Ten Questions Worth Bringing to Your Next GLP-1 Appointment

Useful questions cover five areas: how your dose will be escalated, what to expect from digestion, how muscle and bone get monitored, what nutrition should look like while your appetite is down, and what the plan is if you stop. Your clinician directs all of it.

Appointments run fifteen minutes. You have been waiting three weeks for them. Half the questions you meant to ask surface in the parking lot afterward, which is where good questions go to die.

This list exists to be saved, printed, or screenshotted. Take what applies.

What should I expect while the dose goes up?

Digestive symptoms are common with this class of medication, and they cluster early.

In pooled data from the STEP 1 through STEP 3 trials, participants on semaglutide 2.4 mg reported nausea at 43.9% against 16.1% on placebo. Diarrhea came in at 29.7% against 15.9%. Vomiting at 24.5% against 6.3%. Constipation at 24.2%. Prevalence of all of them declined over the course of treatment.

Common does not mean you have to white-knuckle it.

Ask:

• What escalation schedule are we using, and what would make you slow it down?
• Which symptoms should I call about, and which are expected?
• At what point do we hold a dose instead of pushing through?

How will we watch my body composition?

Weight is one number covering several tissues. Muscle is one of them, and it does not announce itself on a scale.

A network meta-analysis of 22 randomized controlled trials covering 2,258 participants found that GLP-1 receptor agonists reduced total body weight, fat mass, and lean mass, with lean mass loss making up roughly 25% of total weight lost. The percentage of lean mass relative to total body weight held steady.

The literature disagrees with itself here, and that is worth knowing rather than hiding. A 2024 review noted that some studies report lean mass reductions between 40% and 60% of total weight lost, while others report approximately 15% or less.

There is no settled figure. That is the accurate state of the evidence, and it is the argument for measuring instead of assuming.

Ask:

• Will we track body composition, and using what method?
• What change in muscle mass or strength would concern you?
• What baseline should we capture now, while there is still a before?

What should I be eating while my appetite is down?

Eating less means fewer nutrients arriving, across the board. Protein and micronutrients included.

A 2026 narrative review in Clinical Nutrition ESPEN laid out a dietitian-led framework for GLP-1 care. It proposed daily protein intake at or above 1.2 g/kg, up to 1.6 g/kg in appropriate adults without chronic kidney disease, spread across meals rather than stacked into one. It proposed a laboratory panel covering vitamin D, B12, iron studies, folate, zinc, and thiamine in higher-risk patients. And it proposed progressive resistance training alongside both.

That is a published proposal, written for clinicians. Whether any of it fits you is a question for the person who knows your kidney function and your history.

Ask:

• What should my protein intake look like, given my health history?
• Which nutrient levels should we check, and how often?
• Would a referral to a dietitian make sense for me?

What kind of activity should I be doing?

Published frameworks for GLP-1 care put progressive resistance training next to protein adequacy as the approach to holding onto lean tissue during weight reduction. It shows up in review after review.

Ask:

• What kind of activity fits my fitness level and any joint or cardiac limits?
• How would we know whether it is working?

What is the plan if I stop?

Ask this on day one. Not on the day you stop.

In the STEP 1 trial extension, participants were followed for a year after withdrawal of once-weekly semaglutide 2.4 mg and lifestyle intervention. On average they regained two-thirds of the weight they had lost, with cardiometabolic variables moving alongside. The authors read the finding as consistent with obesity behaving like a chronic condition that requires ongoing treatment.

Knowing that in advance changes what you plan for.

Ask:

• Is this something I should expect to continue long term?
• If I stop, for any reason, what does the plan look like?
• What would a taper involve, and what would we monitor during it?

What should I watch for between appointments?

Ask:

• What symptoms warrant a call rather than waiting for my next visit?
• How do I reach your office in between?
• What should I be writing down so the next appointment starts further along?

What can I bring to make this appointment better?

Three things.

1. Notes. Track your appetite throughout the day, your digestion, energy, sleep patterns, and any symptom with the week it started. 
2. Create a current list of every medication and supplement, with doses.
3. Data! If you have taken a microbiome test or blood panel, bring the clinician summary. Our Dayhoff Health GLP-1 Map includes a one-page version written for a clinician who has never seen it before.

The list, condensed

1. What escalation schedule are we using, and what would slow it down?
2. Which symptoms should I call about?
3. Will we track body composition, and how?
4. What change in muscle or strength would concern you?
5. What should my protein intake look like?
6. Which nutrient levels should we check, and how often?
7. What activity fits my situation?
8. Should I expect to be on this long term?
9. If I stop, what is the plan?
10. How do I reach you between appointments?

Frequently Asked Questions

Will my clinician mind if I bring a list? Prepared questions make short appointments productive. Most clinicians would rather have the list than the parking-lot version.

Are digestive symptoms a reason to stop? That is a decision for your clinician. In the STEP trials, symptoms were most common during dose escalation and declined over time. Report what you experience and decide together.

How much muscle do people lose on GLP-1 medication? Published estimates run from roughly 15% to 60% of total weight lost, depending on the study, with one 22-trial meta-analysis landing near 25%. There is no single number, which is the case for measuring.

Does Dayhoff Health tell my clinician what to do? No. Dayhoff Health performs sequencing and analysis and returns information. Interpretation, diagnosis, and prescribing belong to your clinician.

Can I bring these results to a clinician I have not seen before? Yes. The summary is built to be read cold.

What if I do not have a clinician? Establishing care with a primary care provider is the place to start. This class of medication involves ongoing monitoring.

References

1. Wharton S, et al. Gastrointestinal tolerability of once-weekly semaglutide 2.4 mg in adults with overweight or obesity, and the relationship between gastrointestinal adverse events and weight loss. Diabetes Obes Metab. 2022. PMID: 34514682.
2. Effect of glucagon-like peptide-1 receptor agonists and co-agonists on body composition: systematic review and network meta-analysis. Metabolism. 2025. PMID: 39719170. (author list to confirm)
3. Neeland IJ, et al. Changes in lean body mass with glucagon-like peptide-1-based therapies and mitigation strategies. Diabetes Obes Metab. 2024. PMID: 38937282.
4. Medical nutrition in the glucagon-like peptide-1 (GLP-1) era: protein strategies, micronutrient monitoring, and lean mass preservation. Clin Nutr ESPEN. 2026. PMID: 42036071. (author list to confirm)
5. Wilding JPH, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension. Diabetes Obes Metab. 2022. PMID: 35441470.