EGuide E of 7 Last reviewed: September 2026
What to expect at your first online visit
Whether it is a video call or a written review, the first visit decides whether you are prescribed, what, and at what dose. Walk in prepared.
Two formats
Asynchronous. You complete the intake, the clinician reviews it on their own schedule, and you exchange messages. Fast and convenient. Allowed for weight-management prescribing in many states but not all, and some states require a live encounter first. If the program offers only asynchronous care and your state requires a live visit, the program should tell you that or decline to serve you.
Live video. A scheduled call, usually ten to twenty minutes. Slower to arrange but gives you a chance to ask questions in real time and to judge the clinician. Some programs offer it as an option; some require it.
What you will be asked
Expect the intake and the visit to cover, at minimum: current weight and height; weight history and prior attempts; current medications and supplements; personal and family history of thyroid cancer, pancreatitis, gallbladder disease, kidney disease, and diabetes; history of eating disorders; whether you are pregnant, breastfeeding, or planning pregnancy; alcohol use; and any history of depression or suicidal thoughts. A thorough clinician also asks about your goals and what "success" means to you, because that shapes the plan.
Answer honestly. Leaving out a medication or a condition to get approved is the single most dangerous thing a patient can do in telehealth, because the clinician cannot examine you and is relying on your answers.
What to have ready
- A current list of medications and supplements, with doses.
- Recent labs if you have them, especially A1c, kidney function, and lipids.
- Your weight history: roughly what you weighed at key points over the last few years.
- Any prior experience with a GLP-1 and how you tolerated it.
- Your questions, written down. The visit is short.
Questions to ask the clinician
- Based on my history, am I a good candidate, and what makes you say so?
- Which medication and why? Brand or compounded, and from which pharmacy?
- What is the dose schedule for the first three months?
- Which side effects should I expect, and which should make me contact you immediately?
- How and how quickly can I reach you between visits?
- What are we doing about nutrition and muscle preservation while I lose weight?
- What is the plan for eventually coming off, or staying on, the medication?
Getting the injection right
Most people are nervous about self-injecting the first time and find it easier than expected after the first one. A good program provides written instructions with pictures, a video, and the option to ask a clinician or nurse to watch your first injection over video. Pens are pre-measured and the steps are mainly attaching a needle, dialing or confirming the dose, and holding the pen against the skin for the count the manufacturer specifies. Vials require drawing up a specific volume with a syringe, which is where errors happen; if you are on a vial product, ask for a live walkthrough and repeat your dose in units back to the clinician before you inject. Rotate injection sites, use a fresh needle every time, and dispose of needles in a sharps container, which many programs include.
The first two weeks
The first dose is low by design and many people feel little beyond reduced appetite. Eat smaller meals, prioritize protein, go slowly with high-fat and very sweet foods, and drink more water than usual. Constipation is common; fiber and fluids help, and your clinician can suggest more if needed. Keep the weekly log from the section above. If you feel fine, that is normal, not a sign the dose is too low; the escalation schedule is fixed for a reason. If you feel unwell in ways that concern you, guide F lists what to do.
Answers that should make you pause
"Everyone qualifies." No. There are clear contraindications (guide F), and a clinician who prescribes to everyone is not screening.
"You'll lose X pounds by Y date." Nobody can promise that. Trials report averages with wide ranges.
"We don't need to know your other medications." They do. Interactions and conditions matter, particularly for people on insulin or certain diabetes medications.
"Start at the highest dose so it works faster." Standard practice is to start low and increase gradually. A rushed titration raises the odds of side effects severe enough to make you quit.
"We can't tell you which pharmacy." A legitimate program names its pharmacy.
No mention of follow-up. Dose changes, side-effect management, and refills all depend on check-ins. If the visit ends with "you're all set" and no next step, the program is treating you as a subscription.
What a good first visit feels like
You are asked more questions than you expected. The clinician explains why they are recommending what they recommend, in plain language, and is comfortable saying "let's start lower" or "let's get labs first." You leave knowing the medication, the dose schedule, the pharmacy, how to inject (with a demonstration or a clear video), what to eat during the first weeks, and exactly how to reach someone if you feel unwell. If any of those are missing, ask before you pay.
If you are declined
Programs decline people for good reasons: a contraindication, a BMI below the labeled threshold, a medication interaction, a pregnancy plan, or an answer that needs in-person evaluation. Being declined by a careful program is information, not an insult. Ask what the concern was, and take that to an in-person doctor. Do not go program-shopping for one that says yes; the one that says yes without addressing the concern is the one to worry about.
After the visit
Save the visit summary or messages. Note the date you started, the dose, and the schedule for increases. Keep a simple log of how you feel each week, including any nausea, constipation, or appetite changes, because your check-ins will go faster and your clinician will make better decisions with real notes than with memory. This log is also what you bring to your regular doctor, who should know you are on this medication.
Tell your regular doctor. Telehealth programs work best as an addition to your existing care, not a replacement. Your primary care physician should know what you are taking and be able to see your labs.