Weight Care

GLP-1 medications explained: semaglutide, tirzepatide and microdosing

What GLP-1 medications are, how semaglutide and tirzepatide differ, what compounded means, common side effects and how a program works.

Published October 26, 20263 min readReviewed for clarity by the Awesentials teamEducational, not medical advice

GLP-1 medications are among the most talked-about prescriptions in weight care. Here is what they are, how the two main ones differ, and what to know before you start an online visit.

What GLP-1 is

GLP-1 (glucagon-like peptide-1) is a hormone your gut releases after you eat. It signals the parts of the brain that control appetite and food intake, and it helps the body manage blood sugar. GLP-1 medications are lab-made molecules that act on the same receptor, and they last much longer in the body than natural GLP-1, which is why they are taken once a week.

Semaglutide and tirzepatide

Semaglutide acts on the GLP-1 receptor. Tirzepatide acts on two receptors, GLP-1 and GIP, another gut hormone involved in appetite and blood sugar. Both are given as a small injection under the skin once a week, usually starting at a low dose that a provider raises step by step. Which one, if either, fits you is a decision for a licensed provider who has reviewed your history.

Public health guidance notes that weight management medications work best alongside a lifestyle program: eating patterns, physical activity, sleep and support. They are not a replacement for those habits.

What "compounded" means here

Brand-name semaglutide and tirzepatide products are made by drug manufacturers and reviewed by the FDA. Compounded versions are prepared by a licensed pharmacy for an individual patient on a prescription, sometimes with an added ingredient such as vitamin B12 or glycine. Compounded medications are not FDA-approved, and the FDA has not reviewed them for safety, effectiveness or quality. The FDA has also reported dosing errors with compounded GLP-1 medications, so measuring each dose exactly as labeled matters. Your provider can talk with you about brand-name options too.

What microdosing means

A microdose program uses a lower weekly dose than a standard program. A provider may consider it as a gentler start, for maintenance after a standard program, or when someone wants a smaller dose alongside lifestyle changes. It is still a prescription and still requires a provider's review.

Side effects and safety

The most common side effects are stomach-related: nausea, vomiting, diarrhea, constipation, stomach pain and heartburn. They are often worse when a dose goes up. Serious but less common risks include pancreatitis, gallbladder problems, kidney problems from dehydration, and low blood sugar when combined with some diabetes medications.

Both medications carry a warning about thyroid C-cell tumors seen in animal studies. People with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia type 2 (MEN 2) should not use them. They are not for use during pregnancy or breastfeeding, and tirzepatide can make birth control pills less effective.

Get medical care right away for severe stomach pain that does not go away, a lump or swelling in the neck, trouble swallowing, or signs of an allergic reaction.

How a provider-guided program works

1. You complete an online visit with your health history, current medications and goals.
2. A licensed provider reviews it and decides whether a GLP-1 program is appropriate, and at what starting dose.
3. If prescribed, a licensed US pharmacy prepares the medication and ships it with syringes and instructions.
4. You message your provider in the patient portal with questions, and your provider adjusts the dose over time.

Questions to ask your provider

• Is semaglutide, tirzepatide or a microdose a better fit for my history, or none of them?
• How will my dose change over the first few months?
• Which side effects should I report, and how quickly?
• How does this fit with my other medications?

The bottom line

GLP-1 medications can be part of a weight care plan when a licensed provider decides they are appropriate. Compounded versions are not FDA-approved, side effects are common at first, and the medication works best alongside everyday habits. Start with an honest online visit and keep your provider in the loop.