GLP-1 therapy has become one of the most widely discussed topics in modern medicine. Who is it really for? How do doctors choose the right medication? Why do results vary from patient to patient, and what happens after treatment ends? We spoke with Yuliia Kovalenko, founder of VONA Beauty Center, about these questions.

Who is GLP-1 therapy really for? Should someone consider it if they only need to lose 5–7 kg, and what tests should be done before starting treatment?

GLP-1 therapy is not a “magic wand” for rapid weight loss. Simply wanting to lose 5–7 kg is not, in itself, an indication for treatment. We assess whether a patient has overweight or obesity and the associated health risks, including metabolic disorders, prediabetes, hypertension, and other conditions.

A doctor considers BMI, waist circumference, blood pressure, glucose and HbA1c levels, lipid profile, and liver, kidney, and thyroid function. Testing is determined individually. The traditional threshold for prescribing medications approved to treat obesity is a BMI of ≥30 kg/m², or ≥27 kg/m² in patients with weight-related conditions or complications.

Semaglutide, tirzepatide, and new molecules: How does a doctor choose a medication, and why might two patients at the same weight receive different treatments?

Our principle is to treat the person, taking into account their metabolic profile, eating behavior, and underlying health conditions. That is why patients at the same weight may receive different recommendations.

Semaglutide targets GLP-1 receptors, while tirzepatide targets both GIP and GLP-1 receptors. Both are effective for weight loss, but individual responses vary. The choice depends on factors such as diabetes or prediabetes, glycemic levels, treatment tolerability, and the desired outcome. The physician’s goal is to find the right balance between efficacy and safety.

Why does one person lose 20 kg while another barely responds to treatment? What should you do if weight loss stalls?

GLP-1 medications do not work the same way for everyone. Outcomes are influenced by starting weight, diabetes status, diet, physical activity, sleep, stress, underlying health conditions, and individual response to therapy. That is why treatment success is assessed not only by pounds lost, but also by metabolic markers.

If weight loss stalls, patients should not increase the dose on their own. Plateaus are a normal part of the process. A doctor will assess diet, physical activity, sleep, and underlying health conditions before deciding whether to adjust the dose or change the treatment. The highest dose is not always the optimal one: the goal is sustainable results without compromising overall health or muscle mass.

What side effects actually occur with GLP-1 medications, who should not use this therapy, and why is it dangerous to increase the dose on your own?

The most common side effects include nausea, a feeling of fullness in the stomach, vomiting, diarrhea, constipation, and reflux. They are typically most pronounced when treatment begins or the dose is increased, which is why these medications are titrated gradually. Increasing the dose without medical supervision raises the risk of side effects and does not guarantee better results.

GLP-1 therapy has contraindications and limitations, including severe gastroparesis. Semaglutide and tirzepatide also carry specific warnings related to a personal or family history of medullary thyroid carcinoma and MEN2. Medications used to treat obesity are also not used during pregnancy.

Severe side effects are not a sign that a medication is more effective. The optimal therapy should be effective, safe, and well tolerated.

Will you need to stay on the medication for life? What happens to your weight after stopping it, and can you become dependent on it?

Obesity is a chronic disease, so for some patients, GLP-1 therapy may be long-term. Once a patient reaches their target weight, the doctor may reassess the treatment plan and determine a strategy for maintaining the results.

After stopping the medication, appetite may increase and some of the lost weight may return. This is not dependence in the traditional sense. That is why it is important to develop a long-term weight-management strategy during treatment, including nutrition, physical activity, sleep, and healthier eating behaviors.