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Considering GLP-1 Medications: A Guide for Patients

Our Philosophy

Many people experience mixed emotions when considering GLP-1 medications, especially if they value Health at Every Size (HAES), body liberation, or eating disorder recovery. You may feel hopeful, conflicted, excited, uncertain, guilty, or skeptical. These feelings are common and understandable.

At Lavender Spectrum Health, we do not believe there is one "right" decision. Instead, we work together to balance:

• Your personal goals and values

• Evidence-based medical guidelines

• Eating-disorder–informed screening and monitoring

• Emerging research suggesting GLP-1 medications may provide benefits beyond weight loss, including improvements in inflammation and metabolic health for some individuals

Our goal is to help you make an informed decision that supports both your health and your values.

Before Starting a GLP-1 Medication

Before prescribing a GLP-1 medication, we will review your medical history to determine whether treatment is appropriate.

These medications are generally not recommended for people with:

• A personal or family history of medullary thyroid cancer

• Multiple Endocrine Neoplasia type 2 (MEN2)

• Pregnancy or breastfeeding

Additional discussion may be needed if you have a history of:

• Pancreatitis

• Gallbladder disease

• Gastroparesis or delayed stomach emptying

• Bariatric surgery

• Depression, suicidal thoughts, or other significant mental health concerns

Eating Disorder Screening

Because GLP-1 medications can significantly change appetite, eating patterns, and body weight, we routinely screen for eating disorders and disordered eating before treatment begins.

This screening is not intended to judge or exclude patients. Rather, it helps us provide the safest possible care.

Depending on your history, we may recommend:

• Additional discussion about your relationship with food

• Referral to a registered dietitian

• Referral to a therapist experienced in eating disorders

• More frequent follow-up visits

• Delaying or avoiding GLP-1 medications if the risks outweigh the potential benefits

Potential Benefits

Depending on your health goals, GLP-1 medications may help improve:

• Diabetes or prediabetes

• Cardiovascular risk factors

• Weight-related medical conditions

• Some inflammatory conditions

Not every patient experiences the same benefits, and treatment decisions are individualized.

Common Side Effects

Many side effects improve over time or with slower dose increases.

Common side effects include:

• Nausea

• Upset stomach

• Vomiting

• Abdominal pain

• Constipation

• Diarrhea

• Bloating

• Early fullness

• Fatigue

• Weakness

• Dehydration

• Increased heart rate

• Hair loss (usually related to rapid weight loss or inadequate nutrition)

Some patients find over-the-counter medications helpful for managing mild symptoms. Depending on your symptoms, your clinician may recommend products such as:

• Loperamide (Imodium®) for diarrhea

• Polyethylene glycol (MiraLAX®) for constipation

• Simethicone (Gas-X®) for bloating

• Calcium carbonate (Tums®) for mild indigestion

Always contact your clinician if side effects are persistent, worsening, or concerning.

Serious Risks

Although uncommon, GLP-1 medications can increase the risk of:

• Pancreatitis

• Gallbladder disease or gallstones

• Gastroparesis (delayed stomach emptying)

• Nutritional deficiencies

• Bone density loss during rapid weight loss

• Muscle loss during rapid weight loss

Most people regain some or all of the weight lost after stopping GLP-1 medications. This is an expected biological effect and does not represent personal failure.

When to Seek Medical Care Immediately

Seek urgent medical care or go to the emergency department if you experience:

• Severe abdominal pain

• Persistent vomiting or diarrhea (especially more than five episodes in 24 hours)

• Severe weakness

• Confusion

• Fainting or feeling like you may faint

Please also notify our office within one week if you receive emergency or urgent care related to your medication.

Nutrition Matters

GLP-1 medications often decrease appetite significantly.

Eating too little can increase the risk of:

• Muscle loss

• Bone loss

• Hair loss

• Fatigue

• Nutritional deficiencies

To help reduce these risks, we often recommend:

• Eating adequate daily protein based on your individual needs (at least 0.8g per kg weight per day)

• Eating a balanced diet that includes protein, fruits, vegetables, healthy fats, and fiber

• Participating in strength or resistance exercise when medically appropriate

• Taking a daily multivitamin if recommended by your clinician, particularly one containing B vitamins

Your clinician can help you determine your individualized daily protein goal.

Monitoring During Treatment

GLP-1 medications require ongoing monitoring to ensure they remain safe and effective.

Depending on your individual circumstances, your clinician may recommend:

• Tracking protein, calorie, fiber, or fluid intake

• Weight monitoring

• Periodic laboratory testing

• Bone density testing

• Physical therapy

• Consultation with a gastroenterologist

• Consultation with a registered dietitian

• Consultation with a mental health professional

• Referral to an eating disorder treatment program if clinically appropriate

Follow-Up Expectations

Because these medications require close monitoring, follow-up is an important part of treatment.

Patients starting GLP-1 medications should expect:

• An injection teaching visit before starting treatment (for injectable medications)

• A follow-up appointment approximately one month after starting medication to discuss side effects and possible dose adjustments

• Monthly follow-up visits while your dose is being adjusted and until treatment is stable

• Follow-up visits approximately every three months once you are doing well on a stable dose

Ongoing prescriptions require regular follow-up appointments.

If your insurance does not cover your medication, your clinician can discuss alternative options that may include manufacturer cash-pay programs, vial formulations, or other medications that may be appropriate for your situation.

Honest Communication Is Essential

Successful treatment depends on open communication.

Please let your clinician know if you experience:

• Difficulty eating enough

• Persistent nausea or vomiting

• Rapid or excessive weight loss

• Increasing weakness

• Falls

• Symptoms of dehydration

• Mood changes

• Restrictive eating behaviors

• Concerns about disordered eating

• Any side effect that worries you

Treatment recommendations may change over time based on your health and your experience with the medication.

Food Noise vs. Hunger

Many people describe food noise as repetitive, intrusive thoughts about food that feel difficult to control and are not necessarily related to physical hunger.

Hunger cues are normal biological signals that your body needs nourishment.

The goal of treatment is not to eliminate healthy hunger. Instead, many patients find that GLP-1 medications reduce intrusive food thoughts while allowing them to continue recognizing and responding to normal hunger cues.

Shared Decision-Making

Choosing whether to use a GLP-1 medication is a personal decision.

Our role is not to convince you to take or avoidthese medications. Instead, we aim to provide evidence-based information, thoughtfully assess potential risks and benefits, and partner with you to determine whether treatment aligns with your health goals, medical history, and personal values.