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Weight Loss: What I Wish I’d Known Before Taking Compounded Semaglutide

Semaglutide erased the constant mental chatter about food that had ruled her life, but along with it went her awareness of basic needs.

Writer Kristen Reed shares her weight loss journey with compounded semaglutide. Photography courtesy of Kristen Reed

Health and wellness touch everyone’s life differently. This is one person’s story. The views and opinions expressed are those of the speaker and do not necessarily reflect the views or positions of Healthline Media.

It hit me at a Mexican restaurant. The chips and salsa were on the table — warm, salty, delicious — and after enjoying just a few, I was done. Not because I was being “good” or disciplined, but because I was satisfied.

In the past, I would have eaten my way to the bottom of the basket. Then it dawned on me: the food noise was gone. 

Six months before that chips-and-salsa moment, I started taking compounded semaglutide after leaving an abusive marriage and learning my A1C was nearing prediabetic. The next 16 months reshaped my body and my relationships with food, my kids, and myself.

The “food noise” disappeared, but so did my awareness of some basic needs. For instance, I’d forget to drink water and cook meals for my kids.

I had learned the hard way that you need medical oversight when taking GLP-1 drugs, which I’d obtained compounded versions of through medical professionals at a local medspa and a compounding pharmacy.

I weighed 180 pounds when I started GLP-1 drugs in November 2023 and stopped at 135 pounds in July 2025.

If I could go back to that first shot of semaglutide, I’d know I’d need a timeline and an exit strategy. I would also know that I’d need community support from people who understand this particular weight loss journey. I don’t regret taking GLP-1 drugs, but here’s what I wish I’d known before starting them.

Food noise went silent

Before I started GLP-1s, food noise was a constant state of mind.

My thoughts swirled around the next snack or meal as if they were a close companion. Food noise was ever-present and then, surprisingly and suddenly, absent.

One unexpected casualty was my baking hobby. A few months into my weight loss journey, I stopped baking. The desire simply dissipated.

Before I started the injections, I’d been on a pound cake kick, baking weekly just for the fun of it. In hindsight, food noise may have been driving the hobby, even though I really enjoyed the process of baking.

At some point, I just stopped baking and didn’t seem to miss it. The food noise that’d prompted weekly fixes for pound cakes was gone. The absence of that noise — the silence, really — was deafening.

Dehydration snuck up on me

As the mental chatter around food quieted, I realized I had missed other signals my body was sending. Painful constipation forced me to confront how little water I was drinking. Turns out dehydration can be a side effect of GLP-1 drugs.

I spoke with Mir B. Ali, MD, a bariatric surgeon and medical director of the MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California, to gain a better understanding of what happened.

He explained that the medication slows your digestive system. That slowdown, combined with even mild dehydration, can create intense constipation.

Ali advises his patients to drink water and other non-sugary liquids throughout the day, aiming for 48 ounces. Severe dehydration is rare with GLP-1 use, he said, but the problem is more subtle.

“Patients just forget to drink, and you can’t gulp a whole bunch at once because your stomach is emptying slower, and it might make you nauseous,” Ali said.

That was my experience. I simply forgot to drink water.

Staying hydrated is about more than avoiding discomfort. Research suggests that chronic dehydration can cause serious health risks as we age. When you forget to eat or drink, those risks can accumulate silently.

So, I tracked my water bottle refills, sometimes adding electrolyte powders. My dehydration wasn’t just an uncomfortable side effect. It had the potential to derail everything I worked toward. This would have been helpful to know up front.

I didn’t want to work out anymore

Doctors advise people taking GLP-1 drugs — and most people in general — to exercise at least 30 minutes daily.

Regular exercise helps your body maintain metabolism and muscle, which are both at risk while taking GLP-1 drugs.

However, I’d lost the motivation to exercise. When I started taking GLP-1s, I found I had very little energy. At times, I could barely summon the energy for even the most mundane tasks, such as answering an email, folding laundry, or taking my toddler to the playground.

Exercising definitely wasn’t going to happen, which was confusing since I’d always been athletic and loved being active.

When I asked Ali about this, he said he wasn’t surprised. He explained that the body has less energy when it’s burning calories. I also learned I likely wasn’t eating enough protein. 

“When patients are low in energy, they’re probably not getting enough protein. Protein is necessary for muscle preservation, as well as for general energy needs. So, we emphasize protein and vegetables in the diet and reducing carbohydrate intake,” Ali said. “That kind of directs your body toward burning fat more.”

My kids were on their own for dinner

I routinely forgot to cook meals for my kids. Judge me if you must, but I was rarely thinking about food for myself, let alone anyone else.

I have a teen and a toddler who’d get home and ask, “What’s for dinner?” and I’d be like, “Oh, right, dinner!” I felt guilty because food was so far from my mind, but my kids still needed to eat.

I remember my 2-year-old opening the freezer one evening and pulling out a bag of frozen vegetables. That smart baby was telling me she was ready for dinner. Ouch. I prepared a quick meal and she devoured the whole thing. That night, I realized I needed better systems in place to prevent this from happening again.

I relied on air-fryer meals for my toddler and encouraged my teen to cook, which worked out great because he enjoys being in the kitchen — but not the part where he has to do the dishes. We also ordered takeout quite a bit. 

Cooking for my kids reminded me that I still had to eat, too.

Stopping cold turkey led to weight regain

About a year after I’d started GLP-1s, I was 15 pounds from my goal weight. However, I stopped losing weight.

My weight plateaued for months, so my primary care physician (who didn’t prescribe my semaglutide injections) recommended I stop cold turkey. In hindsight, I should have planned an exit strategy.

There was no dramatic shift. My appetite returned gradually, almost imperceptibly. A little more interest in food one week, a basket of tortilla chips the next. Five months passed, and 10 pounds returned. I remember looking at vacation pictures and realizing my hard-earned body was slipping away.

I decided to try semaglutide again, but I knew I couldn’t just restart the injections and expect different results.

My goal weight wasn’t worth risking my health

Compounded semaglutide kept my appetite consistently low, even during my second run with it.

On many days, I ate one meal a day. However, this eating pattern was setting the stage for a potentially dangerous side effect. I simply wasn’t getting enough nutrition.

My nails were brittle, and my beautician noticed my hair was dry and weak, cutting off two inches of what looked like straw on the salon floor. I blamed work stress.

I mentioned it casually during my annual physical, prompting my doctor to ask questions like: What was I eating daily? Was I tracking protein? How often was I actually eating?

My doctor wasn’t managing my GLP-1 treatment; I did my own thing while keeping her informed. But she connected the dots I missed. The hair loss, brittle nails, and my diet: we suspected malnutrition.

I stopped the compounded medication at 135 pounds, which was 5 lbs from my target. I set the target weight low because experience taught me I’d likely settle at a higher weight once off the meds.

I later learned that malnutrition while taking GLP-1s is rare. Ali said that what I experienced could have been triggered by a hormonal shift resulting from rapid weight loss. 

Fat loss decreases estrogen, which can contribute to hair loss, he explained.

I learned you need someone watching more than the scale — a medical professional who can see patterns you’re too close to recognize. Weight loss was never supposed to be the only metric that mattered.

I needed a weight loss support system

My girlfriends were on GLP-1 drugs before me, and understood the experience in ways research couldn’t capture.

We quickly became each other’s sounding board at different stages on different medications and with different goals, like weight regain when I plateaued.

We traded practical strategies: Pepto-Bismol pills before injections helped alleviate nausea, intermittent fasting worked for maintenance, and long walks were easier when done together. The tips helped, but that wasn’t the real gift.

This community gave me permission. After years in survival mode, I needed to see women prioritizing themselves — taking up space, investing time and money, asking for what they needed. They showed me what that looked like. Watching them showed me I was allowed to want it, too.

How I maintain a healthy weight without GLP-1s

I’ve been off semaglutide since August and am maintaining my new healthy weight.

For me, intermittent fasting, deliberate daily movement, and a balanced diet rich in protein and fiber help me stay strong, healthy, and motivated. I still choose only the carbs worth eating — good bread, not mediocre bread.

And the food noise? Well, it’s back, but I’m keenly aware of it now. When I open the pantry, I pause and ask: Does my body actually feel hungry right now? Sometimes the answer is no, and I eat anyway.

But the difference is the pause. The awareness. The choice. 

GLP-1 didn’t cure my relationship with food — it gave me the silence I needed to start listening to my body again after years of survival mode had trained me to ignore it.

Now, when I sit down at that Mexican restaurant, the chips and salsa in front of me, I don’t always make the choice to be “good,” but in that split second between impulse and action — I make a choice.

That little moment of agency before my hand reaches my mouth is the gift I’m going to hold onto. 

FDA Approves Wegovy Weight Loss Pill: How It Compares to Injectables

The Food and Drug Administration (FDA) recently approved a tablet version of the GLP-1 drug Wegovy for weight loss. Image courtesy of Novo Nordisk

Novo Nordisk officials said a new pill version of its weight loss drug Wegovy is now available in the United States.

The Food and Drug Administration recently approved the Wegovy tablet as a prescription treatment for obesity and weight management. 

Experts say a pill version of a GLP-1 drug could make it easier for people to stay on a weight loss regimen, but they added that diet and exercise still remain the most important components of these types of programs.

A well-known weight loss medication is now available in the United States in pill form.

The availability comes just weeks after the Food and Drug Administration (FDA) approved the tablet version of the GLP-1 drug Wegovy for weight loss.

Officials at Novo Nordisk, the manufacturer of the medication, said a “starter dose” of 1.5 milligrams (mg) can now be purchased with a prescription at pharmacies and other facilities in the United States.

Higher doses of the Wegovy pill will be available by the end of this week, company officials said.

They note that the new pill is the only medication that is specifically prescribed for weight loss that can be taken as a tablet as opposed to an injection.

They reported that the Wegovy pill produced an average of 16% weight loss in people who took the medication over a 64-week period in a phase III clinical trial.

“We know there are people who are interested in addressing their weight but have been waiting on the sidelines for a medicine that was right for them. For many of them, that wait is over as we can now offer the powerful efficacy of Wegovy in a once-daily pill,” said Ed Cinca, senior vice president of marketing and patient solutions at Novo Nordisk, in a statement.

Eli Lilly is currently seeking FDA approval for an oral weight loss medication it has developed and tested in phase III clinical trials.

Experts say a pill form of GLP-1 medication could help people adhere to a weight loss routine that also involves a healthy diet and regular exercise.

“The advent of a weight loss pill certainly has some advantages,” said Mir Ali, MD, a general surgeon, bariatric surgeon, and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California. “People are more used to taking pills than they are taking injections.”

“I think this will be a great option for individuals who have not considered taking these drugs… due to them being injectables,” added Kristin Kirkpatrick, RD, the president of KAK Consulting and a dietitian at the Cleveland Clinic Department of Wellness & Preventive Medicine in Ohio.

What to know about the Wegovy pill

Novo Nordisk officials said the Wegovy pill is now available in more than 70,000 U.S. pharmacies, including CVS and Costco, as well as select telehealth providers. 

They said the medication will cost about $149 for a month’s supply without insurance coverage or special savings under an agreement between the company and the Trump administration.

With insurance, the Wegovy starter dose could cost as little as $25 per month.

A 4 mg dose of the pill will also cost $149 per month until April 15. After that, the monthly price will rise to $199. The 9 mg and 25 mg doses are projected to cost $299 a month.

The Wegovy pill must be taken on an empty stomach with a small amount of water. Patients are directed not to eat, drink, or ingest other medications for 30 minutes after taking the pill.

It is intended to be prescribed along with a reduced calorie diet and daily exercise routine to help people lose weight.

“Patients will have a convenient, once-daily pill that can help them lose as much weight as the original Wegovy injection,” said Mike Doustdar, president and chief executive officer of Novo Nordisk, in a statement to Healthline.

“The Wegovy pill provides patients with a new, convenient treatment option that can help patients start or continue their weight loss journey,” he added.

Benefits, drawbacks of a weight loss pill

Experts say tablet forms of weight loss drugs do provide some conveniences.

They said they are generally cheaper than injections and don’t need to be refrigerated.

In addition, the pills don’t involve needles.

“[The pill] may open up the option for many more people,” Kirkpatrick told Healthline. “It also appears that the price may be more affordable taking away yet another potential barrier to consideration for taking these drugs.”

However, Sun Kim, MD, an associate professor of medicine at Stanford University in California, said once-a-week injections can be considered more convenient for some people than remembering to take a pill each day.

“I also think it may be easier to quit or delay an oral medication when faced with side effects like nausea, which is common with GLP-1 medications,” she told Healthline.

Some experts note that the costs of the new medication could continue to be a barrier.

Ali said insurance companies may be reluctant to cover these medications, at least initially, as they have been in the past with other weight loss treatments.

“These kinds of issues aren’t going to change dramatically,” he told Healthline. “Companies may not be inclined to offer insurance coverage.”

“I’m concerned about access as coverage of GLP-1 medications will be reduced for patients, especially those who rely on Medicaid,” noted Kim.

Kirkpatrick shared similar concerns.

“This will probably differ based on a case-by-case basis, but the price may still be too high for some individuals to consider — especially if their diagnosis is not covered by insurance,” she said.

“The other factor I see with some of my patients is the length in which insurance will cover the medication as well, with many patients stopping the medication once they have to pay out of pocket,” Kirkpatrick added.

Recap of current weight loss medications

There are a number of options for people seeking treatment for type 2 diabetes or obesity. Most of these medications are approved only for adults.

Wegovy has been available as an injection medication since receiving FDA approval in June 2021. It now costs $349 per month for the higher doses for consumers who don’t use insurance. The lower doses are available for $199 per month until March.

Wegovy contains the active ingredient semaglutide in both pill and injectable form. Ozempic, which is also manufactured by Novo Nordisk, is also a semaglutide-based GLP-1 medication.

Wegovy has been approved for use as a treatment for obesity or weight management issues. Ozempic is approved only for use as a treatment for diabetes. Ozempic is also only available as an injection.

Another Novo Nordisk product, Rybelsus, has been available as a tablet since September 2019 as a treatment for type 2 diabetes. It also is semaglutide-based.

Eli Lilly also has two GLP-1 medications, both of which contain the active ingredient tirzepatide. Mounjaro is approved as a treatment for type 2 diabetes while Zepbound is approved for weight loss treatment.

Eli Lilly is currently developing a weight loss medication in pill form called orforglipron. That drug doesn’t contain the active ingredient tirzepatide. It is a GLP-1 medication that affects different receptors than Zepbound and Mounjaro.

Eli Lilly officials reported that a recent phase III clinical trial indicated that orforglipron helped people maintain weight loss after they switched to the daily pill from injectable medications Zepbound and Wegovy.

The company has submitted an application to the FDA to have orforglipron approved for use as a treatment for weight management.

“If approved for the treatment of obesity, orforglipron could provide a convenient alternative for the millions of individuals living with obesity around the globe to continue their long-term health journey,” said Kenneth Custer, PhD, executive vice president and president of Lilly Cardiometabolic Health, in a statement.

Tips for successful weight loss

Most experts agree that weight loss medications do not magically melt away fat or burn off calories.

The medications work by suppressing the body’s hunger and appetite responses, prompting people to eat less.

Experts say these medications only assist a person in developing and maintaining a healthy diet and a regular exercise program.

“GLP-1-based medications, including the Wegovy pill, have been revolutionary to the care of patients living with obesity,” Kim said. “However, it is important to also continue to focus on eating a quality diet and exercising regularly.”

Ali said that 90% of a person’s weight is the result of what they eat. Exercise, he said, can help burn off calories, but diet is the most important component.

He said he advises his patients to reduce their consumption of carbohydrates and sugars while increasing their intake of proteins and vegetables.

“There are no magic solutions,” he said. “You must eat well and exercise regularly.”

Kirkpatrick said her advice remains the same no matter what type of weight loss medication a person is taking.

“Lifestyle change also has to accompany the pharmacological approach. Diet and exercise will still be strong predicators of long-term success,” she said.

Stopping GLP-1s May Lead to Weight Regain In Less Than 2 Years, Review Finds

Research shows that people who stop taking GLP-1 medications regain weight within 2 years. Image Credit: Tatsiana Volkava/Getty Images

A new study has found that people regain weight within 2 years of stopping a GLP-1 drug.

Metabolic improvements also tend to fade within that time, researchers found.

Experts advise that slowly tapering off the medication is better than quitting abruptly.

It’s also important to incorporate supportive changes in diet, exercise, and lifestyle for long-term weight management.

Many people looking to lose weight and improve their health turn to medications like semaglutide (Ozempic, Wegovy) or tirzepatide (Mounjaro, Zepbound). 

As noted by the authors of a recent review published in The BMJ, glucagon-like peptide-1 (GLP-1) drugs can help patients lose between 15% and 20% of their body weight.

However, their findings indicate that despite the success of these medications, people who stop them tend to regain quickly, returning to their original weight within an average of 1.7 years.

During that timeframe, people also experience a reversal of the cardiometabolic health benefits seen while on the medications.

The researchers suggest that a “more comprehensive” approach may be needed in order to achieve lasting weight loss with GLP-1s.

Assessing weight management after GLP-1s

The team of researchers conducted a review of the available evidence to determine the amount of weight people regain when they stop taking GLP-1 medications.

They additionally wanted to examine how they compare to when people lose weight via diet and exercise.

To answer these questions, they searched for and combined results from all available studies to get an overall picture. Altogether, data from 37 studies involving 9,341 adults with overweight or obesity were included.

The studies included randomized controlled trials (considered the gold standard), non-randomized trials, and observation studies. All participants tested the medications for a minimum of 8 weeks, and were followed for at least 4 weeks after ceasing treatment.

Medications included popular GLP-1s, such as semaglutide, tirzepatide, and liraglutide, as well as other anti-obesity medications, including orlistat. Some studies combined drug treatments with behavioral supports such as diet and exercise.

For comparison purposes, the research team utilized data from a prior review of behavioral weight management programs and employed statistical models to estimate the average rate at which individuals regained weight after discontinuing medication.

They also examined changes in blood sugar levels, cholesterol, and blood pressure to determine if participants maintained the improvements they experienced while on the medication.

Most people regained all their weight after GLP-1s

When they reviewed the data, they found that people lost an average of 8.3 kilograms (about 18 pounds) while they were using medication.

However, once they stopped treatment, they regained their lost weight at a rate of about 0.4 kilograms (nearly 1 pound) per month. And, within an average of about 1.7 years, most had regained all of their weight.

They additionally noted that newer drugs like semaglutide and tirzepatide were associated with an even faster rate of regain: about 2 pounds per month with a return to baseline in about 1.5 years.

When the researchers compared weight regain after stopping medication to weight regain following the cessation of behavioral weight management programs, people generally lost less weight with behavioral techniques. However, weight regain was slower, at approximately 0.1 kilograms (one-quarter pound) per month.

Furthermore, it took approximately 3.9 years for them to return to their starting weight.

The study also examined various markers of metabolic health, including blood sugar (HbA1c and fasting glucose), cholesterol, triglycerides, and blood pressure. While these values had improved on the medications, they gradually returned to their original levels within around 1.4 years.

The team also found no clear evidence that the continuation of behavioral supports after quitting weight loss drugs helped slow down the regain.

According to the study authors, their findings show that while GLP-1 medications can provide tremendous benefits, those benefits may only last as long as you are using them.

While behavioral programs may provide smaller results to GLP-1s, weight loss may be more sustainable.

Tapering off GLP-1s can help your body adjust

“Stopping GLP-1 medications often reveals something we don’t talk about enough: the drug was doing part of the physiological work that lifestyle alone may not yet be prepared to sustain,” said Flávio Mitidieri Ramos, MD, MSc, director of EndoDiagnostic Advanced Treatment for Obesity.

According to Ramos, who wasn’t involved in the study, GLP-1s suppress appetite and food noise, but the body adapts to them over time.

“When the medication is reduced or stopped abruptly, hunger signals, reward pathways, and metabolic efficiency tend to rebound,” he told Healthline. “Weight regain is not a personal failure; it is a predictable biological response.”

Ramos added GLP-1s should almost never be stopped without a gradual taper, both by reducing the dose and by extending the interval between dosing.

“This gradual step-down allows the brain, gut, and metabolic system time to recalibrate,” he explained.

Ramos further noted the importance of close follow-up during this phase.

“This is not about rushing off the medication, but about preparing the physiology for the next step,” he said.

It involves eating structure, protein intake, movement, and behavioral awareness so that the patient is able to manage appetite and weight with each lower dose.

Tips for long-term weight management

Brian Parana, a health and nutrition coach, shared how he assists clients as they exit treatment with GLP-1s. Prana wasn’t involved in the study.

“The first actionable step is rebuilding eating structure before appetite fully returns,” he told Healthline.

“I have clients move to three planned meals per day, each built around a clear protein anchor.” According to Parana, protein increases satiety and slows digestion during a time when hunger signals can often overshoot. It also supports the preservation of muscle mass.

“Strength training should also be introduced or reinforced before stopping GLP-1s,” he advised, adding that many lose muscle along with fat, especially if they are not doing strength training. “Muscle tissue plays a major role in daily calorie burn and glucose regulation,” said Parana.

Regular movement is another key piece of the puzzle. “Walking improves insulin sensitivity, helps regulate appetite hormones, and lowers stress, all of which matter more once appetite suppression is removed,” he said.

Parana said that sleep and stress management must also be addressed, since lack of sleep and chronic stress raise cortisol, a hormone that drives cravings and fat regain. “Simple routines like consistent bedtimes, morning light exposure, and reducing late-night screen use make a measurable difference in appetite control,” he said.

Finally, Parana suggested viewing GLP-1s as a bridge rather than your final destination. “Clients who treat the medication as time to practice eating structure, movement, and recovery habits are far more successful long term than those who rely on appetite suppression alone,” he said.

Adding to these tips, Ramos advised that you ultimately need to be realistic, keeping in mind that obesity is a chronic, relapsing condition. As such, some individuals may require ongoing medical treatment to achieve success.

“The goal should not be to come off GLP-1s at any cost, but to integrate medication, behavior, and physiology in a way that patients can actually sustain in real life,” he said.