5 Questions to Ask Before Starting a GLP-1 Weight Loss Medication

GLP-1 Medications: Powerful, but Not a Decision to Rush

GLP-1 receptor agonists — including semaglutide (Ozempic, Wegovy) and liraglutide (Saxenda) — represent the most significant advance in medical weight management in decades. Clinical trials show average weight loss of 15–17% of body weight with weekly semaglutide, outcomes that were previously only achievable with bariatric surgery.

But starting a GLP-1 medication is a medical decision that deserves a thorough conversation with your doctor. Here are five questions you should ask before your first injection.

1. Am I Actually a Candidate for This Medication?

Not everyone who wants to lose weight is a suitable candidate for GLP-1 medications. The clinical criteria are:

• BMI of 30 or above, OR
• BMI of 27 or above with at least one weight-related health condition (type 2 diabetes, high blood pressure, sleep apnoea, dyslipidaemia)

Beyond BMI, your doctor will assess your medical history for contraindications. GLP-1 medications are not appropriate if you have:

• A personal or family history of medullary thyroid cancer or multiple endocrine neoplasia type 2 (MEN2)
• A history of pancreatitis
• Severe kidney disease (certain medications, at certain doses)
• Current or planned pregnancy

Ask your doctor to confirm clearly that you meet the clinical criteria and that there are no contraindications in your history.

2. What Side Effects Should I Actually Expect?

The most common side effects of GLP-1 medications — nausea, vomiting, and diarrhoea — are well known, but what patients are often not told is how to manage them proactively.

• Nausea is most common in the first 4–8 weeks and almost always improves with time
• Eating smaller, lower-fat meals significantly reduces nausea
• Avoiding rich, spicy, or greasy foods during the early weeks helps considerably
• Staying well hydrated (at least 2 litres of water daily) is important

Ask your doctor not just what side effects are possible, but what you should do when they occur — having a management strategy ready dramatically improves adherence through the early adjustment period.

3. How Will We Know If It's Working?

Define success before you start. Ask your doctor:

• What weight loss should I realistically expect, and over what timeframe?
• When will we do the first review to assess my response?
• What blood tests will you monitor, and how often?
• At what point would you consider adjusting the dose or switching medications?

Typically, patients are reviewed every 4–8 weeks in the early stages. If you have not lost at least 5% of your body weight after 12–16 weeks on the maximally tolerated dose, your doctor may recommend reassessing the treatment approach.

4. How Long Will I Need to Stay on This Medication?

This is one of the most important questions, and one that many patients don't ask.

GLP-1 medications treat obesity — a chronic, relapsing condition. Like blood pressure or cholesterol medications, they work while you take them. Most clinical trials show that weight regain occurs when the medication is stopped, because the appetite-reducing effect is reversed.

This does not mean you must stay on the medication forever — but it does mean that decisions to stop should be planned with your doctor, ideally with a transition strategy (lifestyle reinforcement, monitoring, possible dose reduction rather than abrupt cessation).

Ask your doctor: "If I stop this medication in the future, what is the plan?"

5. Where Should I Get This Medication, and How Much Will It Cost?

GLP-1 medications in Australia are prescription-only. They are currently not on the PBS (Pharmaceutical Benefits Scheme) for weight management (though semaglutide is subsidised for type 2 diabetes), which means out-of-pocket costs apply.

• Ozempic (semaglutide 0.5–2 mg): Approximately $120–140/month
• Wegovy (semaglutide 2.4 mg): Currently limited availability in Australia; pricing varies
• Saxenda (liraglutide): Approximately $350–400/month

Avoid purchasing GLP-1 medications from unregulated online sources — counterfeit or substandard products have been reported, and these medications require medical supervision to be used safely.

Ask your doctor to clearly outline the expected cost, the titration schedule, and what is included in the ongoing consultation fees.

Ready to Find Out If You're a Candidate?

Dr Chun Guan Chong at Medi Weight Loss provides thorough, personalised assessments for patients considering medical weight management, including GLP-1 pharmacotherapy. Call (03) 9967 1996 or book online via HotDoc.