Questions to Ask Before Starting a GLP-1 Medication

A practical checklist from Dr. Anjmun Sharma, MD, to help you walk into any weight-loss consult as an informed, active participant in your own care.

The questions to ask before starting a GLP-1 cover seven areas: whether you are a candidate and why, which medication fits you, your dose and titration plan, the side effects and how to handle them, how often you are seen and reachable between visits, the full cost and what it includes, and how to stop safely if it is not working.

I tell patients that a good consult should feel like a conversation, not a sales pitch. You are about to put a prescription medication into your body, often for many months. You are allowed to ask hard questions, and the answers should be clear, specific, and unhurried. If a clinic seems annoyed that you are asking, that itself is useful information.

Here is how I would walk through each question if you were sitting across from me, or on a video visit, deciding whether this path is right for you.

Am I actually a candidate for a GLP-1, and why?

Start here, because everything else depends on it. A GLP-1 medication is not for everyone, and a careful clinician should be able to tell you specifically why you qualify rather than waving you through. Ask what in your history points toward treatment: your weight relative to height, your blood sugar or A1c if known, blood pressure, cholesterol, a family history of metabolic disease, or conditions like sleep apnea or fatty liver.

Just as important, ask what would make you not a good candidate. A personal or family history of medullary thyroid cancer, a history of pancreatitis, certain gallbladder problems, current pregnancy or planning pregnancy soon, or a history of an eating disorder all change the conversation. A thoughtful provider asks about these before writing anything. When I review a new patient, I want to understand the whole picture, not just a number on a scale.

Which medication will I be on, and why that one?

The two main options in this space are semaglutide and tirzepatide. They are related but not the same. In the large trials, semaglutide produced an average of about 14.9 percent of body weight in the STEP-1 study, and tirzepatide produced an average of about 20.9 percent in SURMOUNT-1. You will sometimes see a higher figure quoted for tirzepatide, but that is tied to a specific top dose and should never be presented as the typical result. Results vary by individual.

For some patients, semaglutide also carries cardiovascular relevance. The SELECT trial showed a cardiovascular benefit for semaglutide in adults who already had established cardiovascular disease along with overweight or obesity. That matters if your history includes heart concerns, and it is worth raising.

One point on honesty: many telehealth clinics, including ours, use compounded semaglutide and tirzepatide. Compounded versions are not FDA-approved and are not identical to the brand-name medications. Brand drugs in this category include Ozempic and Wegovy (Novo Nordisk) and Mounjaro and Zepbound (Eli Lilly); we are not affiliated with either company. Ask your provider to explain plainly what you are getting and why, so there are no surprises.

What is my dose plan and how will we titrate?

Nobody should start at a high dose. These medications work best when you begin low and step up slowly over weeks, giving your body time to adjust. Ask exactly what your starting dose is, how long you stay there, and what the criteria are for moving up. The right answer is rarely a fixed calendar applied to everyone. It depends on how you tolerate each step.

I often slow titration down for patients who feel queasy, and I am in no rush to push the dose if someone is losing weight comfortably at a lower one. The goal is the lowest dose that gives you a steady result, not the highest dose the bottle allows.

What side effects should I expect, and what do I do about them?

Most side effects are digestive: nausea, fullness, constipation, sometimes reflux, occasionally diarrhea. They tend to be strongest in the first days after a dose increase and usually settle as your body adapts. Ask for the practical plan, not just the warning label. Smaller meals, more water, easing off greasy or very large portions, and slowing the dose increase all help.

You also need to know the rare but serious signs to act on right away: severe abdominal pain that will not let up, signs of a gallbladder attack, or an allergic reaction. Ask your provider which symptoms mean "call us today" versus "go to urgent care now." A clinic that has given real thought to this will have a clear answer.

How often will I be seen, and how do I reach you between visits?

This is the question people forget to ask, and it is one of the most important. Weight management is not a one-time prescription. Ask how frequently you will check in, who reviews your progress, and what the path is if something comes up at 8 p.m. on a weekend. Access between visits is part of the standard of care, not a bonus.

At New Hope Weight Loss and Wellness, care is telehealth and bilingual, and patients can reach us by phone in English at (657) 837-3342 or in Spanish at (213) 214-3325. Whatever clinic you choose, you should leave the first visit knowing exactly how to get a question answered without starting over each time.

What is the total cost, and what is included?

Ask for the full picture in plain numbers, including anything that might be added later. Hidden fees are where a lot of frustration lives. For reference, here is how our cash-pay pricing works, with no insurance needed: the initial visit is $119. Compounded semaglutide runs $166 per month, roughly $5.50 a day, with a 90-day Reset option at $499. Compounded tirzepatide is $233 per month, about $7.70 a day, with a 90-day Reset at $699. For someone who wants to test the waters first, we offer a one-month $199 Skeptics Trial.

Whatever the clinic, ask what the medication price includes, whether visits are separate, and what happens to your cost if your dose changes. Clear pricing is a sign of respect for the patient.

What happens if it does not work, and how do I stop safely?

A fair provider talks about the exit before you ever begin. Ask what counts as "working," and over what time frame, so you are not guessing. Ask what the plan is if the scale does not move the way you hoped: is the dose adjusted, the medication switched, the eating and activity plan revisited, or something else looked into?

And ask how to stop. People can and do come off these medications. The smart approach is usually to taper rather than quit abruptly, and to have a maintenance plan so the work you did is not lost. Be cautious of any promise of guaranteed results, because no honest clinician can offer that. What you should expect instead is a plan, a way to measure it, and a doctor who stays with you whether the answer is to continue, adjust, or stop.

If you read back through these, you will notice they all point in one direction: you deserve specific answers from someone who knows your history and will be reachable while you are on treatment. That is what good care looks like, and it is exactly the standard you should hold any clinic to, including ours.

Frequently asked questions

This article is informational only and not medical advice. Speak with a licensed physician before starting or changing any GLP-1 therapy. Individual results vary. New Hope Weight Loss is a physician-supervised medical weight loss clinic in Costa Mesa, CA. Eligibility for treatment is determined during the medical consultation. Compounded semaglutide and compounded tirzepatide are not the same products as Wegovy®, Ozempic®, Mounjaro®, or Zepbound®.