The side-effect protocol we give every GLP-1 member

Almost everyone who quits GLP-1 therapy quits in the first six weeks, and almost always over side effects that are manageable. Here is the order of operations we use.

First, slow the titration. Most side effects are a dose-escalation problem, not a drug problem. Holding a dose for an extra two or four weeks costs you very little in outcome and preserves adherence, which is the only thing that actually matters over a year.

Second, protein and water before anything else. Appetite suppression means people under-eat protein and under-drink, then blame the medication for fatigue that is really under-fueling. We target 1.6 grams of protein per kilogram of body weight and add electrolytes.

Third, get ahead of constipation rather than treating it. Magnesium at night and soluble fiber daily, started week one, prevent the problem that otherwise arrives in week three.

Fourth, resistance training twice a week minimum. Muscle is the tissue you are most at risk of losing on aggressive caloric restriction, and it is the tissue that determines what your metabolism looks like when you stop.

If all four are in place and symptoms persist, then it is time to change medication or route. Not before.