRx: your source for online pharmacy information. U.S. Food and Drug Administration. (accessed October 6, 2026) Government page
- FDA warns consumers not to use counterfeit Ozempic found in U.S. drug supply chain. U.S. Food and Drug Administration, 2025. (accessed October 7, 2026) Government page
- Medicare GLP-1 Bridge: information for providers. Centers for Medicare and Medicaid Services. (accessed October 7, 2026) Government page
- A New Use for Wegovy Opens the Door to Medicare Coverage for Millions of People with Obesity. KFF, 2024. (accessed October 6, 2026) Other
- Wegovy at NovoCare Pharmacy: self-pay prices. Novo Nordisk (NovoCare Pharmacy). (accessed October 7, 2026) Other
- Zepbound coverage and savings. Eli Lilly and Company. (accessed October 6, 2026) Other
Facts checked on October 6, 2026
Educational information, not medical advice. Talk with a qualified healthcare professional about your own situation. In an emergency call 911.
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