I own Steel Health and Hormones Centre, an HRT and medical weight loss clinic located right here in Pittsburgh, Pennsylvania. However, I am not a doctor and therefore none of this is medical advice. If you’re interested in working with a medical professional, fill out the contact form down below and we’ll be in touch within 24 hours. Today, I want to share something purely from my experience working hands-on with medical weight loss patients — specifically, the top three biggest mistakes I see people make when starting GLP-1 receptor agonists (GLP-1RAs) like semaglutide, tirzepatide, and retatrutide.
These medications can be life-changing. They can help regulate appetite, stabilize blood sugar, and make adhering to a calorie deficit significantly easier. But like anything in medicine, they work best when they’re used correctly — and a lot of people unintentionally sabotage their own progress without realizing it.
Let’s get into the three big ones.
1. Uncontrolled Substance Use — Especially Alcohol
This is, without question, the number one issue I see. If someone has an uncontrolled substance use disorder — most commonly alcohol — it can completely derail their progress.
Why? Because alcohol is sneaky. It adds calories quickly, lowers inhibitions, disrupts sleep, increases stress hormones, and makes sticking to a calorie deficit nearly impossible. Someone might be doing “everything right” during the week, then drinking heavily on the weekends and unknowingly wiping out their entire deficit.
It’s not about judgment — it’s about physiology. If alcohol is a major part of someone’s routine and it’s not addressed, even the strongest GLP-1 medication can only do so much.
2. No Lifestyle Intervention at All
The second biggest mistake is assuming the medication alone will carry all the weight — literally.
Don’t get me wrong: I’ve seen GLP-1s work for people who change absolutely nothing except taking the injection. They still lose weight because appetite gets suppressed and cravings drop.
But the people who get the best results, the long-term transformations, are the ones who use the medication as a springboard to build better habits:
- improving food quality
- increasing daily protein
- drinking more water
- walking more
- doing resistance training
- building a consistent sleep routine
These changes don’t have to be extreme. In fact, the most successful patients make small, realistic adjustments they can maintain for life. GLP-1s make this easier by giving people the appetite control and mental “breathing room” they need to actually follow through.
3. Not Being Patient with the Process
This is a big one — and it’s totally understandable. When someone starts a medication like semaglutide, tirzepatide, or retatrutide, they’re excited and ready to see results now. But the reality is that these medications have very long half-lives, which means the drug builds up in your system over time.
For example, if you take a weekly injection, some of the previous dose is still in your body when you take the next one. Because of this slow buildup, it can take several weeks — sometimes even a couple of months — for the medication to reach steady state and for someone to feel the full effect.
People often want to jump to higher doses ASAP, thinking that’s what will speed things up. But in many cases, the best results come from slow, steady titration and patience with the pharmacology. Trying to rush the process can lead to nausea, fatigue, GI issues, and ultimately quitting the medication prematurely.
If you’re interested in working with us for medical weight loss, fill out a contact form down below and we’ll be in touch within 24 hours.
