Today we’re diving into a topic that’s been everywhere lately: GLP-1 medications like semaglutide and tirzepatide for weight loss. You may know them by names like Wegovy, Ozempic, Mounjaro, or Zepbound.
I want to give you a clear, realistic picture of what to expect—because while the media loves to highlight the dramatic before-and-after photos, the real journey can be slower and more nuanced for some.
So in this episode, we’re going to talk about the truth—what these medications can do, what they can’t, how long things really take, and what you need to know to set yourself up for success. Not hype, not magic promises—just real, honest insight to help you understand the process.
Let’s get into it.
How GLP-1 & GIP/GLP-1 Agonists Work
So first things first—how do these meds work?
Semaglutide is a GLP-1 receptor agonist, and tirzepatide is a dual GIP and GLP-1 receptor agonist. Basically, they mimic natural hormones in your body that help regulate blood sugar, slow digestion, and—most importantly for weight loss—reduce appetite and improve satiety.
That means you feel fuller faster and stay full longer. You’re not obsessing over food like before. And that’s powerful.
But—and this is a big one— these peptides don’t magically erase years of weight gain overnight. What they do is help make weight loss easier by reducing hunger and supporting your metabolism—but they don’t do all the work for you. It’s important to remember they’re a powerful tool, not a replacement for your efforts. You’re still in control of your choices, habits, and long-term success.
Why We Titrate the Dose—and What “Therapeutic Dose” Means
Now, let’s talk about dosing.
When you start Wegovy, you don’t start at the highest dose. It’s gradually increased over several weeks to give your body time to adjust and to help reduce side effects like nausea or stomach upset.
The usual schedule looks like this:
- You’ll start with 0.25 mg once a week for the first month.
- Then it increases every four weeks—0.5 mg, then 1 mg, then 1.7 mg.
- By week 17, most people reach the full dose of 2.4 mg once a week—that’s the dose shown in studies to lead to the most consistent weight loss, with many people losing around 15% of their total body weight over about a year.
But here’s the thing—not everyone follows this path exactly, and that’s okay. Some people need to slow down or stay longer at a lower dose if they’re having side effects. Others may need to increase sooner if they’re not seeing appetite changes and are tolerating the medication well.
And even though 2.4 mg is considered the “therapeutic dose,” not everyone needs to reach it. Some people feel great and lose weight at a lower dose—and if that’s you, that’s your sweet spot. The real goal is to find the lowest effective dose that controls your hunger, helps you lose weight at a steady pace, and keeps side effects to a minimum.
This isn’t a one-size-fits-all journey, and pushing through side effects just to hit the max dose isn’t necessary—or safe. Your best dose is the one your body handles well and helps you make progress.
*How Much Weight Can You Expect to Lose—and How Fast?
Let’s take a look at the clinical studies.
In large trials, people on semaglutide lost about 15% of their total body weight over 68 weeks. For tirzepatide, it was even higher—20% or more in some cases.
But here’s the thing—those results happened over a year to a year and a half. Not 6 weeks. Not 3 months. It’s a marathon, not a sprint.
Also, most of the weight loss doesn’t happen during the titration phase. You may see some weight loss early on, especially if your appetite plummets. But the bulk of the weight loss happens once you reach and maintain your therapeutic dose.
Why Everyone’s Journey Looks Different
I can’t stress this enough—everybody’s journey is different.
Some people feel zero hunger from their very first injection. Others don’t notice a big change until week 10 or 12. Some drop 10 pounds in the first month. Others lose two pounds and feel discouraged. All of those experiences are normal.
Your age, hormones, medications, stress levels, sleep, and past diet history? They all play a role.
And let’s be real—gaining 20, 50, or 100 pounds didn’t happen in a few weeks, right? It likely took months or even years of lifestyle habits, hormonal shifts, emotional eating, or underlying conditions.
So we have to give ourselves that same grace and patience when we’re trying to take the weight off—even with medical support.
Navigating Side Effects and Setbacks
Let’s talk about the side effects.
Nausea, constipation, acid reflux, bloating—yeah, these are pretty common as your body adjusts. And sometimes, those symptoms are your body’s way of saying: Hey, slow down.
Pushing through intense side effects just to hit a higher dose isn’t the goal. In fact, it’s not safe.
You want the lowest effective dose that keeps your appetite under control, the weight coming off gradually, and your side effects minimal or nonexistent.
If you need to pause treatment to let your gut settle or even go back down a dose, that’s not failure. That’s smart, safe self-care. We’re in this for the long haul.
Trial and Error with Food—and That’s OK
One part of this journey that catches people off guard is how sensitive your stomach becomes—especially to certain foods or drinks.
Greasy or fried foods, spicy meals, carbonated drinks, alcohol—these can all be triggers for nausea or even vomiting while you’re on this medication.
And it makes sense when you think about it: the medication slows down how quickly food and drink leave your stomach. So if you’re eating or drinking things that already tend to irritate the stomach lining, the effects can hit harder and last longer. Even if those foods didn’t bother you before starting treatment, they might now. It’s just one of those things your body has to adjust to, and it may take some trial and error to figure out what still works for you.
What is Healthy, Sustainable Weight Loss?
So what’s a healthy pace of weight loss?
In general, 1 to 2 pounds per week is considered safe and sustainable. But on GLP-1s, that might vary. Some weeks you may lose 3 pounds. Some weeks, nothing. And guess what? That’s normal.
You’re looking for overall downward trends, not perfection.
The goal here is steady, sustainable fat loss—not dropping weight so quickly that you feel miserable, drained, or start losing muscle. Remember, we’re not chasing “skinny”—we’re aiming for strong, lean, energized, and healthy.
And I know we’ve talked about this before, but it’s worth repeating: exercise is not optional when you’re on a GLP-1. It’s a must. When you lose weight, you lose both fat and muscle. If you’re not actively working to maintain or build muscle, you risk becoming weaker and slowing down your metabolism in the process. We want to keep the muscle you have—and ideally, build more—so your body stays strong and your results last.
What Is a “Non-Responder”?
Now let’s touch on something important: what if the medication doesn’t seem to work?
Let’s talk about what it means to be a “non-responder” on a GLP-1 medication like Wegovy or Zepbound.
In clinical terms, a non-responder is someone who has been on their therapeutic dose for at least 3 months and has lost less than 5% of their total body weight—even though they’re taking the medication correctly and making lifestyle changes like adjusting their diet, increasing physical activity, and managing stress or sleep.
Let’s break that down with an example:
If someone weighs 200 pounds, 5% of their total body weight would be 10 pounds. So if they’ve been on their therapeutic dose for 12 weeks and have only lost, say, 4 or 5 pounds—despite doing everything right—they may be considered a non-responder.
But as we mentioned before, everyone’s therapeutic dose may be different.
The therapeutic dose isn’t just the maximum dose like 2.4 mg of semaglutide or 15 mg of tirzepatide. It’s the dose at which you personally begin to experience consistent appetite suppression, weight loss, and minimal side effects.
For some people, that may happen at 1 mg of semaglutide. Others may not feel much of a difference until they reach the full 2.4 mg. Some may even respond better at 1.7 mg and not tolerate the higher dose at all. That’s why we titrate slowly, monitor your symptoms, and assess both how you feel and how your body is responding.
So how do we know if you’ve reached your therapeutic dose?
We look at things like:
- Has your appetite significantly decreased?
- Are you noticing earlier fullness or fewer cravings?
- Are you losing weight consistently over time
- Are side effects tolerable or nonexistent?
If the answer is yes, you’re probably at your therapeutic dose.
But if the answer is no—if your hunger hasn’t changed much, the scale hasn’t moved, and you’re not noticing any shift in your eating patterns after 3 months on a stable, higher dose—it might be time to re-evaluate. That could mean adjusting the dose, checking for other health issues that might be interfering (like thyroid problems or certain medications), or even considering a different treatment approach.
*So what are my final thoughts?
Your journey is unique. Not everyone responds the same way, and that’s okay. The key is finding what works for your body, not just what the label says.
These medications can absolutely change lives. But they’re not magic. They work with your efforts—not instead of them.
You’ll need to be patient, flexible, and kind to yourself along the way. You may need to tweak your dose, change your food choices, or give your body time to adjust. That’s part of the process.
And remember—this isn’t just about weight loss. It’s about reclaiming your health, confidence, and energy. So take it one step at a time. Celebrate every win. And know that slow progress is still progress.
Thank you for listening to The Peptide Podcast. If you enjoyed the show and want to support what we do, head over to our Partners Page. You’ll find some amazing brands we trust—and by checking them out, you’re helping us keep the podcast going.
Until next time, be well, be patient, and keep showing up for yourself. And as always, have a happy, healthy week.
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