Most people expect the first month of medical weight loss to be the big one. It usually isn't, and that's on purpose. Both semaglutide and tirzepatide start at a low dose whose main job is to let your stomach adjust, and your provider raises it gradually from there.
If you start
medical weight loss at Nōvuu Med Spa in early October, your first 12 weeks run through Halloween, Thanksgiving and most of December, so we plan around the calendar before your first injection.
Semaglutide acts on one appetite hormone, GLP-1, and tirzepatide acts on two, GLP-1 and GIP. Both slow how quickly your stomach empties and quiet the signals that keep you thinking about food, so you feel full sooner and snack less between meals. Both are once-weekly injections. Your plan starts with a $100 consultation, and that deposit goes toward your treatment, which you can see alongside our other services on the
Nōvuu pricing page.
How the Dose Builds Over Your First Three Months
The step-up approach is the part that surprises people. You start on a low dose, and your provider increases it gradually, only when you're tolerating the current one well. How fast that happens, and where your dose ends up, depends on your health history, how your body responds and which medication you're on.
That's why your schedule is set at your consultation and adjusted at each check-in. Some people move up steadily, and others hold at one dose longer while side effects settle. We'll also show you exactly how your dose is measured before you take anything home, and many people are still building toward their long-term dose at the three-month mark, which is worth knowing before you step on a scale.
Month One: Your Stomach Is Adjusting
Some people notice their appetite drop within the first few days, and others feel very little at the starting dose. Both are normal.
The most common side effects are nausea, an early sense of fullness, and constipation or diarrhea, and they tend to show up right after a dose increase and ease over the following days. Smaller meals help more than anything else. Stop eating at the first sign of fullness, start each meal with protein, and keep water nearby, because dehydration makes nausea and constipation worse.
Month Two: Fewer Cravings, and Thanksgiving
For many people, the second month brings a first dose increase, and this is when the medication starts to feel noticeable between meals. Cravings get quieter, and portions that used to feel normal start to feel like too much.
If you started the first week of October, Thanksgiving on Thursday, November 26 falls near the end of your second month.
Month Three: Building the Habits That Last
By the third month, the routine usually feels familiar, and you've learned how your body responds when your dose changes. This stretch is where daily habits start to matter as much as the dose.
Protein at every meal and strength training at least two days a week, which matches the
CDC's physical activity guidelines for adults, help you hold on to muscle while the scale moves. December parties start in this window too, and the Thanksgiving rules carry over to every one of them.
Expect steady progress here, with most of the result still ahead. Each dose change is a good time to check in with us about how you're feeling and whether the pace is right for you. Bring your questions, your wins and anything that isn't sitting well, because those check-ins are where your plan in our
medical weight loss program gets fine-tuned.
How to Enjoy Thanksgiving on Medical Weight Loss
Thanksgiving is manageable on these medications, though it takes a different plan than the one you're used to. Because your stomach empties more slowly, a meal that would have felt heavy last year can now leave you nauseated for the rest of the evening. Use a smaller plate, start with turkey and vegetables, and go easy on the fried, rich and buttery dishes, which are the ones most likely to cause trouble. Alcohol tends to hit harder and can add to the nausea, so pace yourself and alternate with water.
The most common mistake is saving up. Skipping breakfast to make room for dinner sounds smart, but on these medications it usually backfires, because you arrive hungry, eat fast and feel sick an hour later. Have a small breakfast with some protein, like eggs or Greek yogurt, and a light lunch if dinner runs late. You'll sit down calm enough to choose the dishes you actually want.
Once you're at the table, slow everything down. Take a few bites of the dishes you look forward to all year instead of a full scoop of everything, and set your fork down between bites while the conversation carries on. Fullness can arrive quickly now, and going past it is what turns a nice dinner into an uncomfortable evening. Give yourself 15 or 20 minutes before deciding on seconds, and most people find the first plate was plenty.
Dessert can stay on the menu. Pick the one pie you'd miss most and have a small slice, ideally after a short break from the main meal. When the leftovers come out, pack them in small containers so tomorrow's lunch is a normal-sized portion. If you're a guest, it's perfectly fine to take a plate home and enjoy it the next day, when you're hungry again and the food tastes just as good.
Family tables come with questions, and you decide how much to share. "I'm full, but everything was wonderful" works with almost every host. If someone keeps offering a second plate, ask for a to-go container and thank them. Your treatment is your own business, and a short, friendly answer ends the conversation faster than a long explanation, which leaves more time for the parts of the day you came for.
After dinner, a 15- to 20-minute walk helps you feel less heavy, and it's an easy way to get a few relatives out of the house for some fresh air. Keep sipping water through the evening, especially if there was wine with dinner. If you're hosting this year, make at least one dish you know sits well with you, so there's always something on the table that works for your plan.
Don't skip or move your injection to make room for a bigger meal. If travel pulls you off your usual injection day, call us before you double up or skip a week, because each medication has its own window for a late dose. And if the holiday weekend left you feeling rough, tell us before your next increase. Your provider may hold your current dose a little longer, which often makes the next step easier.
Ready to Plan Your First 12 Weeks?
October is a good month to start, because your second month lines up with Thanksgiving and your third carries you into the holidays with a plan.
Call (410) 205-6160 or
book your weight loss consultation online, and we'll map your dose schedule against your own calendar.
You can also
contact Nōvuu Med Spa in Pikesville with questions before you book.
Answers about visits, booking and payment are also on our
frequently asked questions page.
