9 months on Wegovy: what nobody told me before I started

I started Wegovy at 218 lbs in August 2025. My A1C was creeping up — 5.9 — and my primary care doc had been suggesting GLP-1 medications for almost a year. I kept putting it off because I was scared of the side effects I had read about online.

Week one was rough. Not "I am going to quit" rough, but the kind of nausea where you suddenly feel like you have eaten a brick after two bites of dinner. The thing nobody warned me clearly enough about: the nausea is not just nausea. It is your body telling you fullness arrives 70% sooner than it used to. If you fight that signal, you vomit. If you respect it, the nausea fades.

The titration helped. We went 0.25 mg for four weeks, then 0.5 mg, then 1.0 mg. Each step brought one rough week, then a steady week. By month three I was on 1.7 mg and the side effects had mostly settled — occasional constipation, mild fatigue if I forgot to eat enough protein.

My weight loss surprised me with how non-linear it is. The first three weeks I dropped 8 lbs (water + appetite drop). Then four weeks of nothing. Then another 6 lbs in two weeks. The plateaus are real and they are normal. Reading the trial data from STEP-1 helped — average loss is 15% body weight at week 68, but with huge variance.

Things I changed: I ate 0.8 grams of protein per pound of goal body weight, walked 25 minutes daily, and stopped weighing myself more than once a week (the daily fluctuations were messing with my head). I also bought a Frio cooling wallet for travel — Wegovy needs refrigeration and TSA does not mind it in carry-on with the pen.

Nine months in: 42 lbs down, blood pressure normal off medication, A1C at 5.4. I still get mild nausea when I push past fullness on holidays. I have not figured out yet whether I taper off or stay on long-term. That is the conversation with my prescriber this month.