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GLP-1 weight loss: the no-BS guide

Most articles on GLP-1s read like ad copy. This one doesn't. Below is what you need to evaluate a program, pricing, eligibility, side effects, refund risk, and the difference between branded and compounded versions.

What GLP-1s actually do

GLP-1 receptor agonists (semaglutide, tirzepatide, liraglutide) mimic a gut hormone called GLP-1. They slow stomach emptying, increase insulin secretion in response to food, and reduce hunger signaling in the brain. The result is meaningful weight loss for most people: 10-15% body weight on semaglutide, 15-20% on tirzepatide in trials.

Who qualifies

FDA-approved indications are BMI ≥30, or BMI ≥27 with a weight-related comorbidity (high blood pressure, prediabetes, sleep apnea, etc). Telehealth clinicians screen against the same criteria, though state law affects what they can prescribe asynchronously.

Branded vs compounded

Branded drugs (Wegovy, Zepbound, Ozempic, Mounjaro) cost $1000-1350/month at retail without insurance. Compounded versions are made by 503A/503B pharmacies during an FDA-declared shortage. They cost $200-500/month, but they're not FDA-approved drugs, and the legal landscape shifts. Buyer beware.

Telehealth vs in-person

Telehealth is faster (days, not weeks), often cheaper, and you'll never sit in a waiting room. In-person is better if you have complex comorbidities, want body composition tracking, or need controlled-substance support medications. Both are legitimate paths.

Hidden costs to watch for

Most programs charge $99-149 for the initial visit, then auto-renew the medication monthly. Watch for: lab fees billed separately, sharps disposal, shipping, fees for dose changes, fees for switching pharmacies. Read the cancellation policy before paying.

Side effects, plainly

Most common: nausea (worst in the first 4-6 weeks), constipation, fatigue. Less common: gallbladder issues, pancreatitis (rare), kidney issues if dehydrated. Stop the medication and talk to a clinician if you can't keep fluids down. Don't push through severe symptoms.

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