Medications

What GLP-1 medications actually do

GLP-1 stands for glucagon-like peptide-1, a hormone naturally produced in the gut after eating. It helps regulate blood sugar, slows gastric emptying, and signals to the brain that you have eaten enough.

GLP-1 receptor agonist medications mimic this hormone’s action at a sustained level, which can significantly reduce appetite, improve blood sugar control, and in many patients, support meaningful and sustained weight loss.

These medications work at the level of biology, not willpower. For the right patient, that distinction matters enormously.

FDA-approved uses include:

  • Type 2 diabetes management
  • Chronic weight management in adults with obesity
  • Chronic weight management in overweight adults with a weight-related condition
  • Cardiovascular risk reduction in certain high-risk patients

Note: FDA approval status varies by specific medication and indication. What is appropriate for you depends on your medical history and goals.

Currently available FDA-approved options

An educational overview, not a prescribing recommendation. Indications and availability evolve; consult a physician for guidance on your situation.

Semaglutide
Wegovy / Ozempic
Weekly injection
Mechanism
GLP-1 receptor agonist
FDA Indications
Wegovy: Chronic weight management. Ozempic: Type 2 diabetes; cardiovascular risk reduction.
Clinical Notes
Most studied GLP-1 agent for weight management. Extensive long-term safety and efficacy data. The benchmark most other agents are compared against.
Most studied for weight
Oral Semaglutide
Rybelsus / oral Wegovy
Daily oral tablet
Mechanism
GLP-1 receptor agonist
FDA Indications
Rybelsus: Type 2 diabetes. Oral Wegovy: Chronic weight management (newer approval pathway).
Clinical Notes
No injections required. Must be taken fasting, 30 minutes before anything else in the morning. Absorption is more variable than injectable forms. Likely to become one of the most popular options as access expands.
Tirzepatide
Zepbound / Mounjaro
Weekly injection
Mechanism
Dual GIP + GLP-1 receptor agonist
FDA Indications
Zepbound: Chronic weight management; obstructive sleep apnea. Mounjaro: Type 2 diabetes.
Clinical Notes
Dual mechanism targets both GIP and GLP-1 receptors. Clinical trials show among the highest average weight loss of any approved agent in this class. Head-to-head data vs. semaglutide shows greater average loss, though individual responses vary.
Highest avg. weight loss in trials
Liraglutide
Saxenda / Victoza
Daily injection
Mechanism
GLP-1 receptor agonist
FDA Indications
Saxenda: Chronic weight management. Victoza: Type 2 diabetes.
Clinical Notes
An established, older agent in the class. Requires daily injection rather than weekly. Generally produces less weight loss than weekly semaglutide or tirzepatide in clinical comparisons. Less commonly initiated for new patients given newer options.
Established, daily dosing
Dulaglutide
Trulicity
Weekly injection
Mechanism
GLP-1 receptor agonist
FDA Indications
Type 2 diabetes; cardiovascular risk reduction.
Clinical Notes
FDA-approved for diabetes and cardiovascular risk reduction. Not currently approved for chronic weight management as a primary indication. May be appropriate in specific clinical contexts.
Diabetes / CV indication

This overview reflects FDA approvals and general clinical positioning as of early 2026. Indications, availability, and approved uses evolve. Consult a physician for current guidance on what is appropriate for your situation.

Injectable vs. oral: what to know

Form factor matters to patients. Here is an honest comparison.

Weekly injection

Semaglutide and tirzepatide injectables

One injection per week using a pen-style auto-injector. Most patients who were initially reluctant find the process straightforward after the first dose. More consistent drug levels in the body compared to oral forms. Strongest clinical trial data for weight loss outcomes. Widest availability including brand-name and, in some cases, insurance-covered forms.

Daily oral

Oral semaglutide (Rybelsus / oral Wegovy)

A daily tablet with no injection required. Must be taken fasting, 30 minutes before anything else in the morning. Absorption is more variable than injectable forms. Clinical weight loss data is developing, especially for the oral Wegovy formulation. Likely to become a popular choice as access and approvals continue to expand. Worth discussing specifically if injections are a barrier for you.

Side effects: what is common, what to watch for

Honesty about side effects is part of a real medical evaluation. Here is what the evidence shows.

Common, especially early

What most patients experience at some point

Nausea is the most common side effect and usually improves with dose titration. Vomiting is less frequent and often dose-related. Diarrhea or constipation, decreased appetite, and fatigue during early ramp-up are all well-documented and often manageable with the right support.

Less common, worth knowing

What to be aware of over time

Heartburn or acid reflux, slowed gastric emptying, hair thinning, and loss of lean mass can occur in some patients. These are part of why protein intake, strength-focused movement, hydration, and medication review matter in a thoughtful long-term plan.

Serious but rare

Discuss specifically with your physician

Pancreatitis, gallbladder disease, thyroid C-cell tumor warning considerations, worsening retinopathy in some patients with diabetes, and kidney injury in the setting of severe dehydration deserve specific review before and during treatment.

FDA boxed warning: GLP-1 medications carry a warning regarding thyroid C-cell tumors based on animal studies. This is a contraindication for patients with a personal or family history of medullary thyroid carcinoma or MEN2 syndrome. A proper medical evaluation should review this specifically.

When GLP-1 medications may not be appropriate

A good physician tells you both when something is likely to help and when it may not be the right fit.

Contraindicated

Situations where these medications are not appropriate

Personal or family history of medullary thyroid carcinoma. Multiple Endocrine Neoplasia type 2 (MEN2). Prior serious hypersensitivity reaction to a GLP-1 medication. History of pancreatitis in certain clinical contexts. Pregnancy or active plans for near-term pregnancy.

Needs careful review

Situations requiring individualized evaluation

Multiple concurrent medications with significant GI or absorption effects. Active or recent eating disorder history. Significant history of gastroparesis. Severe renal or hepatic impairment. History of serious cardiovascular events (some medications in this class may actually be beneficial; evaluation is required to sort that out).

Medication questions we hear often

How long do I need to take these medications?

This varies by patient and goal. For weight management, most clinical evidence suggests that weight tends to return when the medication is stopped, which means long-term treatment is often part of the plan for patients whose primary goal is sustained weight loss. Some patients eventually taper successfully. Others choose to continue indefinitely at a maintenance dose. This is something to plan and revisit over time, not decide in advance.

What is the difference between Wegovy and Ozempic?

Both contain semaglutide. The difference is in the FDA-approved indication, dosing range, and how they are labeled and prescribed. Ozempic is FDA-approved for type 2 diabetes management and cardiovascular risk reduction. Wegovy is approved for chronic weight management in adults with obesity or overweight with a related condition. Wegovy’s approved maximum dose is higher than Ozempic’s.

Is tirzepatide more effective than semaglutide?

Head-to-head clinical trials suggest tirzepatide produces greater average weight loss than semaglutide in the populations studied. Individual results vary considerably. Some patients respond better to one than the other. Cost, access, insurance coverage, and prior experience are all factors in the decision, not just the headline trial numbers.

What about compounded semaglutide?

Compounded semaglutide was widely available during the period when brand-name semaglutide was on the FDA shortage list. As of early 2026, the FDA has ended the shortage designation, which significantly changes the legal and regulatory landscape for compounded versions. We do not currently prescribe compounded GLP-1 medications. We prescribe FDA-approved brand-name options.

How much does medication cost?

Medication costs depend heavily on your insurance coverage, any manufacturer savings programs you qualify for, and the pharmacy you use. Without coverage, brand-name injectables can be expensive, though manufacturer programs have reduced costs significantly for commercially insured patients. This is worth discussing during the consultation. We will help you think through realistic access options for your situation.

Full Medication Guide

Want the complete picture?

The full GLP-1 Medication Guide goes deeper: every FDA-approved brand compared side by side, complete dose ladders from introductory to maintenance, oral versus injectable tradeoffs clearly explained, and a breakdown of access models and monitoring approaches. If you are doing thorough research before deciding, this is where to go.

Read the Full Medication Guide Includes oral Wegovy, dose tables, and access models

Questions about which medication fits your situation?

This is exactly what a thorough consultation is for. Bring your questions. There are no wrong ones.