All About the Shots
Everything you need to know about GLP-1 weight loss shots
Start here to learn more about GLP-1 and GIP weight loss injection medications.
These days, the media is buzzing with stories about GLP-1 (glucagon-like peptide) agonist drugs. There are several different types, including dulaglutide (Trulicity), liraglutide (Saxenda/Victoza), semaglutide injection (Wegovy/Ozempic) and semaglutide tablets (Rybelsus).
Tirzepatide (Zepbound/Mounjaro) are GLP-1 drugs that combine a GIP (gastric inhibitory polypeptide) receptor.
The thing to know about all of these medications is that they can all lower blood sugar levels and suppress hunger, resulting in weight loss. That’s why they are used to treat Type 2 diabetes and obesity.
Some pharmaceutical companies market the same drug under two different names for two different purposes. For example, if you are overweight but don’t have Type 2 diabetes, your doctor may prescribe Zepbound. However, if you have Type 2 diabetes, your RX would be for Mounjaro. Both are tirzepatide medications, but they are marketed and sold to different markets.
However, some drugs, such as dulaglutide (Trulicity), are only available to treat Type 2 diabetes and not obesity. Your doctor can explain which option is right for your situation.
As I note on every page of this site, I’m not a doctor or a scientist. If you’d like to know exactly how GLP-1 and GIP drugs work, ask your doctor or read the many available medical journal articles. However, in a nutshell, here’s how these drugs work.
GLP-1 drugs…
- slow down how quickly your stomach empties. As your digestion rate slows, your body won’t release as much sugar into your system as usual.
- act on your brain, giving you a feeling of being full after eating. That feeling of fullness can also last longer than without the medication. Many users report a decrease in food cravings and general thoughts about food (often called “food noise”).
- help your pancreas release insulin. This helps your system better use the food you eat (specifically reducing the amount of sugar in your blood).
- block something called glucagon, which also stops more sugar from entering your bloodstream.
Tirzepatide (Zepbound/Mounjaro) adds a GIP (glucose-dependent insulinotropic polypeptide), another weapon that makes it easier to eat less without being hungry.
Yes, there are a lot of similar-sounding weight loss drugs and they work in similar ways too. Your doctor can best explain the nitty gritty, or you can read the clinical trials of each medication.
Consult the table below to see which drug is marketed under what brand names and by what companies.
| Drug | Type | Frequency | Manufacturer | For Weight Loss | For Type 2 Diabetes |
| Tirzepatide | GLP-1 and GIP | Weekly injection | Lilly | Zepbound | Mounjaro |
| Semaglutide | GLP-1 | Weekly injection | Novo Nordisk | Wegovy | Ozempic |
| Semaglutide | GLP-1 | Daily tablet | Novo Nordisk | n/a | Rybelsus |
| Liraglutide | GLP-1 | Daily injection | Novo Nordisk | Saxenda | Victoza |
| Dulaglutide | GLP-1 | Weekly injection | Lilly | n/a | Trulicity |
- Thyroid cancer (not yet linked to humans and this drug but was detected during the trial in rats injected with the medication)
- Severe stomach problems
- Kidney failure
- Gallbladder problems
- Pancreatitis
- Allergic reactions
- Hypoglycemia (low blood sugar)
- Changes in vision in patients with Type 2 diabetes
- Depression/thoughts of suicide
Some patients never experience any side effects while others may have mild to severe symptoms. You’ll only know how you’ll do on the shots once you take them. Side effects may include:
- Nausea
- Vomiting
- Constipation (very common)
- Diarrhea
- Stomach pain
- Indigestion
- Injection site reactions
- Feeling tired
- Allergic reaction
- Sulpher burps
- Hair loss
- Heartburn
I had never heard of “food noise” before starting Zepbound, but it’s a common issue for many people. It’s when you fixate on what you’ll eat next and when. Maybe you’re already planning lunch as you finish breakfast. Or, you know there are chocolate chip muffins on the counter and you can’t stop thinking about them until you get up and eat one. Read more about food noise.
One of the many positive aspects of GLP-1 drugs is that they quiet that noise in your head. This peace and quiet makes a huge difference.
These medications also lessen your cravings for particular things. Pre-Zepbound, I had to have a can of diet Coke at regular intervals throughout the day — whether I was thirsty or not. During my first two weeks on Zepbound, I didn’t even think about cracking a frosty one. In fact, I only had one and that was while watching the Super Bowl, so I considered that a “special occasion” moment.
GLP-1 weight loss medications are relatively new in the marketplace and guidelines may change over time. However, manufacturers agree that women should not take these drugs while pregnant or if planning to become pregnant. Current data suggests that patients should stop taking the drug at least two months before they try to conceive.
If you do become pregnant while on a GLP-1 medication, you should contact your doctor immediately.
Note that oral birth control is not as effective if the individual is also on a GLP-1 drug. Talk with your doctor to find the most effective birth control method for your situation.
Medications like Mounjaro and Ozempic were developed to treat Type 2 diabetes and that’s their FDA-approved use. Most doctors will not prescribe these drugs for weight loss only and insurance companies will not approve the use of these medications by individuals that do not have Type 2 diabetes.
However, your doctor may prescribe GLP-1 drugs that are FDA-approved for weight loss, including Zepbound, Wegovy, and Saxenda.
Zepbound and Mounjaro, developed by Eli Lilly, are the same chemical compound. Zepbound is FDA-approved for weight loss, while Mounjaro is approved to treat Type 2 diabetes. This is a GLP-1 receptor antagonist with the addition of a GIP (glucose-dependent insulinotropic polypeptide).
Wegovy and Ozempic, developed by Novo Nordisk, are the same chemical compound. Wegovy is FDA-approved for weight loss, while Ozempoic is approved to treat Type 2 diabetes. This is a GLP-1 receptor antagonist.
Zepbound/Mounjaro (Eli Lilly) is similar to Wegovy/Ozempic (Novo Nordisk) in that the drugs are prescribed for weight loss and to control Type 2 diabetes. Zepbound and Wegovy are FDA-approved to treat obesity while Mounjaro and Ozempic are prescribed to treat Type 2 diabetes.
Both are GLP-1 injection medications. However, Zepound/Mounjaro add a GIP so there are double-acting agents for appetite suppression. Scroll up to the first three questions/answers on this page for more details.
Wegovy, prescribed for weight loss, costs $1,349.02 for four pens (a 28-day supply) without insurance.
If you have insurance that doesn’t cover Wegovy, Novo Nordisk offers its WeGoTogether savings program, with which you can save up to $500 for a 28-day supply.
If your insurance covers Wegovy, ask your pharmacy benefits manager how much you’ll pay per month, and if you have to spend your deductible first before coverage kicks in.
When Zepbound is prescribed for weight loss, it costs $1,113 out of pocket without insurance for a month’s supply (four pens).
If you have a commercial insurance plan that doesn’t cover Zepbound, you can get a savings card from manufacturer Eli Lilly that reduces that monthly cost by $563 so you’ll pay $550 per four pens (a 28-day supply).
If your insurance plan covers Zepbound, you may pay as little as $25 per month.
Start your fact-finding mission with your primary care doctor. Ask about GLP-1 drugs and if they may be right for your situation. However, not all primary care doctors know enough about these drugs and the latest strides in weight management.
When it comes to your decision to start a GLP-1 drug — which is a long-term commitment, potentially for the rest of your life — you owe it to yourself to talk with a specialist.
Look for an endocrinologist who specializes in treating obesity. If, like me, you live somewhere with a limited choice of doctors, consider telemedicine. There are a variety of telehealth clinics that specialize in this discipline.
I use Sequence (owned by Weight Watchers). Other options include Form Health, PlushCare and Ro, among others.
An added benefit of using a weight loss clinic or telehealth option is that they have extensive experience submitting prior authorization (PA) requests to insurance companies. While a local doctor’s office may struggle with this task because they don’t have enough staff or experience in this specific niche, specialists know what has to be included in those PAs to get quick approval.
My PA for Zepbound was approved in a matter of hours. My local doctor told me repeatedly that it wouldn’t get it approved. So, in my case, going with an endocrinologist was the right move.
Here are a few popular telehealth clinics specializing in weight loss:
- Weight Watchers Clinic powered by Sequence
- Form Health
- PlushCare
- Ro
Here’s what my Weight Watchers Clinic sign-up experience was like.
You should follow a realistic nutrition and fitness plan, no matter what approach you use to lose weight. Your doctor will help you create both.
In many cases, starting a GLP-1 medication also means visiting a registered dietician or nutritionist. (It’s included with most telehealth plans, including Weight Watchers Clinic and Form.)
That’s important because you need to learn how many grams of protein your meal plan should include per day (generally .8 to 1 gram of protein per kilogram of your weight) and your goals for fiber, carbs and calories (should you choose to count them — I do not).
It’s also important to learn how these medications work and what types of foods may cause adverse side effects like nausea or diarrhea. Most people who use these injection medications find that they eat almost anything in moderation and your doctor and dietician can help you define what’s likely in and out of bounds.
When it comes to exercise, start with light activity if you lead a sedentary lifestyle now. I like Weight Watchers Clinic because it offers workout videos for all fitness levels. I augment that with workouts on Apple Fitness+ as well as easy walking.
Combining a GLP-1 medication with a reasonable calorie-restricted meal plan and light to moderate activity will help you achieve your weight loss goals more easily.
If you haven’t received nutritional or fitness guidance from your doctor, demand it. Starting a long-term GLP-1 medication is a major commitment — not to mention expense. You want to give yourself every advantage to start this medication on the right foot.
I know it’s intoxicating to step on the scale and see a lower number. However, it’s really important not to focus too much on the numbers on the scale or the date on the calendar.
Related article: How much can I lose on Zepbound?
Some people will begin losing weight on week 1 at the 2.5mg GLP-1 dose, while others don’t start to see results until a few weeks in or once they move up to the 5mg dose. Everyone is different, and you won’t know what camp you’re in until you start.
It’s also not very useful to compare how much someone else lost on the drug each week since everyone is different. Someone starting at 300 pounds with a goal of 125 will likely have a different weekly loss rate than someone starting at 175 with the same goal weight.
What’s important to know is that losing 0.5 to 2 pounds per week is considered safe. According to Mayo Clinic, “to lose 1 to 2 pounds a week, you need to burn 500 to 1,000 calories more than you consume each day, through a lower calorie diet and regular physical activity.”
You don’t want to lose weight too quickly because that’s when you risk losing muscle in addition to fat — and we don’t want that.
Factor in a realistic amount of time to get to your goal weight. Enjoy the process, and don’t get too wrapped up in the day-to-day or week-to-week numbers. You’re good as long as you’re trending in the right direction. And, don’t forget about those non-scale victories! Is your blood pressure lower? Do your clothes fit better? Do you have more energy? Those are all great benefits beyond the scale.
Many insurance companies do not cover weight loss medications. When they do, they often require a prior authorization (PA). Your doctor sends this paperwork to explain why you need this specific medication, what else you’ve tried to solve this medical issue (called “step therapy”), and why other treatment options aren’t being prescribed
Sometimes, the first draft PA is rejected, but the insurer will send a letter explaining why. Your doctor can submit a follow-up with any information that was missing or requested in the rejection note.
PAs can be frustrating. Sometimes, they are approved in hours, while others take weeks or months to pass muster.
Many telehealth companies specializing in weight loss employ insurance concierges who are experts in writing and getting PAs approved. If you’ve hit a block in this process, consider working with a weight loss clinic or telehealth program with a better track record of getting PAs approved than a small, local doctor’s office.
If your PA is still denied, it may be because the requested medication isn’t yet in the insurer’s “formulary” list of approved drugs, or because your insurance plan simply will not cover weight loss medications.
If you run into the latter, reach out to your benefits manager at work and ask if they can also contact the insurance company on your behalf. If that’s impossible, try to persuade them to add weight loss drug coverage to the company’s plan next year.
