Week one is adjustment, not results. Appetite changes are usually noticeable within days; meaningful weight change is assessed over months. Side effects peak after each dose increase.
Before you start
You will have had blood work, a medication review and injection training. Stock the kitchen with protein-forward options and plan your injection day.
Take a starting weight, waist measurement and photograph. The scale alone is a poor guide, and you will want the comparison later.
Week 1: adjustment
Most patients notice appetite changes within a few days — meals feel adequate sooner, and food preoccupation quietens.
Mild nausea is common in the first few days. Smaller portions, slower eating and avoiding fatty foods help considerably. This is not the week to judge results.
Week 2: settling
Side effects typically ease as your body adapts. Eating patterns start to reorganise around genuinely smaller portions.
Watch hydration. Reduced intake often means reduced fluids, which causes headaches and constipation that get wrongly blamed on the medicine.
Week 3: establishing the pattern
By now most patients have a workable routine. This is when nutrition quality matters most — small meals must carry real protein.
Some weight change is usually visible, though it varies widely. Fluid shifts make early numbers unreliable.
Week 4: first review and dose step
Your review covers weight trend, side effects, nutrition and how you are managing. The dose usually steps up if you are tolerating the current level well.
Expect side effects to return briefly after the increase. This is normal and settles again.
What is not normal
Severe or persistent abdominal pain, especially radiating to the back. Persistent vomiting or signs of dehydration. Severe upper-right abdominal pain.
These warrant same-day contact with your care team, not waiting for the next scheduled review.
Preparing your kitchen
Stock protein you can prepare quickly: eggs, curd, paneer, dal, tinned fish, roasted chana. When appetite is low and cooking feels like effort, whatever is easiest is what gets eaten.
Reduce the presence of ultra-processed snacks. Appetite suppression makes this far easier than it has ever been, which is exactly why the first month is the moment to reset the household's default foods.
Tracking that is actually useful
Weigh weekly rather than daily, at the same time and under the same conditions. Daily fluctuations are mostly fluid and will mislead you.
Record waist measurement fortnightly and take photographs monthly. Many patients see clear change in measurements and clothes before the scale reflects it.
Common first-month mistakes
Escalating dose too quickly. Skipping meals entirely because appetite is absent, which accelerates muscle loss. Neglecting fluids. Judging the whole treatment on two weeks of data.
The patients who do best treat the first month as learning a new way of eating rather than as a race.
Frequently asked questions
How much weight will I lose in the first month?
When will I notice appetite changes?
What if I feel very nauseous?
Can I exercise in the first month?
Which day should I inject?
Medical disclaimer. This article is general information, not medical advice, and does not replace consultation with a qualified doctor. The medicines discussed are prescription-only and must be prescribed and monitored by a physician. Outcomes vary between individuals. Never start, stop or change a prescribed medicine without medical advice.