Taking GLP-1 Weight Loss Medications Safely: A GP’s Practical Guide

Who may be suitable for GLP-1 treatment?

GLP-1 medications may be considered for adults who:

• Have obesity or a raised BMI in line with national guidance
• Have attempted lifestyle changes without sufficient success
• Have no contraindications following GP assessment

They are not suitable for everyone and should only be used under medical supervision.

The first 4 weeks

GLP-1 medications are started at a low dose and increased gradually over time. This approach allows the body to adapt and helps minimise side effects.

During the early stages of treatment, many people notice:

• Reduced appetite and earlier fullness
• Slower digestion
• Changes in eating patterns
• Mild gastrointestinal symptoms

Weight loss is typically gradual and varies between individuals. Some people experience noticeable changes early on, while others see more benefit after dose increases. This variation is normal and does not mean the treatment is ineffective.

Dose increases and ongoing treatment

Dose increases are gradual and usually occur every 4 weeks, depending on tolerability.

This slow titration helps minimise side effects. Doses should only be increased following a medical review. Patients should not self-adjust dosing.

Coming off GLP-1 treatment and dose reduction

GLP-1 medications are not necessarily lifelong treatments. Some people may reach a point where they wish to reduce the dose or stop treatment altogether, for example after achieving weight loss goals or if side effects become problematic.

Stopping GLP-1 therapy can lead to a return of appetite and some weight regain, particularly if lifestyle changes are not well established. For this reason, any decision to reduce or stop treatment should be planned and supported by a clinician.

In some cases, a gradual dose reduction rather than abrupt stopping may help minimise gastrointestinal symptoms and allow time to reinforce long-term eating habits. The best approach varies between individuals and should be guided by medical review.

Common side effects

Most side effects are mild to moderate and improve with time.

Common side effects include:

• Nausea
• Vomiting
• Diarrhoea
• Constipation
• Bloating
• Reflux symptoms

Helpful tips:

• Eat slowly and stop when full
• Choose smaller meals
• Avoid very fatty foods initially
• Stay well hydrated

Hair loss and other common concerns

Some people notice temporary hair thinning during weight loss treatment. This is usually related to rapid weight loss or reduced calorie intake, rather than a direct effect of GLP-1 medications. This type of hair shedding, known as telogen effluvium, is typically reversible once weight stabilises.

To reduce the risk:

• Maintain adequate protein intake
• Avoid very low calorie diets unless supervised
• Ensure nutritional deficiencies are addressed if suspected

Hair regrowth usually occurs over several months.

Other commonly raised concerns include:

Fatigue
Mild tiredness can occur, particularly during early dose increases. This often improves as the body adjusts.

Cold sensitivity
Weight loss can reduce insulation and change metabolism, leading some people to feel colder than usual.

Changes in bowel habit
Constipation or looser stools are common and usually settle with hydration, fibre adjustment and time.

Reduced enjoyment of food
Some people report less interest in food. This can be helpful for weight loss but may require mindful eating to maintain balanced nutrition.

If symptoms are persistent or concerning, they should be discussed with a clinician.

Less common but important risks

GLP-1 medications are generally well tolerated when prescribed appropriately, but like all medical treatments they carry some less common risks. Understanding these helps patients recognise when to seek medical advice and allows treatment to be used safely.

Gallbladder problems

Weight loss itself, particularly when it is rapid, can increase the risk of gallstones. This risk is not unique to GLP-1 medications and is seen with many forms of significant weight reduction.

GLP-1 treatments may slightly increase this risk in some people, especially during the early stages of weight loss. Symptoms to be aware of include:

• Right-sided upper abdominal pain
• Pain after eating, particularly fatty meals
• Nausea or vomiting
• Fever or feeling unwell

People with known gallbladder disease may require additional assessment before starting treatment. New or persistent symptoms should always be discussed with a clinician.

Pancreatitis

Inflammation of the pancreas is a rare but serious condition that has been reported in people using GLP-1 medications. A direct causal link has not been clearly established, but caution is advised.

Symptoms of pancreatitis include:

• Severe upper abdominal pain
• Pain that spreads through to the back
• Persistent vomiting
• Feeling acutely unwell

Anyone experiencing these symptoms should stop the medication and seek urgent medical attention. GLP-1 treatment should only be restarted following medical review.

Why monitoring matters

Because these risks are uncommon but important, GLP-1 medications should always be prescribed following appropriate clinical assessment. Monitoring symptoms, dose escalation and relevant blood tests helps reduce risk and ensures treatment remains safe and effective over time.

Further Reading and Hub Links

Visit our Diabetes and Endocrine Health hub or browse more health topics in the AccessGP Knowledge Base.