How to Get Started on Semaglutide or Tirzepatide: A Step-by Step Guide.
How to Get Started on
Semaglutide or Tirzepatide
If you read our comparison of semaglutide and tirzepatide and thought "okay, but how do I actually start?" — this post is for you. Here's exactly what the process looks like at Defiance Health, from your first call to your first dose.
Do You Qualify?
The FDA has established clear qualification criteria for GLP-1 weight loss medications. Most patients fall into one of two categories:
A BMI of 30 or higher meets the standard FDA threshold for both semaglutide and tirzepatide for weight management — no additional health conditions required.
A BMI of 27 or higher may qualify if you have at least one weight-related condition — such as high blood pressure, high cholesterol, type 2 diabetes, or sleep apnea.
BMI is the starting point, but it's not the whole picture. At your first appointment, we also review your full medical history, current medications, family history, and any prior weight loss attempts. The goal isn't just to confirm you meet a number — it's to make sure the medication is the right fit for you specifically, and to identify anything that might affect which medication we recommend.
Who may not qualify: GLP-1 medications are generally not recommended for patients with a personal or family history of medullary thyroid cancer, multiple endocrine neoplasia syndrome type 2 (MEN2), a history of pancreatitis, or those who are pregnant or planning to become pregnant. Your provider will review all of this at your first visit.
Your First Appointment: What to Expect
At Defiance Health, new patients can typically be seen within the same week — in person or via telehealth, depending on your preference and location. The first appointment is comprehensive by design. We don't just write a prescription and send you on your way. We build the full picture before recommending anything.
We go through your full medical history — current diagnoses, medications, prior weight loss attempts, family history, and your goals. This gives us the clinical context to make the right recommendation rather than a generic one.
In-person or telehealthWe confirm your current BMI and establish your baseline weight. This becomes your reference point for tracking progress and adjusting your plan over time.
In-person or telehealthThis is where we go beyond BMI. The InBody scan measures your muscle mass, body fat percentage, visceral fat level, and metabolic rate — giving us a precise, detailed picture of your body composition that BMI alone can't provide.
In-personWe order baseline bloodwork to assess metabolic health, thyroid function, blood sugar, kidney and liver function, and lipids. This is both a safety screen and a baseline — so we can track real improvements in your metabolic markers as you progress.
In-personOnce we have the full picture, your provider reviews all findings with you and recommends a specific medication, starting dose, and titration schedule. We also discuss what to expect in your first few weeks and how to reach us if anything comes up.
In-person or telehealthWhy the InBody Scan Matters
Most weight loss programs track one number: the scale. We track four. The InBody scan takes about five minutes and gives us information that changes how we approach your treatment — and how we measure your success.
BMI tells you your weight relative to your height. Body composition tells you what that weight is actually made of — and that distinction matters enormously when you're on a GLP-1 medication.
Preserving muscle during weight loss is critical — GLP-1 medications can reduce both fat and muscle if not managed properly.
A more accurate picture of fat loss progress than weight alone, especially as body composition shifts.
The fat around your organs — the most metabolically harmful type, and the most responsive to GLP-1 treatment.
Your baseline caloric burn, which helps us set realistic expectations and nutrition targets for your plan.
We repeat the InBody scan at follow-up appointments so you can see exactly how your body composition is changing — not just what the scale says. Patients often find this the most motivating part of the process, because the changes in muscle and fat are visible even when the scale moves slowly.
Cost and Payment
Defiance Health operates on a self-pay basis for our services, which means no insurance hassles, no prior authorization delays, and no surprise billing. We believe that should never be what stands between you and getting started.
For the medications themselves, both semaglutide and tirzepatide have become significantly more accessible over the past year. Manufacturer savings programs, pharmacy discount cards, and compounding options have all expanded — and our team will walk you through what's currently available so you can make the most cost-effective choice for your situation.
No prior authorizations. No insurance runaround. We keep our process simple so you can focus on your health — not paperwork. If you have questions about medication costs before booking, give us a call and we'll give you a straight answer.
What to Expect in Your First Few Weeks
Starting a GLP-1 medication is not a dramatic overnight change. The medications are designed to be introduced gradually — which is why side effect management in the early weeks matters so much.
You'll begin at the lowest dose. Most patients notice reduced appetite relatively quickly. Nausea is most common in this window — eating smaller meals, avoiding high-fat foods, and staying hydrated helps considerably.
If you're tolerating the starting dose well, we increase to the next level. Appetite suppression typically becomes more pronounced. Most patients begin to see meaningful scale movement in this window.
We continue stepping up the dose every 4 weeks, monitoring for side effects and adjusting if needed. Weight loss tends to be most rapid during this phase as doses approach therapeutic levels.
Once you reach your target dose, the focus shifts to sustaining results, monitoring metabolic markers, and building the lifestyle habits that will support your weight long-term — with or without medication.
Telehealth vs. In-Person: Which Is Right for You?
We offer both, and the right choice depends on your situation. Telehealth works well for initial consultations, follow-up appointments, prescription management, and patients who are further from our clinic. In-person visits are required for the InBody body composition scan and lab draws — and many patients find the in-person experience more motivating for accountability and check-ins.
A common approach for new patients is to start with an in-person visit for the full baseline workup, then transition to a mix of telehealth and in-person follow-ups depending on preference. We'll figure out what works best for you at your first appointment.
Frequently Asked Questions
That's exactly what the first appointment is designed to answer. The short version: tirzepatide tends to produce greater weight loss on average, while semaglutide has a longer track record and broader age approval. Your provider will factor in your health history, goals, and current situation before making a recommendation. You can also read our full comparison post — linked below.
Medically, no — the FDA criteria don't require prior weight loss attempts. Some patients come to us having tried everything else; others are starting here first. Either way, what matters is building the right plan for where you are now, not documenting where you've been.
That varies by patient and by your goals. Some patients use medication for a defined period and then transition off with a structured plan. Others manage it as a long-term therapy. We'll discuss this with you honestly — including what the research shows about weight regain after stopping — so you can make an informed decision about your approach.
That's worth discussing in detail. Poor response to semaglutide doesn't mean tirzepatide won't work — the dual-receptor mechanism is meaningfully different. Side effect issues at one dose often resolve at a lower starting dose or with a slower titration. We'd rather troubleshoot than give up on a medication that might still be right for you.
Ready to Get Started?
Same-week appointments available — in person or via telehealth. Book directly below and our team will confirm your visit within 24 hours.
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This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. Individual results vary. Qualification criteria referenced reflect current FDA labeling — individual eligibility is determined by your provider.
Sources: FDA prescribing information for Wegovy (semaglutide) and Zepbound (tirzepatide); SURMOUNT-1 and STEP 1 clinical trials; InBody body composition analysis methodology; Defiance Health clinical protocols.