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GLP-1 Medication Informed Consent

Last updated: September 2026

This consent describes the risks, benefits, and alternatives of treatment with GLP-1 receptor agonist medications (such as semaglutide) and GLP-1/GIP dual agonists (such as tirzepatide) for weight management. Read it fully before consenting.

1. About these medications

GLP-1 medications mimic natural gut hormones that regulate appetite and blood sugar. When prescribed for weight management, they are used together with a reduced-calorie diet and increased physical activity. They are typically administered as a once-weekly subcutaneous injection with a dose that is gradually increased ("titrated") over several months.

2. Boxed warning — thyroid C-cell tumors

Semaglutide and tirzepatide carry an FDA boxed warning: in rodent studies these medications caused thyroid C-cell tumors. It is unknown whether they cause medullary thyroid carcinoma (MTC) in humans. Do not use these medications if you or a family member has a history of MTC or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Tell your provider immediately if you develop a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath.

3. Common side effects

  • Nausea, vomiting, diarrhea, or constipation (most common, usually improving over time)
  • Abdominal pain, indigestion, bloating, or burping
  • Decreased appetite, fatigue, headache, dizziness
  • Injection-site reactions (redness, itching)

4. Serious risks

  • Pancreatitis: severe, persistent abdominal pain (with or without vomiting) requires immediate medical attention and discontinuation.
  • Gallbladder disease: gallstones and cholecystitis, particularly with rapid weight loss.
  • Hypoglycemia: risk increases if combined with insulin or sulfonylureas.
  • Kidney injury: usually related to dehydration from vomiting/diarrhea — maintain fluid intake.
  • Gastroparesis: delayed stomach emptying; may affect absorption of oral medications.
  • Severe allergic reactions: anaphylaxis and angioedema have been reported.
  • Vision changes in patients with diabetic retinopathy.
  • Mood changes: report depression or thoughts of self-harm to your provider immediately.
  • Aspiration risk with anesthesia: tell any surgeon or anesthesiologist you take a GLP-1 medication before any procedure.

5. Pregnancy and fertility

GLP-1 medications may cause fetal harm and must not be used during pregnancy or while breastfeeding. Discontinue at least 2 months before a planned pregnancy. Weight loss and these medications may also reduce the effectiveness of oral contraceptives in some cases (particularly with tirzepatide) — discuss contraception with your provider.

6. Compounded medication disclosure

If your provider prescribes a compounded form of semaglutide or tirzepatide, you understand that compounded drugs are prepared by state-licensed compounding pharmacies for an individual patient and are not FDA-approved. The FDA does not review compounded drugs for safety, effectiveness, or quality before they are dispensed. Compounded medications may differ from FDA-approved products. FDA-approved alternatives (e.g., Wegovy®, Zepbound®) exist and may be available to you through other channels; discuss options with your provider.

7. Alternatives

Alternatives to GLP-1 therapy include lifestyle modification alone (diet, exercise, behavioral therapy), other prescription weight-management medications, bariatric surgery, and no treatment. Your provider can discuss these options with you.

8. Your commitments

  • Use the medication only as directed; never increase your dose without provider approval.
  • Store medication as instructed and never share it with anyone else.
  • Report side effects promptly and complete scheduled check-ins.
  • Inform all of your healthcare providers that you take a GLP-1 medication.

9. Acknowledgment

By checking the GLP-1 Medication Informed Consent box during intake, you confirm that you have read and understood the above; that no specific weight-loss outcome has been promised to you; that you have had the opportunity to ask questions; and that you consent to GLP-1 treatment if, and only if, a licensed provider determines it is appropriate for you.

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