Preparing for GLP-1 Therapy: 6 Steps Before Your First Injection

You've heard about the results: minus 15-22% weight in a year. Maybe a friend lost weight on Mounjaro, or a colleague finally got rid of his "beer belly" thanks to Ozempic. And now you're thinking: "Maybe I should try it too?"

But here's what's rarely discussed: starting GLP-1 therapy isn't just buying a pen and giving yourself an injection. It's a medical decision that requires preparation. And proper preparation determines whether you'll get maximum results with minimum discomfort.

Who actually needs GLP-1 for weight loss?

Not everyone wanting to lose 5 kg before summer is a candidate for GLP-1 therapy. International protocols clearly define the criteria.

Tirzepatide — the main active ingredient in Mounjaro; the same tirzepatide for weight loss is sold in the US as Zepbound. The drug is FDA-approved for adults 18+ with BMI 30 kg/m² or higher. If BMI is 27-29.9, it's prescribed only with weight-related comorbidities: hypertension, type 2 diabetes, or elevated cholesterol [1].

Semaglutide (Wegovy) has broader age ranges. FDA approved it for adolescents 12+, if their BMI is at or above the 95th percentile for their age and gender [1]. But this doesn't mean the drug is suitable for all overweight adolescents. The decision is made by a doctor after thorough examination.

Updated 2024-2025 recommendations from the European Association for the Study of Obesity go further. They propose moving away from purely BMI-centric classification and considering staging systems based on obesity-related complications [5].

Important to understand: GLP-1 medications are prescribed alongside lifestyle changes. This isn't a magic pill. Approved products should be used "together with a reduced-calorie diet and increased physical activity" [1].

Contraindications: who is banned from GLP-1 therapy?

There are absolute contraindications where GLP-1 medications cannot be used under any circumstances.

Medullary thyroid cancer

All GLP-1 and GLP-1/GIP agonists have a "boxed warning" — the most serious category of FDA warnings. In rats, tirzepatide caused dose-dependent increases in thyroid C-cell tumors [27]. Whether this occurs in humans is still unknown.

The contraindication is categorical: if you or close family members have had medullary thyroid cancer (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN-2), GLP-1 medications are prohibited [16].

Pregnancy and pregnancy planning

GLP-1 agonists are contraindicated during pregnancy due to potential fetal risk [32]. If you're planning to become pregnant, discuss this with a specialist before starting therapy. Most protocols recommend stopping 2 months before planned conception.

History of pancreatitis

If you've had acute pancreatitis, the decision to prescribe GLP-1 is made individually. FDA recommends "considering alternative treatments for patients with a history of pancreatitis, as semaglutide has not been sufficiently studied in this population" [28].

Situations requiring caution also include:

• Severe gastrointestinal diseases
• Diabetic retinopathy (especially for semaglutide and tirzepatide)
• Severe kidney failure
• Gallstone disease or gallbladder disorders [36]

Which tests to take before starting GLP-1 therapy?

Basic laboratory examination isn't bureaucracy. It's your baseline for tracking progress and safety. Tests aren't mandatory for starting, but for complete confidence, it's better to ensure key indicators are normal.

Recommended minimum

Comprehensive metabolic panel (CMP) — evaluates kidney and liver function. GLP-1 medications are metabolized by the body, and it's important to know your organs are functioning properly [31].

Glycated hemoglobin (HbA1c) — shows average glucose levels over the past 2-3 months. Even if you're not diabetic, this indicator is critically important for evaluating treatment effectiveness [31].

Fasting glucose and insulin — help detect insulin resistance, which often accompanies excess weight. Fasting insulin level is an indicator that's "often missed" [31].

Thyroid function (TSH ± free T4) — considering thyroid warnings, basic screening is necessary [17].

Lipid profile — cholesterol, LDL, HDL, triglycerides. GLP-1 therapy often improves these indicators, so it's important to have a starting point.

Additional but important

Amylase and lipase — especially if there are pancreatitis risk factors [31]. These enzymes increase with pancreatic inflammation.

Vitamin B12 and vitamin D — GLP-1 agonists may affect nutrient absorption through slowed gastric emptying [31].

hs-CRP (high-sensitivity C-reactive protein) — inflammation marker that helps assess cardiometabolic risk.

Retinal examination — recommended before starting subcutaneous semaglutide or tirzepatide, especially with diabetic retinopathy [40].

Dose titration: why slow means effective?

One of the most common mistakes is wanting to "start with maximum." The logic seems obvious: higher dose, faster results. But physiology works differently.

Standard protocol for semaglutide (Wegovy)

The FDA-approved semaglutide titration schedule for weight loss starts with 0.25 mg weekly for the first 4 weeks. Then the dose increases gradually [7]:

• Weeks 1-4: 0.25 mg
• Weeks 5-8: 0.5 mg
• Weeks 9-12: 1 mg
• Weeks 13-16: 1.7 mg
• Week 17+: 2.4 mg (maintenance dose)

Full titration cycle takes about 16-20 weeks [8].

Standard protocol for tirzepatide (Mounjaro/Zepbound)

Tirzepatide has its own schedule with 2.5 mg steps every 4 weeks [4]:

Switching between medications

If you're switching from one GLP-1 to another, the safest approach is starting with the lowest dose of the new medication and titrating slowly [2]. No validated dose equivalent exists between semaglutide and tirzepatide due to their different receptor profiles.

In practice, patients more often switch from weaker semaglutide (Ozempic/Wegovy) to more powerful Mounjaro — rather than the other way around, because tirzepatide acts on two receptors at once and provides greater weight loss. Approximate starting doses when switching to Mounjaro [6]:

What to expect in the first weeks: a realistic view

The first weeks on GLP-1 are an adaptation period. Your body adjusts to the new hormonal signal, and this comes with certain sensations.

Most common side effects

Nausea — "the most frequently reported side effect of semaglutide" [18]. In the STEP 1 study, approximately 44% of Wegovy group participants reported nausea at some point during treatment. But here's the key point: semaglutide nausea typically begins within the first 1-3 days after starting or dose increase, is most intense in the first weeks, and significantly improves as the body adapts [18].

Vomiting occurs in about 24% of Wegovy users, though it's generally less common than nausea [18]. For tirzepatide, numbers are somewhat lower: nausea in 12-29% depending on dose, vomiting in 5-14% [21].

Interesting fact: in the direct comparison SURMOUNT-5 study, discontinuation rate due to gastrointestinal effects was higher for semaglutide (5.6%) than tirzepatide (2.7%), despite tirzepatide providing greater weight loss (20.2% vs 13.7%) [23].

How to minimize discomfort?

Practical tips that actually work:

• Eat smaller portions more frequently — instead of 3 large meals, 5-6 small ones
• Avoid fatty and heavy foods — they stay in the stomach longer
• Drink enough water — dehydration worsens nausea
• Don't lie down immediately after eating — wait 30-60 minutes
• Antiemetics — for severe nausea, a doctor may prescribe anti-nausea medications [20]

What's normal and what's not?

Normal:

• Mild nausea after injection (1-3 days)
• Decreased appetite (this is exactly why you started)
• Feeling "full" after small portions
• Temporary fatigue in the first weeks
• Mild constipation or diarrhea

NOT normal and requires attention:

• Severe abdominal pain radiating to back
• Persistent vomiting (inability to keep food/water down)
• Signs of dehydration (dark urine, dizziness)
• Jaundice (yellowing of skin/eyes)
• Neck swelling or swallowing problems

Red flags: when to seek immediate medical care?

GLP-1 medications are generally safe, but serious side effects exist that require immediate medical attention.

Acute pancreatitis

In 2024, MHRA (UK regulator) strengthened warnings for all GLP-1 agonists regarding acute pancreatitis risk, including rare cases of necrotizing and fatal pancreatitis [29].

Symptoms to watch for [24]:

• Severe, persistent upper abdominal pain that may radiate to back
• Persistent nausea and vomiting
• Fever
• Abdominal tenderness on palpation

Other serious conditions

Severe allergic reactions — facial, lip, tongue swelling; difficulty breathing; severe skin rash.

Signs of thyroid problems — neck lumps, persistent hoarseness, difficulty swallowing or breathing [37].

Kidney failure — may occur due to severe gastrointestinal symptoms and dehydration. GLP-1 agonists are associated with prerenal acute kidney injury in cases of severe dehydration [43].

Gallstone disease — rapid weight loss (more than 1.5 kg weekly) may trigger stone formation. Patients with excessively rapid weight loss are recommended gallbladder ultrasound [39].

Why specialist supervision is not optional, but necessary?

As you can see, GLP-1 therapy isn't "inject and forget." It's medical treatment that requires:

1. Proper pre-start evaluation — contraindications, tests, individual medication selection
2. Competent titration — slow dose increase under tolerance control
3. Process monitoring — tracking effectiveness and side effects
4. Quick problem response — recognizing red flags

In the DOZA program, each client receives specialist support from the first consultation to achieving results. We help with selecting tests, determine the optimal starting dose, and stay in touch throughout the entire course. You can read more about how Mounjaro works and how Ozempic works in separate materials.

Summary: your pre-start checklist

Before making your first injection, make sure:

✅ Your BMI meets criteria (≥30 or ≥27 with comorbidities)

✅ You have no absolute contraindications (MTC, MEN-2, pregnancy)

✅ Preferably — took basic tests (metabolic panel, HbA1c, TSH, lipids) for safety assurance

✅ You understand titration protocol and are ready for slow start

✅ You know nausea in first weeks is normal and passes

✅ You know red flags requiring immediate help

✅ You have a specialist you can contact with questions

GLP-1 therapy is one of the most effective weight loss tools available today. Clinical studies show weight reduction of 15% and more for semaglutide and over 20% for tirzepatide [17]. But these results are achieved by those who approach the process competently.

If you're ready to start your journey to healthy weight under the supervision of an experienced specialist — we at DOZA are ready to help. The first step is a free consultation, where we'll discuss your situation and select the optimal option specifically for you.

Where to order DOZA products

DOZA supplies all products mentioned in the article with official cold chain and 24/7 specialist support. Choose what you need:

• Buy Mounjaro in Ukraine — DOZA catalog with all 6 doses (2.5, 5, 7.5, 10, 12.5, 15 mg) and official thermal delivery within 24 hours. Current Mounjaro prices 2026 — from ₴1,000 for test dose.
• Buy Ozempic in Ukraine — original semaglutide from Novo Nordisk with thermal delivery. Current Ozempic prices 2026 — from ₴1,600 for starting dose.