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Guide 8 of 9 · Stage: Live with it

Life on a GLP-1: eating, exercise and injections

Day-to-day life on semaglutide or tirzepatide in the US: protein, muscle, Thanksgiving and Ramadan, missed doses, storing pens in the heat, flying, and getting rid of needles safely.

The short answer

Life on a GLP‑1 means eating less, but eating well. Get protein at every meal, eat small portions slowly, drink enough and do strength exercise to keep muscle. Inject on the same day each week, keep pens in the fridge until you start them, and put used needles and pens in a sharps container. Expect regular check-ins with your prescriber. Talk to your doctor before starting, stopping or changing a dose.

Key facts

Protein
1.2–1.6 g per kg (about 0.55–0.73 g per lb) a day has been proposed during weight loss, or a flat 80–120 g a day1
Exercise
Strength training at least 3 times a week, plus 150 minutes of brisk activity1
Missed weekly dose
Wegovy: take it if the next dose is more than 2 days away. Zepbound: within 4 days. Never take two doses together.3,4
Storage
Fridge (36–46°F, 2–8°C) before first use. Never freeze. Never above 86°F (30°C).3,4
Needles
Into an FDA-cleared sharps container right away, never the household trash. Rules for getting rid of it vary by state3,9
Review
No fixed cut-off on the Wegovy or Zepbound labels; Saxenda's label uses 4% at 16 weeks3,4,8
On this page
  1. What should I eat on a GLP‑1?
  2. How do I keep my muscle?
  3. What about Thanksgiving, Ramadan and other fasts?
  4. How do I inject, and what if I miss a dose?
  5. How do I store it, and travel with it?
  6. How do I know if it's working?
  7. What should I keep track of?
  8. What about food noise and family meals?
  9. Questions people ask

What should I eat on a GLP-1?

Smaller meals with protein first. You will eat less, so each bite needs to count for protein, fiber and fluids.

A 2025 advisory from four US nutrition and obesity groups proposes 1.2–1.6 g of protein per kg of body weight a day during weight loss.1 The everyday minimum for adults is 0.8 g per kg.1

For a 200 lb (91 kg) person, that works out to about 109–145 g a day.1 But using your full body weight can overestimate what you need.1 So the same advisory offers a simpler goal: 80–120 g a day.1 It also warns against staying at 2 g per kg or more for long.1 If you have kidney disease, ask your doctor before eating more protein.

Eating the protein part of your plate first helps you finish it before you feel full.1 The advisory favors beans and lentils, dairy, fish, eggs and chicken. It suggests keeping red and processed meat low.1

Protein in everyday US foods

We worked out each serving from the USDA's FoodData Central (its standard reference foods).2 Each line says whether the food is weighed raw, cooked or from a can.

Beans, lentils and soy
  • Lentils½ cup (99 g), cooked9 g
  • Chickpeas½ cup (120 g), canned, drained8 g
  • Black beans½ cup (86 g), cooked8 g
  • Edamame½ cup (75 g), frozen, prepared9 g
  • Tofu, firm3 oz (85 g)15 g
  • Peanut butter2 tbsp (32 g)7 g
Dairy and eggs
  • Greek yogurt, plain nonfat¾ cup (170 g)17 g
  • Cottage cheese, 2%½ cup (113 g)12 g
  • Cheddar1 oz (28 g)6 g
  • Milk, 1%1 cup (244 g)8 g
  • Egg, hard-boiled1 large (50 g)6 g
Meat and fish
  • Chicken breast3 oz (85 g), roasted26 g
  • Tuna, light3 oz (85 g), canned in water, drained17 g
  • Ground beef, 85% lean4 oz (113 g), raw21 g
  • Ground turkey4 oz (113 g), raw22 g
  • Salmon, farmed4 oz (113 g), raw23 g

Source: USDA FoodData Central, SR Legacy, protein per 100 g, multiplied up to each serving and rounded to whole grams.2

A worked example: 3 oz of roasted chicken breast, ¾ cup of plain nonfat Greek yogurt and ½ cup of black beans add up to about 51 g of protein.2 That is well over half of the 80 g goal.

Smaller meals, fiber and fluids

  • Small meals. Vomiting is more likely after a large meal.1
  • If you feel sick: try a small breakfast, then small meals every 3–4 hours.1
  • Fiber, slowly. Go easy on high-fiber food in the first few days. After that, add fiber gradually to prevent constipation.1
  • Fluids. Losing fluids through vomiting or diarrhea can harm your kidneys.1,3 The advisory says to drink enough fluids.1 For alcohol, see Questions people ask.

How do I keep my muscle?

Do strength exercise at least 3 times a week, and eat enough protein. Walking alone protects less muscle than walking plus strength training.1

Not all the weight you lose is fat. In one semaglutide trial, of every 10 lb lost, about 4 lb was "lean mass": muscle and other non-fat tissue. About 2 lb of that was muscle.1

What every 10 lb (4.5 kg) lost was made of, on average1
~6 lb~2 lb~2 lb
FatMuscleOther lean mass: water, organs

The 2025 advisory suggests strength training at least 3 times a week, plus at least 150 minutes of moderate activity, like brisk walking.1 The plan should match your fitness level.1

Mon
InjectionWalk 30 min
Tue
Strength
Wed
Walk 30 min
Thu
StrengthWalk 30 min
Fri
Walk 30 min
Sat
StrengthWalk 30 min
Sun
RestWeigh in

One example week, not a prescription: 3 strength days and 150 minutes of walking, as in the 2025 advisory.1 Pick one injection day you'll remember, and use the same day each week.3

What about Thanksgiving, Ramadan and other fasts?

Big meals make vomiting more likely, so take small plates and stop early.1 Fasting needs a plan, especially if you take insulin or a sulfonylurea (an older type of diabetes pill).3,10

Thanksgiving, holidays, game days and parties

Thanksgiving dinner, holiday parties, tailgates, weddings, Eid and other feast days all follow the same rules:1

  • Small portions, eaten slowly, with the protein first.1
  • Fewer rich, fried and sweet dishes.1
  • Keep alcohol to a minimum.1
  • You don't have to finish what you're served, or have a second helping to be polite.

If your injection day lands on a big day and you'd rather move it, you can: the Zepbound label allows a new day as long as there are at least 3 days between two doses, and the Ozempic label at least 2 days.4,5

Ramadan

The main international guidance is the 2021 Ramadan guidelines from the International Diabetes Federation and the Diabetes and Ramadan International Alliance (IDF-DAR).10,11

  • GLP‑1 medicines can be used while fasting, if taken on schedule with a doctor's oversight.10,11 Don't stop without medical advice.10
  • Finish dose increases first. Pharmacy advice published in the UK in 2026 suggests completing them at least 4 to 6 weeks before a planned fast, and putting off the next increase if the fast starts soon.12
  • Weekly injections stay on the same day each week. Some people inject after iftar to limit nausea, others after suhoor to stay full through the day.12
  • The Wegovy pill needs an empty stomach and a 30-minute wait before eating, so it fits best on waking for suhoor.3,12
  • Watch for constipation and dehydration. Fasting raises the risk of these. Fill the eating window with whole grains, beans and lentils, fruit, vegetables and enough fluids.12
  • The research is mostly on older GLP‑1 medicines (liraglutide, lixisenatide and exenatide). The 2021 guidelines don't name semaglutide or tirzepatide, and say more research is needed.11

Other fasts

We found no US guidance written for GLP‑1 users during other religious fasts, such as Yom Kippur or Lent. The same practical advice applies to any planned fast: finish dose increases weeks before, and plan your fluids.12

On insulin or a sulfonylurea? These raise the risk of low blood sugar (hypoglycemia) with a GLP‑1, sometimes severely.3 Fasting adds to it.10 Plan any fast with your doctor first. Their doses may need lowering.3

How do I inject, and what if I miss a dose?

Inject once a week, on the same day, into your belly, thigh or upper arm. Use a new needle and a new spot each time.

  • Where: just under the skin of the belly, thigh or upper arm.3,4 For Zepbound, the back of the upper arm is for someone else to inject.4
  • When: any time of day, with or without food.3,4
  • Rotate: use a different spot each week.3,4
  • Vials: if you use Zepbound vials, your pharmacist or prescriber should show you how to draw up the dose with a syringe.4
  • Never share a pen, even with a new needle. It can spread serious infection.3

Getting rid of needles and pens

  • Use an FDA-cleared sharps container, right away after each injection. If you don't have one, the Wegovy instructions allow a heavy-duty plastic household container with a tight, puncture-resistant lid, labeled as hazardous waste.3
  • When it's almost full, follow your community's rules. Options include drop-off sites, household hazardous waste sites, mail-back programs and special pickup; they vary by state.9
  • Never put needles or pens loose in the household trash. Don't reuse or overfill a sharps container. For your state's rules, call Safe Needle Disposal on 1-800-643-1643.3,9

Missed a dose?

Wegovy injection
Next dose more than 2 days away?Take it now, then carry on on your usual day.
Less than 2 days away?Skip it. Take the next one on your usual day.3
Zepbound or Mounjaro
Remembered within 4 days?Take it now, then carry on on your usual day.
More than 4 days?Skip it. Take the next one on your usual day.4

Never take two doses to catch up. For Ozempic the window is 5 days.5 If you miss 2 or more Wegovy doses in a row, the label says to restart at a lower dose and step up again, to lower the risk of stomach side effects. Ask your prescriber which dose to restart on.3

On pills?

  • Wegovy pill: take one each morning on an empty stomach, swallowed whole with up to 4 oz (120 ml) of plain water. Then wait at least 30 minutes before eating, drinking or taking other pills. If you miss a day, skip it and take the next one the following day.3
  • Rybelsus (for type 2 diabetes) is also taken on an empty stomach, followed by a 30-minute wait.6
  • Foundayo (orforglipron) is taken once a day, with or without food. If you miss a dose, take it as soon as you can, but don't double up.7

How do I store it, and travel with it?

Keep unopened pens in the fridge. Many can sit outside the fridge for a while, but only at or below 86°F (30°C).

Store new pens at 36–46°F (2–8°C). Never freeze them, and never use one that has frozen.3,4 Keep them in the carton or with the cap on, to protect them from light.3

Wegovy single-dose pen, including Wegovy HDIf needed, up to 28 days at 46–86°F (8–30°C), in the carton, before the cap comes off.3
Wegovy FlexTouch pen, in use56 days at 59–86°F (15–30°C) or in the fridge.3
Ozempic pen, in use56 days at 59–86°F (15–30°C) or in the fridge.5
Zepbound single-dose pen or vialIf needed, up to 21 days in total at up to 86°F (30°C).4
Zepbound KwikPen or multi-dose vialFridge or up to 86°F (30°C). Throw away after 30 days at room temperature, 30 days after first use, or 4 doses.4
Wegovy pill and FoundayoRoom temperature, 68–77°F (20–25°C).3,7

From the US prescribing information. Always follow the Medication Guide in your own pack.

86°F is the limit, not a guide. Every allowance above assumes the pen stays at or below 86°F (30°C).3,4 In much of the US, summer days pass that, and a parked car gets far hotter. Never leave a pen in the car; keep it in the fridge or an insulated bag. Heat, travel and the TSA.

Flying. The TSA allows unused syringes when they're with injectable medicine; declare them to the officers at the checkpoint. It recommends, but doesn't require, that medicines are labeled.13 Keep pens in your carry-on, with your prescription, and remember a pen must never freeze, so don't let it touch a frozen ice pack.3

How do I know if it's working?

Expect regular check-ins with your prescriber. US labels for Wegovy and Zepbound don't set a fixed cut-off; your prescriber weighs your response and how well you tolerate it.3,4

  1. Week 0Start on a low dose. Write down your weight and waist.
  2. Every 4 weeksThe dose usually steps up, if side effects allow. If you don't tolerate a step, the next one can wait 4 weeks.3,4
  3. At the full doseYour prescriber and you decide on the dose to stay on, based on how it's working and how you feel.3,4
  4. After thatRegular reviews, for as long as you take it.

For a 200 lb (91 kg) person, 5% is 10 lb (4.5 kg). Falling short doesn't mean you failed. Your doctor weighs up the benefits and risks of carrying on. Guide 3 covers the other options.

On the older daily medicine liraglutide (Saxenda), the label is stricter: stop if you haven't lost at least 4% of your starting weight after 16 weeks.8 And none of these medicines replaces diet and exercise: the labels approve them alongside a reduced-calorie diet and more physical activity.3,4

What should I keep track of?

Your weight, waist and side effects, and your sugar if you have diabetes. Bring the notes to each review.

  • Weight and waist: write them down, so you can compare at your reviews. Guide 1 shows how to measure your waist.
  • Blood sugar, if you have diabetes: check before you start and while you take it.3 Low sugar can show as dizziness, sweating, shaking, blurred vision, confusion or a fast heartbeat.3
  • Doctor checks: your heart rate, because your resting pulse can rise on these medicines. Tell your doctor if your heart races while you are resting.3 Kidney tests if you've had bad vomiting or diarrhea.3 If you have diabetes, report any change in your eyesight.3
  • Side effects and meals: note what you ate before nausea. Patterns help.
  • Report side effects to the FDA's MedWatch program, online or at 1-800-FDA-1088. Anyone can report.14
Call 911 if you have: severe belly pain that won't go away, sometimes spreading to your back; yellow skin or eyes with fever or upper belly pain; vomiting so bad you can't keep fluids down; or swelling of the face, lips or throat, or trouble breathing.3 If you injected too much, call Poison Control on 1-800-222-1222.15 Full list in Guide 5

What about food noise and family meals?

Many people find the constant thoughts about food go quiet. Some also lose the pleasure of eating, and that can feel strange at family meals.

Studies show less "food noise", less emotional eating and fewer binges on these medicines.1 But some people miss the joy of food, or of cooking for others.1 If food has always been how your family shows care, that change can be hard. Talking it through, or seeing a counselor, can help.1

Don't skip meals for hours because you aren't hungry. Getting very hungry can bring back cravings for sweets and refined carbs.1

At home, it helps if the people you eat with know why your plate is smaller. A simple line works: "I'm on a medicine that fills me up fast. I'll have a little of everything."

Questions people ask

Can I drink alcohol on a GLP-1?

The 2025 US nutrition advisory says to keep alcohol to a minimum.1

Can I change my injection day?

Yes. The Zepbound label allows it as long as there are at least 3 days between two doses; the Ozempic label, at least 2 days.4,5

My pen froze in the fridge. Can I still use it?

No. The labels say not to use a pen that has been frozen.3,4

How long can Zepbound stay out of the fridge?

Single-dose pens and vials: up to 21 days in total, at up to 86°F (30°C). The KwikPen and multi-dose vial can be kept at room temperature up to 86°F, and must be thrown away after 30 days.4 The labels don't say what to do after a pen has been hotter than 86°F, so ask your pharmacist before you use it.

I take the birth control pill. Does it matter?

With tirzepatide (Zepbound, Mounjaro), yes. The label advises switching to a non-pill method, or adding a barrier method such as condoms, for 4 weeks after starting and for 4 weeks after each dose increase.4

Can I fly with my GLP-1 pen?

Yes. The TSA allows unused syringes with injectable medicine; declare them at the checkpoint.13 Keep pens in your carry-on.

I have an operation or endoscopy coming up. What should I do?

Tell every doctor involved that you take a GLP-1. The labels ask for this before any surgery or procedure.3

Before you move on

  • Protein first, at every meal. Small portions, eaten slowly.
  • Strength exercise at least 3 times a week to protect muscle.
  • Missed dose: check your own brand's window. Never double up.
  • Never freeze a pen, and never keep it above 86°F; never in a hot car.
  • Used needles and pens go in a sharps container, never the trash.
  • Fasting for Ramadan? Finish dose increases weeks before, and plan with your doctor.
  • Expect regular reviews with your prescriber.
Was this guide easy to understand?

Sources

  1. Mozaffarian D et al. Nutritional priorities to support GLP-1 therapy for obesity: a joint advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association and The Obesity Society. Am J Clin Nutr 2025;122:344–367 (also published in Obesity). Declared interests: 4 of 18 authors declare advisory or speaker roles with Novo Nordisk and 5 with Eli Lilly (paper's own declaration). PMC12612741 · doi:10.1002/oby.24336
  2. US Department of Agriculture, Agricultural Research Service. FoodData Central, SR Legacy (April 2018), protein per 100 g: lentils, cooked, boiled 9.02 (FDC 172421); chickpeas, canned, drained, rinsed 7.04 (173801); black beans, cooked, boiled 8.86 (173735); edamame, frozen, prepared 11.91 (168411); tofu, raw, firm, prepared with calcium sulfate 17.27 (172475); peanut butter, smooth 22.21 (172470); yogurt, Greek, plain, nonfat 10.19 (170894); cottage cheese, lowfat 2% 10.45 (172182); cheddar 22.87 (173414); milk, 1% 3.37 (170872); egg, hard-boiled 12.58 (173424); chicken breast, meat only, roasted 31.02 (171477); tuna, light, canned in water, drained 19.44 (173709); ground beef 85% lean, raw 18.59 (171796); ground turkey, raw 19.66 (171505); salmon, Atlantic, farmed, raw 20.42 (175167). fdc.nal.usda.gov
  3. Novo Nordisk. Wegovy (semaglutide) injection and tablets, US prescribing information, Medication Guide and instructions for use, revised June 2026 (administration, missed doses, storage, sharps disposal, warnings). PDF
  4. Eli Lilly. Zepbound (tirzepatide) US prescribing information and instructions for use, revised August 2026 (missed dose within 4 days; changing the dosing day with at least 3 days between doses; injection sites; storage; oral contraceptives). uspl.lilly.com
  5. Novo Nordisk. Ozempic (semaglutide) US prescribing information, revised May 2026 (missed dose within 5 days; changing the dosing day with at least 2 days between doses; 56 days in use). PDF
  6. Novo Nordisk. Rybelsus and Ozempic tablets (oral semaglutide) US prescribing information, revised January 2026. PDF
  7. Eli Lilly. Foundayo (orforglipron) US prescribing information, revised July 2026 (with or without food; missed dose; storage 68–77°F). uspl.lilly.com
  8. Novo Nordisk. Saxenda (liraglutide) US prescribing information, revised February 2026 ("discontinue SAXENDA if the patient has not lost at least 4% of baseline body weight" at 16 weeks). PDF
  9. US Food and Drug Administration. Best way to get rid of used needles and other sharps (sharps disposal containers; drop-off sites, household hazardous waste sites, mail-back programs and special pickup; don't reuse or overfill containers; Safe Needle Disposal 1-800-643-1643). Updated August 10, 2023. fda.gov
  10. Alayed KM. Glucagon-like peptide-1 (GLP-1) during Ramadan: narrative review of the published literature. J Obes, 2023. doi:10.1155/2023/8626081
  11. Hassanein M et al. Diabetes and Ramadan: practical guidelines 2021 (IDF-DAR). Diabetes Res Clin Pract, 2022;185:109185. doi:10.1016/j.diabres.2021.109185. Full guidelines (IDF with the DAR International Alliance, 2021), chapter 15: PDF
  12. Carvalho A. Fasting and weight-loss medications: what to advise your patients (citing IDF-DAR 2021). The Pharmacist (UK), July 29, 2026. Link
  13. Transportation Security Administration. What can I bring? Unused syringes ("allowed when accompanied by injectable medication. You must declare these items to security officers at the checkpoint"). Checked October 12, 2026. tsa.gov
  14. FDA. MedWatch: the FDA safety information and adverse event reporting program (1-800-FDA-1088). Content current as of October 9, 2026. fda.gov
  15. America's Poison Centers. Poison Control: 1-800-222-1222. Checked October 12, 2026. poison.org

Last checked Oct 12, 2026 · Next review due Jan 2027 · Report an error

How this guide was made. Written by the GLP Guidebook team from the sources above: US prescribing information, the USDA food tables, FDA and TSA advice, and published reviews. It's general information, not medical advice. Talk to a qualified doctor or pharmacist before starting, stopping or changing any medicine. In an emergency, call 911. How we write