Questions to Ask Your Doctor About GLP-1 Medication Before Starting

A good question list for a GLP-1 appointment covers whether the drug is approved for your reason for taking it, how your eligibility will be measured, safety screening before the first dose, interactions with your other medications, pregnancy and birth control, surgery and anesthesia, dosing and follow-up, and cost. The questions below come from the FDA prescribing information for Zepbound, Wegovy, Foundayo, and Ozempic ^[1][2][3][7], an FDA patient information page on unapproved (“off-label”) drug use ^[4], and the American Diabetes Association’s Standards of Care in Diabetes–2026 ^[5][6].

The FDA notes that a drug’s approved labeling tells providers how to use it safely, lists the diseases it is approved to treat, describes its risks, and spells out what providers should discuss with patients before they take it ^[4]. Some drugs also carry patient-facing labeling such as Medication Guides, Patient Package Inserts, and Instructions for Use ^[4]. One simple question for your visit: “Can I get the patient labeling for this drug?”

Is this drug approved for my reason for taking it?

This is the first question to ask, because the GLP-1 products are approved for different reasons. Zepbound (tirzepatide) is approved, along with a reduced-calorie diet and more physical activity, to reduce excess body weight and keep it off long term in adults with obesity, or adults with overweight plus at least one weight-related comorbid condition, and to treat moderate to severe obstructive sleep apnea in adults with obesity ^[1]. Wegovy injection is approved to reduce the risk of major adverse cardiovascular events in adults with established cardiovascular disease and either obesity or overweight; to reduce excess body weight in adults and patients aged 12 and older with obesity, and in adults with overweight plus at least one comorbid condition; and to treat noncirrhotic MASH with F2 to F3 fibrosis under accelerated approval ^[2]. Wegovy tablets carry the cardiovascular risk reduction and adult weight reduction indications ^[2]. Foundayo (orforglipron) tablets, first approved in the United States in 2026, are approved for weight reduction and long-term maintenance in adults with obesity or overweight plus at least one comorbid condition ^[3].

Ozempic (semaglutide) is different. It is approved to improve glycemic control in adults with type 2 diabetes, to reduce major cardiovascular events in adults with type 2 diabetes and established cardiovascular disease, and to reduce sustained eGFR decline, end-stage kidney disease, and cardiovascular death in adults with type 2 diabetes and chronic kidney disease ^[7]. It carries no weight loss indication ^[7].

All three weight products are labeled for use “in combination with a reduced-calorie diet and increased physical activity” ^[1][2][3], so it is fair to ask what diet and activity support comes with the prescription. Also ask about the labeled limitation: concomitant use with another GLP-1 receptor agonist is not recommended for Zepbound, Wegovy, and Foundayo ^[1][2][3].

If a prescription is for an unapproved use, the FDA calls that “off-label” — meaning the drug is used for a condition it is not approved to treat, given in a different way, or given at a different dose ^[4]. Providers generally may prescribe off-label when they judge it medically appropriate, but the FDA has not determined the drug is safe and effective for that use ^[4]. The FDA suggests asking: What is the drug approved for? Are there other approved therapies for my condition? What studies support this use? Is it likely to work better than an approved treatment? What are the benefits and risks? Will my insurance cover it? Are there clinical trials I could join? ^[4]

How will my eligibility be measured and documented?

Ask how your doctor is documenting that you qualify. BMI categories are overweight 25–29.9, obesity class 1 30–34.9, class 2 35–39.9, and class 3 at or above 40 kg/m² ^[5]. The ADA recommends screening with BMI annually and confirming excess adiposity with anthropometric measures such as waist-to-hip ratio, or direct measures such as DXA or bioelectrical impedance, where available ^[5]. Confirmation with at least one anthropometric criterion — waist circumference, waist-to-hip, or waist-to-height ratio — is recommended especially for people with BMI 25–34.9 and for South Asian individuals ^[5].

This matters because BMI can misclassify people who are very muscular or who have low muscle mass ^[5]. If you fall into either group, ask whether an additional measurement will be used.

It is also worth asking how the choice of treatment was made. The ADA recommends individualizing the initial approach — lifestyle and nutrition therapy, medication, or metabolic surgery, or a combination — based on medical history, life circumstances, and preferences ^[5]. In people with type 2 diabetes and overweight or obesity, the ADA treats weight management as a primary treatment goal alongside blood sugar control ^[5].

What safety screening should happen before my first dose?

Every one of these products carries a boxed warning about the risk of thyroid C-cell tumors and is contraindicated in people with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 ^[1][2][3][7]. Ask whether your family history rules the drug out. The Zepbound label lists thyroid tumor symptoms to watch for: a mass in the neck, trouble swallowing, trouble breathing, and persistent hoarseness ^[1]. The label also states that routine calcitonin monitoring or thyroid ultrasound is of uncertain value for detecting MTC in treated patients ^[1].

Other screening questions to raise:

• Hypersensitivity is a contraindication across the products, though the wording differs: the Zepbound and Foundayo labels list known serious hypersensitivity to the active drug or its excipients ^[1][3], the Ozempic label lists a serious hypersensitivity reaction to semaglutide or any of its excipients ^[7], and the Wegovy label lists known hypersensitivity to semaglutide or any of its excipients ^[2]. Ask about any past reactions to similar drugs.
• Zepbound, Foundayo, and Ozempic are not recommended in people with severe gastroparesis ^[1][3][7].
• The labels warn about acute pancreatitis (with instructions to discontinue if it is suspected), acute gallbladder disease, acute kidney injury from volume depletion, and serious hypersensitivity reactions including anaphylaxis and angioedema ^[1][3][7].
• The Zepbound and Foundayo labels direct monitoring for progression of diabetic retinopathy in patients with type 2 diabetes who have a history of the disease ^[1][3]; the Ozempic label says patients with a history of diabetic retinopathy should be monitored ^[7].
• Foundayo is not recommended in severe hepatic impairment ^[3].
• Ask about pen sharing: a Zepbound KwikPen, Wegovy FlexTouch pen, or Ozempic pen should never be shared between patients, even with a new needle ^[1][2][7].

One label change worth asking about: the suicidal behavior and ideation warning was removed from the Zepbound and Wegovy labels in February 2026 ^[1][2].

How will this drug interact with my other medications?

Bring a complete list of everything you take. The Zepbound and Foundayo labels state that the drugs delay gastric emptying and have the potential to affect the absorption of other oral medications ^[1][3]; the Ozempic label states the same and adds the instruction to use oral medications with caution ^[7]. Ask whether any of your pills need timing changes or monitoring.

Foundayo has specific labeled interactions worth asking about if you take common drugs: the maximum Foundayo dose is 9 mg once daily with a strong CYP3A4 inhibitor; strong CYP3A4 inhibitors that also inhibit OATP1B should be avoided; strong CYP3A4 inducers should be avoided, and effectiveness should be monitored with moderate inducers; and simvastatin should not exceed 20 mg once daily when taken with Foundayo ^[3].

If you take insulin or an insulin secretagogue, ask about hypoglycemia. Concomitant use raises the risk, including severe hypoglycemia, and reducing the dose of the insulin or secretagogue may be necessary ^[1][3][7]. For Wegovy, the label says patients with diabetes should have blood glucose monitored before starting and during treatment ^[2].

What should I ask about pregnancy and birth control?

If pregnancy is a possibility, ask about timing. Zepbound and Foundayo may cause fetal harm, and the labels say to discontinue when pregnancy is recognized ^[1][3]. Zepbound’s label advises oral contraceptive users to switch to a non-oral method or add a barrier method for 4 weeks after starting and for 4 weeks after each dose increase ^[1]. Foundayo’s label gives the same advice but with a 30-day window after initiation and after each dose escalation ^[3].

For Ozempic, the label says to discontinue in women at least 2 months before a planned pregnancy because of semaglutide’s long washout period ^[7]. Ask your doctor how the label for your specific product applies to your plans.

What about surgery, anesthesia, and side effects to watch?

Tell every provider about planned surgeries or procedures. Pulmonary aspiration has been reported during general anesthesia or deep sedation in people receiving GLP-1 receptor agonists undergoing elective procedures, and the Zepbound, Foundayo, and Ozempic labels instruct patients to inform their providers about planned surgeries ^[1][3][7]. Ask your prescriber what to do before an upcoming procedure.

Ask which side effects are common and which warrant a call. The most common reactions reported in at least 5% of Zepbound patients are nausea, diarrhea, vomiting, constipation, abdominal pain, dyspepsia, injection site reactions, fatigue, hypersensitivity reactions, eructation, hair loss, and gastroesophageal reflux disease ^[1]. For Foundayo, the list is nausea, constipation, diarrhea, vomiting, dyspepsia, abdominal pain, headache, abdominal distension, fatigue, eructation, GERD, flatulence, and hair loss ^[3]. For Ozempic, it is nausea, vomiting, diarrhea, abdominal pain, and constipation ^[7]. Ask what to do if vomiting or diarrhea leads to dehydration, since the labels say to monitor renal function in patients reporting reactions that could lead to volume depletion ^[1][3][7].

You can also ask how to report a suspected reaction: Eli Lilly at 1-800-545-5979, Novo Nordisk at 1-888-693-6742, or the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch ^[1][3][7].

How does dosing and titration work for my product?

Ask for the full titration schedule in writing, because every product ramps up differently:

Product	Starting dose	How it increases	Usual maintenance	Maximum
Zepbound (weekly injection)	2.5 mg once weekly for 4 weeks [1]	2.5 mg increments after at least 4 weeks [1]	5, 10, or 15 mg weekly; 10 or 15 mg for OSA [1]	15 mg once weekly [1]
Wegovy injection (weekly)	0.25 mg once weekly for 4 weeks [2]	Titration every 4 weeks [2]	2.4 mg once weekly (varies by indication) [2]	—
Wegovy tablets (daily)	1.5 mg once daily for 30 days [2]	Titration every 30 days [2]	25 mg once daily [2]	—
Foundayo tablets (daily)	0.8 mg once daily [3]	2.5 mg after at least 30 days, then 5.5 mg after at least 30 days; optional steps to 9, 14.5, or 17.2 mg [3]	Based on response and tolerability [3]	17.2 mg once daily, one tablet per day [3]
Ozempic (weekly injection)	0.25 mg once weekly, then 0.5 mg after 4 weeks [7]	1 mg, then 2 mg, after at least 4 weeks on each, if additional glycemic control is needed [7]	Depends on glycemic control needed [7]	—

The label excerpts reviewed here state a maximum only for Zepbound and Foundayo. For the other three products, the highest steps shown are the 2.4 mg usual weekly maintenance dose for Wegovy injection, the 25 mg daily tablet dose for Wegovy tablets, and the 2 mg weekly escalation step for Ozempic — so ask your prescriber what maintenance dosing applies to your indication.

The Wegovy injection label lists available strengths of 0.25, 0.5, 1, 1.7, and 2.4 mg, plus a 7.2 mg Wegovy HD single-dose pen ^[2] — those are dosage forms, not a stated maximum.

For Zepbound, the label says to consider treatment response and tolerability when selecting the maintenance dose ^[1] — so ask how your doctor will decide whether to go up, stay put, or stop. For Foundayo, escalation beyond 5.5 mg is optional and based on response and tolerability ^[3].

Ask about missed doses too. The label excerpts reviewed here include a missed-dose window only for Ozempic: administer within 5 days of the missed dose ^[7]. For the other products, ask your doctor or pharmacist for the rule that applies to your product before you start rather than guessing.

For the injectables, ask about technique: Wegovy is injected under the skin in the abdomen, thigh, or upper arm, once weekly on the same day each week, at any time of day, with or without meals ^[2]. Ozempic is also injected under the skin in the abdomen, thigh, or upper arm, once weekly at any time of day, with or without meals ^[7]. Wegovy tablets have strict rules: take once daily on an empty stomach in the morning with water only (up to 4 ounces), swallow whole without splitting, crushing, chewing, or dissolving, and wait at least 30 minutes before food, other drinks, or other oral medications ^[2]. Foundayo tablets are taken once daily with or without food, swallowed whole, not broken, crushed, or chewed, with no more than one tablet per day ^[3].

What follow-up schedule and long-term plan should I ask about?

Ask when the next visit is and what will be measured. The ADA recommends monitoring obesity-related anthropometric measurements at least annually, and at least every 3 months during active weight management treatment ^[5].

Ask what counts as success. The ADA recommends aiming for any magnitude of weight loss, noting that 5–7% of baseline weight improves glycemia and intermediate cardiovascular risk factors, and that sustained loss of more than 10% usually confers greater benefits, including disease-modifying effects and possible remission of type 2 diabetes ^[5]. In type 2 diabetes, modest weight loss reduces the need for glucose-lowering medications, particularly insulin ^[5]. If medication is not enough, it is fair to ask about other options: metabolic surgery averages more than 20% body weight loss with glycemic improvement and often remission of diabetes ^[5].

What cost and coverage questions are worth raising?

The FDA specifically lists “Will my health insurance cover treatment of my disease or medical condition with this drug?” as a question to ask when a drug is being used off-label ^[4] — but coverage is worth asking about either way. One practical question: what will the drug cost at your likely maintenance dose, not just the starting dose? No specific prices or coverage figures are stated in the labeling or patient information reviewed here, so the numbers have to come from your plan and pharmacy.

What should a good appointment feel like?

The ADA says care should use person-centered, nonjudgmental, person-first language — “person with obesity” rather than “obese person” ^[5] — and that accommodations should provide privacy during body measurements ^[5]. Treatment goals should be cocreated by the care team and the person receiving care, based on individual preferences and values, in a shared decision cycle ^[5][6].

Ask who else can be involved. The ADA notes an interprofessional team may include diabetes care and education specialists, registered dietitian nutritionists, exercise specialists, pharmacists, and behavioral health professionals ^[6]. And communication should account for literacy, numeracy, and barriers to care ^[6] — so if something is unclear, asking for it in plainer terms is part of the standard, not an interruption.

Sources

1. Eli Lilly and Company. ZEPBOUND (tirzepatide) injection, for subcutaneous use. Prescribing information.
2. DailyMed. WEGOVY- semaglutide injection, solution; semaglutide tablet.
3. DailyMed. FOUNDAYO- orforglipron tablet, film coated.
4. US Food and Drug Administration. Understanding unapproved use of approved drugs “off label”.
5. PMC. Obesity and weight management for the prevention and treatment of diabetes: Standards of Care in Diabetes-2026.
6. PMC. Comprehensive medical evaluation and assessment of comorbidities: Standards of Care in Diabetes-2026.
7. DailyMed. OZEMPIC- semaglutide injection, solution.
8. Business Group on Health. GLP-1 costs loom large for employers, forcing challenging coverage decisions, survey finds.
9. PMC. Obesity management in primary care: A joint clinical perspective and expert review from the Obesity Medicine Association and the American College of Osteopathic Family Physicians. 2025.
10. HealthCare.gov. Appealing a health plan decision: Internal appeals.
11. Medicare. Weight loss drugs.