Semaglutide and tirzepatide are weekly injectable medications used in medical weight loss programs to help reduce appetite, decrease cravings (“food noise”), and improve metabolic health. Semaglutide is a GLP-1 receptor agonist (brand examples: Wegovy®/Ozempic®). Tirzepatide is a dual GIP + GLP-1 receptor agonist (brand examples: Zepbound®/Mounjaro®). Both can support clinically meaningful fat loss when paired with nutrition and lifestyle changes.
At Steadman Aesthetics, we provide a compounded form of the medication that includes B12 + glycine to support tolerability.

Brand-name medications (Wegovy®/Ozempic®/Zepbound®/Mounjaro®) are FDA-approved products made by the manufacturer with standardized pens and labeling. Compounded semaglutide and compounded tirzepatide are prepared by a compounding pharmacy and are not the brand-name products; formulations and delivery methods can differ.
At Steadman Aesthetics, we provide a compounded form of the medication that includes B12 + glycine to support tolerability. Glycine is an amino acid, and emerging research suggests it may help support muscle protein metabolism and reduce muscle-wasting signals in certain settings—important because some lean-mass loss can occur with rapid weight loss. (Nutrition + resistance training remain the biggest drivers of preserving muscle.)

Both are highly effective, but many patients lose more weight on tirzepatide on average in studies. That said, the best medication is the one you tolerate well and can stay consistent with—because steady adherence plus a high-protein, strength-training-supported plan produces the best long-term results.

Many people notice appetite changes within the first few weeks, but more visible weight loss commonly builds over 8–12+ weeks as doses are increased gradually. Your results depend on dose tolerance, protein intake, movement, sleep, stress, and baseline metabolic health.

The most common side effects are gastrointestinal: nausea, constipation, diarrhea, reflux/heartburn, bloating, decreased appetite, and occasional vomiting—especially when starting or increasing the dose. Side effects often improve as your body adjusts.

These medications aren’t appropriate for everyone. People with a personal/family history of medullary thyroid carcinoma (MTC) or MEN2 typically should not use them. Rare but serious risks can include pancreatitis, gallbladder disease, severe dehydration (especially if vomiting/diarrhea), and allergic reactions. A medical consult is essential to confirm safety for you.

Most nausea improves with:

• Smaller meals and slower eating

• Avoiding greasy/high-fat meals and large portions

• Prioritizing protein first, then produce/fiber as tolerated

• Hydration (plus electrolytes if intake is low)

• Slower dose increases when symptoms linger
  If nausea is persistent or severe, your clinician may adjust your dosing plan.

Constipation is common and usually improves with:

• Consistent hydration

• Gradual fiber increases (not a sudden jump)

• Daily walking or movement

• Adequate protein and balanced meals
  If constipation lasts more than a few days or becomes painful, talk with your clinician about safe, short-term options.

Don’t double-dose. If you miss a dose, the safest next step depends on how long it’s been and when your next scheduled dose is. If you’ve been off for about 2 weeks or more, many patients need a clinician-guided restart (often at a lower dose) to reduce side effects.

Switching should be clinician-guided because there is no validated “equivalent dose” between semaglutide and tirzepatide. A safe transition typically considers your last dose, side effects, and how long you’ve been on treatment—then starts conservatively and titrates based on tolerability.

Most patients do best with a low introductory starting dose and a gradual titration plan—especially if they experienced nausea, constipation, or reflux on semaglutide. The ideal starting dose depends on your prior dose, tolerance, and medical history, so it should be individualized.

Not a reliable one. Because these medications work differently, “conversion charts” can push dosing too fast and increase side effects. A medical plan based on your response and tolerability is safer than any one-size-fits-all conversion.

Plateaus are normal as your body needs fewer calories at a lower weight and your metabolism adapts. Plateaus often improve with higher protein intake, strength training (to preserve lean mass), increased daily movement, better sleep, and addressing stress. Sometimes dose adjustments or a strategy refresh are needed.

Many people regain some weight after stopping because hunger signals can return. Long-term success depends on building sustainable habits during treatment—especially protein targets, consistent movement, and resistance training. Some people also use a maintenance plan rather than stopping abruptly.

Hair shedding can happen during rapid weight loss and is often related to reduced calorie/protein intake or nutrient deficiencies (commonly temporary). Prioritizing protein, avoiding extreme restriction, and preserving muscle with strength training can reduce risk. If shedding is sudden or persistent, ask about labs (iron/ferritin, vitamin D, thyroid, zinc) and nutrition support.

You can, but most people do best with a transition to maintenance rather than stopping suddenly. Obesity is often a chronic condition, and stopping completely can lead to return of hunger and weight regain. A maintenance dose (or a structured step-down plan) helps many patients keep results while continuing healthy habits. Your clinician can tailor a plan based on your weight stability, appetite, side effects, and long-term goals.