How can you help your patients when they experience weight loss failures with GLP-1s semaglutide and tirzepatide?
While semaglutide and tirzepatide are amazing, weight loss failures can happen. These instances are frustrating for you and your patient. After helping hundreds of pharmacies launch GLP-1 weight loss programs, we have seen weight loss failures of about 10-20%. These weight loss failures can often be overcome with recommendations to the patient.
Let’s run through some common causes of patients failing to lose weight with semaglutide or tirzepatide. Patients can run into barriers with any of the formulations: injectable, sublingual, nasal, troche, or film. While failure rates do seem to be less with injectable versions, they can still happen.
For more information on purchasing ready-made or compounding with tirzepatide or semaglutide, check out our previous article HERE.
What Is The Patient Eating?
This is kind of an obvious question when addressing weight loss struggles, but it is particularly important when addressing GLP-1 failures. Semaglutide and tirzepatide slow gastric emptying, making patients feel fuller longer, but it’s more effective with solid foods. Liquid calories, like those in protein shakes, sugary drinks, or alcohol, bypass this slowing effect and the patient won’t get the feeling of fullness. Encouraging patients to focus on solid foods can enhance the medication’s effectiveness and help them better manage their caloric intake for optimal weight loss results.
A big cause of weight loss failures is the nightly glass of wine. I have had a ton of patients suddenly get success or start losing again when they eliminate alcohol from their diet.
Actionable Tip: Encourage your patients to focus on solid foods and minimize liquid calories. Prioritizing meals that require chewing can enhance their feeling of fullness and support their weight loss journey.
Where Is The Patient Injecting Semaglutide or Tirzepatide?
The injection site can play a role in treatment success. While scientific evidence may not show a significant difference, many patients report better results with certain injection sites. Some prefer the abdomen, while others find the thigh or arm reduces side effects like nausea or causes an increased effectiveness.
If your patient has always used the same injection site, it is probably worth a try to change it. Every person’s body is different, and they may see different results with a different injection site.
Actionable Tip: Suggest that patients try different injection sites to find if a different site works better for them.
How Long Is The Patient Holding Sublingual GLP-1 In Their Mouth?
For your sublingual patients, the length of time they hold the medication in their mouth is of the utmost importance. This time is the most common point of failure for sublingual GLP-1 patients. In my experience, patients start out following the instructions perfectly. Then, as time goes on, they slowly get worse, and the amount of time they hold the medication in their mouth will decrease.
If a sublingual GLP-1 patient swallows their medication without holding it in their mouth for the required 10 minutes, they won’t get the full dose they are supposed to, and of course, they won’t get the results they are looking for either.
Actionable Tip: Always double-check how long your patient is holding the sublingual liquid in their mouth. Ask them how they ensure it is for the full length of time.
Gender Differences and Metabolic History
It’s common to see men achieve faster and more noticeable weight loss results than women. This difference is attributable to their physiology (hello testosterone!) and likely fewer instances of yo-yo dieting. Women often have a long history of trying many diets, which make their metabolism more dysfunctional. Also, many women struggle with hormonal imbalance due to stress, age, or unhealthy diet.
No matter if your patient is a man or a woman, if they are nearing insulin resistance, it will take them longer to lose weight. Metabolic resistance can come from yo-yo dieting, many years of being overweight, or even a genetic predisposition.
Actionable Tip: Set realistic expectations with female patients, particularly those with a history of dieting. Explain that their bodies may take longer to respond and that higher doses or longer treatments may be needed.
Setting Realistic Expectations
Managing expectations is key. As independent pharmacy owners, we understand that patients often start treatment with high hopes for rapid weight loss. However, it’s important to set realistic expectations and be empathetic towards their journey. If these expectations aren’t met, they may become discouraged.
Actionable Tip: Before starting treatment, have a thorough conversation with patients about realistic weight loss expectations. Explain that progress may be gradual and unique to each person, but it’s more sustainable in the long run. Setting these expectations early on can help maintain motivation.
Addressing Psychological Factors
Weight loss isn’t just physical; it’s psychological, too. Many patients struggle with emotional eating, body image issues, and other mental health concerns that can hinder progress. Patients who have struggled with weight loss over a long period may have difficulty learning how to enjoy daily life when it doesn’t revolve around food. GLP-1s often cause the “food noise” to disappear, and that can feel very abnormal to a patient at first.
During counseling, suggest they lean into current hobbies or look for new ones. It is important they learn new habits and enjoy life outside of food. Adopting ways to reduce stress without that glass of wine at night.
Technology Can Lend A Hand
Technology can be a great tool for supporting your patients’ weight loss journeys. It can be hard for your patients to know what is on their plates. Understanding calories, carbohydrates, protein, and fast can be stressful and confusing. Many apps are available that will make it easy for patients to keep a record of what they have eaten. Patients who record their movements and diet are more likely to experience success.
Actionable Tip: Recommend apps that track food intake, physical activity, and progress. These tools can help patients stay accountable and motivated.
Don’t let weight loss failures with GLP-1s be the end of treatment. Many times, just a tweak will get your patients back on the road to success with their semaglutide or tirzepatide treatment.
As independent pharmacy owners, we have the unique opportunity to impact patient health and well-being. By offering personalized care, education, and support, we can help patients reach their weight loss goals and improve their overall quality of life.
Visit our main website HERE for free resources to help you create more freedom and security in your pharmacy.
