Getting started

Starting a GLP-1: your first-month checklist

Last reviewed · By GLP1 Sidekick Editorial · 4 min read

The short answer

Before your first dose, read the Medication Guide, tell your prescriber about birth control, pregnancy plans and any upcoming surgery, and lock in how you’ll pay. In the first month, eat small protein-first meals, sip fluids, add fiber gradually, and expect stomach side effects to be most noticeable when starting or increasing a dose. Know the warning signs—severe belly pain, vomiting you can’t stop, signs of dehydration—that mean calling your prescriber.

This guide is educational and not medical advice. It does not give dosing instructions. Talk to your prescriber or pharmacist about your own situation.

What should I ask my prescriber before starting?

  • Which medicine, device and plan for dose increases are right for me? (Your prescriber sets your dose—we don’t give dosing advice.)
  • Birth control: Zepbound’s label advises switching from oral contraceptives to a non-oral method, or adding a barrier method, for 4 weeks after starting and after each dose increase. Lilly gives similar advice for Foundayo (30 days).
  • Pregnancy plans: Wegovy’s label says to stop at least 2 months before a planned pregnancy.
  • Surgery or procedures: 2024 multi-society guidance says most people can continue GLP-1s before elective surgery, but those at higher risk may need a 24-hour liquid diet or other steps—tell your surgical team.
  • Other medicines: insulin or sulfonylureas raise low-blood-sugar risk; oral medicines may need timing changes with the Wegovy pill.
  • Medical history: pancreatitis, gallbladder disease, kidney problems, diabetic eye disease, or a personal or family history of medullary thyroid cancer or MEN 2.

How will I pay for it?

Sort this out before the first fill so you don’t stall mid-month. Check your insurance first; if it covers the drug, look at the maker’s savings card. If not, compare self-pay prices (Zepbound from $299, Wegovy pen from $199 intro then $349, pills from $149) and the $50 Medicare GLP-1 Bridge if you have Part D. Our savings programs guide walks through every official option. Note that some self-pay prices require refilling within 45 days.

What should I stock up on for the first month?

ForIdeas
ProteinGreek yogurt, eggs, cottage cheese, ready-to-drink shakes, meat sticks, tofu
Nausea daysCrackers, broth, ginger or peppermint tea, acupressure bands
ConstipationHigh-fiber foods, prunes; ask your pharmacist about a fiber supplement or laxative to have on hand
HydrationA water bottle you like; electrolyte drinks if you’re losing fluids (check first if you limit sodium)
TrackingAn app to log doses, side effects, protein and weight

What side effects are normal in the first month?

Stomach side effects—nausea, diarrhea, vomiting, constipation, indigestion—are the most common, and the labels and 2025 joint advisory note they’re most frequent when starting or increasing a dose and tend to ease on a stable dose. Fatigue and reduced appetite are also common. See our guides to nausea and constipation.

When should I call my prescriber?

  • Severe stomach pain that won’t go away, with or without vomiting (possible pancreatitis).
  • Vomiting or diarrhea you can’t control, or signs of dehydration such as dizziness or very little urine.
  • Upper-stomach pain, fever, yellow skin or eyes (possible gallbladder problems).
  • A lump or swelling in your neck, hoarseness or trouble swallowing.
  • Signs of a serious allergic reaction—call 911.

Report side effects to your prescriber and, if you like, the FDA’s MedWatch program.

What habits matter most from week one?

  • Protein first at every meal (sample day).
  • Strength training at least a few times a week (keeping muscle).
  • Use only FDA-approved, brand-name medicine from a licensed pharmacy—the FDA warns about unapproved and counterfeit GLP-1s.
  • Never share a pen. The Wegovy label says never to share a Wegovy FlexTouch pen between patients, even if the needle is changed.

What should I track in the first month?

  • Dose day and time (or daily pill time), plus any missed doses to mention to your prescriber.
  • Side effects: what, when, and what helped.
  • Protein and fluids, at least roughly.
  • Bowel movements, if constipation is a concern.
  • Weight and waist once a week rather than daily, plus how your clothes fit and your energy.

Bring the notes to your follow-up visit—they make dose and side-effect conversations faster.

What if I want to stop later?

Talk to your prescriber first. In the STEP 1 extension, people who stopped semaglutide regained about two-thirds of the weight they had lost within a year, and in SURMOUNT-4 people switched from tirzepatide to placebo regained weight while those who continued kept losing. Planning for the long term—habits, strength, and cost—from month one makes any later decision easier.

Quick answers

What should I know before starting Zepbound or Wegovy?

Read the Medication Guide, tell your prescriber about birth control, pregnancy plans, surgery and your medical history, plan how you’ll pay, and stock up on protein-rich foods and fluids. Expect stomach side effects to be most noticeable when starting or increasing a dose.

Is it normal to feel sick the first week on a GLP-1?

Nausea and other stomach side effects are the most common reactions and are often worst after starting or a dose increase. Small, low-fat meals and steady fluids help. Call your prescriber if you can’t keep fluids down or have severe belly pain.

Do GLP-1s affect birth control pills?

Zepbound’s label says it may make oral contraceptives less effective and advises a non-oral method or added barrier method for 4 weeks after starting and after each dose increase. Lilly gives similar advice for Foundayo. Ask your prescriber about your specific medicine.

Do I still need to exercise on a GLP-1?

Yes. GLP-1 medicines are approved for use with a reduced-calorie diet and more physical activity. The CDC recommends at least 150 minutes of moderate activity a week plus muscle-strengthening on 2 or more days, and strength training helps protect muscle.

Products & programs mentioned

Full directory →

Apps & trackers

Shotsy

GLP-1 injection tracker for dose logs, injection sites, side effects, and weight.

Why it helps on a GLP-1: Built specifically for GLP-1 users—handy for spotting patterns to share with your prescriber.

Free; optional premiumVisit site →
Apps & trackers

Lilly Health app

Eli Lilly's free companion app with education and insights for people on Lilly medicines.

Why it helps on a GLP-1: An official, no-cost companion from the maker of Zepbound and Mounjaro.

Apps & trackers

Medisafe

Medication reminder and tracking app.

Why it helps on a GLP-1: Helps you remember a weekly shot or daily pill and log doses.

Free; premium optionsVisit site →
High-protein foods & shakes

Premier Protein Shakes

Ready-to-drink shakes with 30g protein and about 1g sugar per bottle.

Why it helps on a GLP-1: When appetite is low, a cold shake is an easy way to get a big chunk of protein without a full meal.

Varies by retailerVisit site →
Side-effect helpers

Metamucil

Psyllium fiber supplement in powder, capsule, and wafer forms.

Why it helps on a GLP-1: Constipation is a common GLP-1 side effect; fiber plus plenty of fluid is a usual first step. Ask your prescriber which option suits you.

Pharmacy pricingVisit site →
Side-effect helpers

Sea-Band Acupressure Wristbands

Drug-free wristbands that apply pressure to the P6 point on the inner wrist.

Why it helps on a GLP-1: Some people find them helpful for mild queasiness, especially after a dose increase. No medication involved.

Pharmacy pricingVisit site →