What to Track in Your First Month on a GLP-1

The pen is in the fridge, the first dose is done, and the box says to come back in four weeks for the next step. Four weeks is long enough to forget most of what happened in them — and short enough that what happened in them really matters.

The first month on semaglutide (Ozempic, Wegovy) or tirzepatide (Mounjaro, Zepbound) is mostly the starting dose. The labels describe it as a dose for getting your body used to the medication rather than for the full effect. Which makes it the best month to learn how you respond, before anything changes.

Here's what we'd write down, and why each one earns its place.

Did every dose happen on time?

Date, time, dose and — for injections — the site. It's dull, and it's the entry you'll lean on most. It answers the questions that come up in week six: Did I miss one? When exactly did I start? Have I been using the same spot?

When did the side effects show up — and when did they leave?

Nausea, constipation, diarrhea and tiredness are common early. The useful part isn't the symptom, it's the timing: how many hours or days after the dose it started, and how long it stayed. After four weeks, that usually settles into a shape — "day one and two after the shot, then fine" — that you can plan around and describe clearly.

Were you eating enough of the right things?

When appetite drops, protein, fiber and water are the first to slip. A 2025 joint advisory from four obesity and nutrition societies lists adequate protein (paired with strength training), fiber and hydration among the core nutritional priorities during GLP-1 therapy.

No need for a food diary. "Some protein at each meal — yes or no?" and "did I drink enough?" already tell you most of what you need.

What is your weight doing — over weeks, not days?

Weight swings with water, salt and digestion, more so when your eating pattern is shifting. Weigh at the same time of day a few times a week and look at the line, not the morning.

How did the days feel?

One word is plenty: steady, flat, queasy, good. Numbers miss things that a word catches — and over a month you'll see whether your good and hard days follow your dosing rhythm.

What we'd track

Here's the whole first-month list in one place:

1. Each dose — date, strength, site.
2. Each symptom — what, how strong, how long after the dose.
3. Protein and fluids — roughly, every day.
4. Weight — a few mornings a week.
5. A word for the day.

Before your first dose step, look back over it: did side effects ease as the month went on? Were most days covered for protein? Is the trend moving the way you and your prescriber expected? Take that summary to your appointment — it makes "how's it going?" an easy question.

Keep your first-month log in Holt