Guide//5 min
Coffee on a GLP-1
Nobody is going to tell you to give up coffee, and nobody should. But it interacts with three things this drug class has already made more fragile, and the interactions are all avoidable.
Medications
Wegovy
Semaglutide at weight-management doses.
27 pieces
Guide//6 min
Dehydration and your kidneys
Acute kidney injury on this drug class is almost never a direct drug effect. It is three days of vomiting in someone who did not think to replace the fluid, and it is entirely avoidable.
Explainer//5 min
Gallstones on a GLP-1
Rapid weight loss has caused gallstones for as long as people have lost weight rapidly. What these drugs added was the speed, the scale, and a great many people discovering it at once.
Explainer//5 min
GLP-1s through menopause
The weight that appears in the forties and fifties is not a failure of discipline. It is a redistribution driven by falling oestrogen, and it responds to a different set of interventions than the ones that worked at thirty.
Explainer//6 min
GLP-1s and your period
Periods returning, periods changing character, periods arriving on a schedule for the first time in years. It is one of the most commonly reported effects in this drug class and one of the least documented.
Guide//6 min
GLP-1 dose charts, side by side
Four drugs, four different ladders, and a great deal of confusion about which rung anyone is standing on. Here is every approved escalation schedule in one place, with the reasoning behind the steps.
Explainer//5 min
GLP-1s and PCOS
These drugs address the insulin resistance sitting underneath polycystic ovary syndrome, which is why they work. Restoring ovulation in women who believed they could not conceive is the part nobody prepares for.
Explainer//6 min
GLP-1s for teenagers
Wegovy has been licensed for twelve-year-olds since 2022 and the trial data is strong. The disagreement is not really about whether the drug works, which is why it has not resolved.
Deep Dive//5 min
The GLP-1 heart benefit
SELECT enrolled seventeen thousand people with heart disease and no diabetes, and found a twenty percent reduction in cardiovascular events. The label change that followed did more for access than any argument about obesity ever has.
Explainer//6 min
Mood on a GLP-1
Regulators on two continents investigated whether these drugs cause suicidal thoughts and concluded they do not. That finding settles a narrow question and leaves a much larger one open.
Guide//6 min
Ozempic alternatives, compared
There are more approved weight-loss drugs than most people realise, and they are not close to each other in effect. Knowing the order matters, because plenty of plans will only cover the bottom of it.
Explainer//6 min
Ozempic face, explained
It is not a drug side effect. It is the face doing what the face has always done during rapid weight loss, in front of an audience that has never watched it happen this fast or this often.
Guide//6 min
Ozempic side effects, ranked
Most side-effect lists are alphabetical, which tells you nothing about what will happen to you. This one is ordered by frequency, with the trial numbers attached and the rare ones kept in proportion.
Guide//6 min
Reflux on a GLP-1
A stomach that empties slowly is a stomach that stays full longer, and a full stomach lying flat has only one direction to go. Most of the fix is mechanical rather than pharmacological.
Explainer//5 min
Semaglutide, explained
Ozempic, Wegovy and Rybelsus contain the same active ingredient. Almost every argument about which one you should be on is an argument about indications and insurance rather than about chemistry.
Guide//6 min
Why weight loss stalls
Every weight loss curve flattens. The trial curves flatten, the surgical curves flatten, and yours will too. The question is whether you have hit a plateau or simply had a fortnight.
Guide//6 min
Do you qualify for a GLP-1?
Clinical eligibility is a short, public, unambiguous rule. Whether anyone will pay for it is a completely separate question, and conflating the two is why so many people believe they were turned down for being too healthy.
Guide//2 min
Best supplements on semaglutide
Semaglutide's signature is gastrointestinal. Nausea, reflux and constipation shape what you can physically swallow, which makes tolerability the first ranking criterion rather than an afterthought.
News//3 min
The head-to-head trial, and what it settles
For three years the comparison between semaglutide and tirzepatide was made by holding two separate trials side by side, which is not a comparison. A direct trial changed that — and the result matters less to your decision than you would think.
Explainer//5 min
Ozempic or Wegovy: why you got the one you got
Ozempic and Wegovy contain the same drug. Which one lands in your hand is decided almost entirely by your insurance plan and your diagnosis code — not by your body.
News//3 min
Semaglutide, MASH, and a new coverage route
Fatty liver disease is common, largely undiagnosed, and now has a GLP-1 approved to treat it. For patients whose plans exclude weight-loss drugs, that is not a footnote — it is a different prescription.
Guide//5 min
How long Wegovy takes to work
Appetite usually changes in the first week. The scale takes considerably longer, and almost everything people believe about the timeline comes from watching someone else's month one.
News//3 min
The semaglutide pill arrives
An oral GLP-1 for obesity removes the needle, the fridge and a good deal of the friction. It also comes with rules about how you take it that people underestimate badly.
Explainer//5 min
The hair loss question
Hair shedding after starting a GLP-1 is real, common enough to be worth naming, and in most cases caused by the speed of the weight loss rather than the drug producing it.
Explainer//5 min
Semaglutide and the eye question
A 2024 study reported a higher rate of a rare optic nerve condition in semaglutide patients. Here is how to read a finding like that without either dismissing it or panicking.
Guide//6 min
Winning a prior authorization appeal
Most denials are not clinical judgments. They are documentation failures, and documentation failures are the kind you can fix — if you know what the reviewer on the other end is actually reading.
Explainer//3 min
Semaglutide or tirzepatide
One is a GLP-1 agonist. The other adds GIP. The trial data favor one of them on weight — which is not the same as saying it is the right one for you.
Also in Medications
On The Jab
The
GLP‑1
Handbook
Dr. Nick Robertson
MD
The book · 14 chapters
The GLP-1 Handbook
Everything I tell my own patients before their first injection. 214 pages of what actually matters in the first year — dosing, side effects, food, muscle, cost, and the part nobody prepares you for: maintenance.
$4Less than your morning coffee.
Priced at four dollars because it should be affordable to everyone taking these drugs — not because it's worth four dollars. No upsell, no course, no supplement line.