What to bring to your doctor when you are on a GLP-1

A follow-up on a GLP-1 is usually ten or fifteen minutes. In that time your prescriber has to decide whether the dose is right, whether to move it, and whether anything you are feeling needs looking at. They can only decide from what you bring. “It’s going okay, I think” leaves them guessing. Six numbers and three questions do not.

The six numbers

1. Your weight, as a line, not a point. One weigh-in on the morning of the appointment is nearly useless; the same scale will give you a different number tomorrow. What tells the story is the trend across the weeks: where you started, where you are, and whether the line is still moving. If it has flattened for a month, say so and say when. The 2025 joint advisory from four nutrition and obesity societies puts weight history at the top of what a clinician should assess.³

2. Doses taken, missed and moved. The date of each shot, any you missed, and any you took a day early or late. This matters more than people think. The Wegovy label has rules about missed doses, including that after more than two consecutive missed doses the escalation is restarted at a lower dosage,¹ and Zepbound’s says a missed dose is taken within four days or skipped.² A prescriber who knows you missed two shots in March reads your March weight completely differently.

3. Side effects, by day of the week and how bad. Not “some nausea”. Which day after the shot, how many weeks it has happened, mild or enough to stop you eating. Both labels say the stomach side effects are most common while the dose is being stepped up and ease over time,^1,2 so “day 2, every week, mild, better than last month” is a sentence that decides things. It tells them the pattern is the expected one.

4. Protein, as days on target. Not calories. The advisory asks clinicians to look at dietary intake through food logs or food photos, and to watch muscle mass and strength, because weight lost on these medications includes lean mass.³ “I hit 90 grams on 22 of the last 30 days” is exactly the kind of thing that answers that question before it is asked.

5. Your waist. A tape measure at the navel, once a week, same time of day. Weight can stall while the waist keeps moving, and the waist is the number that tracks the fat that matters.

6. Anything from the watch list. The labels name specific things prescribers are told to look for. Bring them if they have happened, even once.

The watch list, from the labels

These are not things to panic about. They are the things the prescribing information tells your prescriber to ask about, so bringing them up yourself saves a step.

• Pain in the upper belly that does not pass, especially if it goes through to the back, with or without vomiting. Both labels say that if pancreatitis is suspected the medication is stopped promptly and looked into.^1,2
• Pain under the right ribs, especially after eating, or yellowing of the eyes. Gallbladder disease occurred in the trials; if it is suspected, the labels call for gallbladder studies and follow-up.^1,2
• Vomiting or diarrhoea that has kept you from holding fluids. The labels warn that losing fluid can hurt the kidneys and tell prescribers to check kidney function in anyone who reports it.^1,2
• Shakiness, sweating, confusion, if you also take insulin or a sulfonylurea. The labels warn about low blood sugar in that combination and say the insulin or sulfonylurea dose may need reducing.^1,2
• A faster resting heart rate. The Wegovy label asks for heart rate to be monitored at regular intervals.¹ If your watch or your phone has been telling you something, bring the number.
• Any surgery or procedure coming up. These medications slow the stomach; the Zepbound label tells patients to inform anyone planning a procedure that they are on it.²

The three questions

Is this the right dose for now? Not “should I go up”. The honest question is whether the dose you are on is doing what it should, at a side effect cost you can live with. The answer might be to stay where you are for longer. The Wegovy label says outright that if a dose is not tolerated during escalation, delaying the next step by four weeks is an option,¹ and Zepbound’s that a lower maintenance dose can be considered if the current one is not tolerated.² Staying is a real choice, not a failure.

Is it time to step up, or to hold? Escalation on these medications runs in four-week steps at the fastest.^1,2 If your weight has flattened and the side effects are quiet, that is the moment to ask. If your weight is moving and day 2 is still rough, holding is the likely answer, and it is worth hearing them say it.

What should make me call before the next appointment? Ask this every time. The answer will be some version of the watch list above, in their words, with their phone number attached. Write it down.

What to leave at home

The apology. Most people arrive with a list of what they did wrong: the week they ate badly, the shot they moved, the walk they skipped. Your prescriber does not need a confession, they need the numbers, and the numbers already contain the bad week. Bring the log, not the guilt.

Tilly keeps all six numbers as you go and turns them into a one-page report for exactly this appointment: the weight line, the doses with any that were missed or moved, side effects by day of your week, protein days on target, the waist, and the questions you wanted to ask. It never tells you what dose to take. That is what the appointment is for.