getting started on glp-1 meds
Here are some of the answers to the most common questions when starting a GLP-1 or similar medications to treat obesity.
How Do I Start a Conversation with My Doctor About GLP-1 Meds?
Q: What's the best way to discuss GLP-1 medications with my doctor? A: Starting a conversation with your doctor about GLP-1 therapies can feel intimidating, but it’s a powerful step toward advocating for your health. Begin by sharing your health goals, whether it’s weight loss, managing associated obesity comorbidities, or both. Mention any specific GLP-1 medications you’ve researched, and don’t hesitate to ask about their risks and benefits. Be honest about your current challenges and why you think a GLP-1 could be the solution you need. If traditional advice feels limiting, telehealth companies offer access to GLP-1s with a patient-centered, stigma-free approach—bypassing some providers' outdated 'eat less, move more' perspectives. Remember, this is your journey; you deserve care that aligns with your health goals.
How Do I Check if a GLP-1 Medication is Covered by My Insurance?
Q: How can I find out if my insurance covers GLP-1 medications? A: You’ll want to check your insurance plan's formulary, usually accessible online through your insurance provider's website. Search by the drug's name (e.g., semaglutide, tirzepatide) or its brand name. If it's not covered, some plans have a process to request an exception. If you need assistance determining what you are eligeable, you may find the insurance checker tool from Ro useful. Simply upload your insurance card, and Ro will email you with your approved medications. https://ro.co/checker
What Can I Do if I Need a Prior Authorization for zepbound or wegovy?
Q: How can I increase my chances of a prior authorization approval? A: Work closely with your doctor, who may need to submit documentation showing the medical necessity of the GLP-1, including details like previous treatments that didn’t work and the specific benefits a GLP-1 could offer for your health. However, keep in mind that primary care providers (PCPs) often lack the time and resources to complete prior authorizations (PAs) efficiently and may be unfamiliar with the specific criteria insurance companies are looking for. In contrast, telehealth providers handle thousands of PAs monthly and are well-equipped to navigate this process. Many people find better success with winning PAs when working with telehealth providers who specialize in meeting insurance requirements and maximizing approval chances.
What is a Formulary Exclusion exception, and How Can I Request an Exception for my glp-1 treatment?
Q: What if the GLP-1 I need is excluded from my insurance formulary? A: Some plans exclude anti-obesity drugs, which can make it extremely challenging. You or your doctor can submit a formulary exception request, explaining why the medication is medically necessary and how other treatments haven't been effective. Your doctor’s detailed notes are crucial here, as is being armed with the latest clinical data outlining how the selected medication could impact your specific comorbidities. Our GLP-1 News section and search feature on our website can be a great resource to look up this type of information.
What Are Compounded Versions of GLP-1 Medications?
Q: What does it mean if a GLP-1 medication is “compounded,” and is it safe? A: Compounded GLP-1 medications are created by pharmacies that mix or alter the medication to meet specific needs, often at a lower cost than branded medication. While they can be an alternative, compounded drugs from 503a pharmacies lack FDA oversight, so quality and consistency can vary. Always discuss compounded options with your doctor to understand the risks and benefits. Ask for 503b pharmacies when available, as they must follow certain FDA regulations. In contrast, 503a pharmacies are governed by their state's respect pharmacy board.
What Should I Expect When Starting a GLP-1 Medication?
Q: Are there common side effects when starting GLP-1 medications? A: Nausea and gastrointestinal issues are quite common at the beginning, and it’s often temporary. Many people find that eating smaller, frequent meals and avoiding high-fat or greasy foods helps. Expect your body to adjust gradually, and talk to your doctor if side effects are unmanageable.
How Much Weight Can I Expect to Lose on a GLP-1?
Q: What is the typical weight loss timeline for GLP-1 users? A: Weight loss varies, but studies show that people often lose between 10-20% of their body weight over a year. Individual results depend on the medication prescribed, lifestyle factors, adherence, and dosage adjustments. Weight loss often stabilizes after a year to a year and a half, but GLP-1s can help with weight maintenance beyond that.
How Can I Maximize My Success on a GLP-1?
Q: Do you have any tips for getting the most out of GLP-1 treatment? A: Lifestyle changes, such as a balanced diet and regular activity, can amplify the medication’s effects. Monitoring blood sugar (if you’re diabetic) and tracking your progress can help you stay on course. Many find that maintaining a supportive network, like a GLP-1-focused community, keeps motivation high.