What Are GLP-1 Medications? The No-BS Guide

GLP-1 medications are the biggest thing to hit weight loss since... honestly, maybe ever. Your coworker's on one. Celebrities won't shut up about them. Your Instagram feed is 40% before-and-afters.

But between the hype machine and the skeptics, actually figuring out what these drugs do — and whether they make sense for you — is harder than it should be.

Let's fix that. No marketing spin. No "consult your healthcare provider" copouts where actual information should be.

What GLP-1 Actually Means

GLP-1 stands for glucagon-like peptide-1. It's a hormone your body already produces. When you eat, your gut releases GLP-1, which does three things:

• Tells your brain you're full. GLP-1 acts on appetite centers in the brain to reduce hunger.
• Slows stomach emptying. Food sits in your stomach longer → you feel satisfied on less food.
• Regulates blood sugar. Stimulates insulin, reduces glucagon, keeps blood sugar stable.

The natural version breaks down in minutes. GLP-1 medications are engineered to last days instead. That's why they're weekly injections, not something you take with every meal.

This isn't some exotic mechanism. Your body already runs this system. The medications just crank the volume up. Think of it as overclocking hardware you already have.

The Two Main Medications

Semaglutide (Wegovy/Ozempic)

• How it works: Pure GLP-1 receptor agonist — one lever, pulled hard
• Administration: Weekly subcutaneous injection
• Clinical results: STEP 1 trial (NEJM) → 14.9% average body weight loss over 68 weeks vs 2.4% placebo
• FDA approved for weight loss: June 2021
• Compounded versions: Yes, at significantly lower cost

Tirzepatide (Zepbound/Mounjaro)

• How it works: Dual GLP-1 + GIP receptor agonist — two levers instead of one
• Administration: Weekly subcutaneous injection
• Clinical results: SURMOUNT-1 trial → 22.5% average body weight loss at highest dose over 72 weeks
• FDA approved for weight loss: November 2023
• Compounded versions: Yes

Tirzepatide produces more weight loss on average. Semaglutide has a longer track record and more safety data. Your provider will recommend one based on your specific situation.

For the full head-to-head breakdown, see our Semaglutide vs. Tirzepatide comparison.

What the Clinical Trials Actually Show

Let's look at actual numbers instead of marketing copy:

Semaglutide (STEP trials):

• Average weight loss: ~15% of body weight
• ~1 in 3 participants lost 20% or more
• Weight loss continued for about 60-68 weeks before plateauing
• Most weight was regained after stopping. This is important.

Tirzepatide (SURMOUNT trials):

• Average weight loss: ~20-22% at highest doses
• About half of participants on the highest dose lost 25%+
• Similar timeline — most loss in first 60-72 weeks
• Also regained after stopping. Same story.

The "regain after stopping" part matters. These meds don't cure obesity. They manage it, like blood pressure meds manage hypertension. Most experts say plan for long-term use.

Common Side Effects

Let's not sugarcoat this. Most side effects are GI-related and tend to improve as your body adjusts:

Very common (20-40% of users):

• Nausea — worst in weeks 1-3, especially at dose increases
• Decreased appetite — that's kinda the point, but it can be intense
• Constipation or diarrhea — your gut is adjusting

Less common but important:

• Gallbladder problems (more common with rapid weight loss)
• Pancreatitis (rare but serious — severe abdominal pain = ER, don't wait)
• Injection site reactions

The dose escalation approach exists for a reason. You start low, increase gradually, and your body adapts. Most people find nausea manageable by week 3-4. Providers who skip escalation steps are cutting corners, and your toilet will make you pay for it.

For the deep dive, read our GLP-1 Side Effects Guide.

Who Qualifies?

Standard criteria for GLP-1 weight loss prescriptions:

• BMI of 30+ (clinical obesity), OR
• BMI of 27+ with at least one weight-related condition (T2 diabetes, high BP, high cholesterol, sleep apnea)

Who should NOT take GLP-1s:

• Personal/family history of medullary thyroid carcinoma
• Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
• History of pancreatitis
• Pregnant or breastfeeding
• Severe gastrointestinal disease

Be wary of any service that prescribes without thorough medical screening. That's not "easy access" — that's a red flag.

Brand-Name vs Compounded: The Cost Reality

This is where things get real, because the price difference is insane:

Brand-name (Wegovy, Zepbound):

• Manufactured by Novo Nordisk / Eli Lilly
• Full FDA approval with extensive trials
• $1,000-1,500/month without insurance
• May be covered by insurance (varies wildly)

Compounded versions:

• Produced by licensed compounding pharmacies (503A or 503B)
• Same active ingredients
• Not individually FDA-approved (but made in FDA-regulated facilities)
• $149-399/month typically
• Not covered by insurance

If a telehealth provider charges under $500/month, they're almost certainly prescribing compounded versions. This isn't inherently bad — these pharmacies are regulated and inspected — but you should know the difference.

How to Get Started

The process is simpler than most people expect:

1. Take an online assessment (5-15 minutes). Medical history, meds, BMI, goals.
2. Provider review. A licensed provider evaluates your case. Some do this async (24-48h), others do video calls.
3. Get your prescription. If approved, they create a dose escalation plan.
4. Medication ships to your door. Usually arrives in 3-7 days with cold packs.
5. Start treatment and follow up. Begin at low dose, increase over time, check in regularly.

Total time from assessment to first injection: 5-10 days for most people.

Choosing a Provider

Not all GLP-1 telehealth providers are created equal. Key things to evaluate:

• Provider credentials: Board-certified physicians? Appropriately supervised NPs?
• Pharmacy sourcing: 503A vs 503B compounding? Brand-name available?
• Pricing transparency: Is medication included in the monthly price?
• Consultation type: Questionnaire-only or actual video call?
• Cancellation policy: Month-to-month or locked commitment?

We've reviewed and compared the top providers. Start with our provider reviews or read How to Choose a GLP-1 Provider for the full framework.

Last updated February 2026. This guide is for informational purposes and doesn't replace professional medical advice. Always consult with a qualified healthcare provider before starting any medication.