Your guide to feeling good on treatment
What to eat, how to move, what is normal and when to message us. Written for the questions patients ask most.
Eat with your injection, not against it
Most people feel the medication strongest in the first two days after the shot and hungrier again near the end of the week. Plan your meals around that rhythm.
Your clinician may move your dose up over time. Each step up can bring the day 1 to 2 feeling back for a week or two.
Your first two weeks
Your box arrives
Shipping is free and usually takes about 2 days once the pharmacy processes your order. You get a tracking email. It comes in a plain box.
Check what is inside
A small glass vial of medication, syringes, alcohol pads, and the pharmacy label with your dose. Keep the box and the label.
Pick your shot day
Any day works. Same day each week keeps it simple. Set a phone reminder. You can inject with or without food.
Eat smaller, eat often
Appetite usually drops in the first weeks. Eat protein first, stop when comfortably full, and keep drinking water.
How to read your syringe
Your pharmacy label shows your dose in units (and sometimes mL). On a standard 100-unit syringe, 0.5 mL is 50 units, the halfway line. Most Direct Wellness prescriptions are 0.5 mL each week, and the pharmacy changes the strength of the vial when your dose goes up, so the amount you draw usually stays the same. Your label is always the final word.
The orange line marks 50 units. If the number of units on your label is not clear, or your label looks different from last month, message your care team in Chat before you inject.
How to give yourself the injection
Wash and wipe
Wash your hands. Wipe the vial top and your skin with an alcohol pad. Let both dry.
Draw your dose
Pull the plunger to your dose line, push that air into the vial, turn the vial upside down and draw the medication to the line on your label. Tap out bubbles.
Pick a spot
Belly at least 2 inches from your belly button, front of the thigh, or back of the upper arm. Use a different spot each week.
Inject
Pinch the skin, insert the needle straight in, push the plunger slowly, count to 5, pull out. A little redness or a small bump for a day or two is common.
Dispose
Put the used syringe in a sharps container or a hard plastic bottle with a screw cap. Never reuse a needle.
Store
Keep the vial in the fridge unless your label says otherwise. Never freeze it. Traveling? A small cooler pouch with an ice pack works for the day.
I missed my shot. What now?
If it has been 4 days or less since your usual day, take it as soon as you remember and keep your normal day next week. If it has been more than 4 days, skip it and take your next one on your usual day. Do not take two doses close together. If you missed more than one week, message your care team before restarting; they may restart you at a lower dose.
When does my dose go up?
Only when you and your clinician agree, usually at your check-ins. A common pattern is to stay at each dose for about 4 weeks, and longer if your stomach is still settling. Going slower is not falling behind. Never change your dose on your own, and never share medication.
Does the price change when my dose goes up?
No. Your plan price is the same at every dose.
The plate: build every meal in this order
- Protein first, a quarter of the plate. Chicken, turkey, fish, shrimp, eggs, Greek yogurt, cottage cheese, tofu, beans, lean beef. Aim for 25 to 35 g.
- Vegetables, half the plate. Cooked is easier on the stomach than big raw salads, especially the first weeks.
- A small carb. Oats, rice, potato, corn tortilla, fruit, whole-grain bread.
- A little fat. Olive oil, avocado, nuts, seeds.
Eat slowly, put the fork down between bites, and stop when you feel satisfied, not stuffed. Serve half of what you used to and wait 20 minutes before going back.
Your protein number
When you eat less, protein is what keeps your muscle and your energy. Most adults on treatment do well with 80 to 120 g a day, split across meals. Find your goal weight for a closer number.
| Your goal weight | Protein per day | Looks like |
|---|---|---|
| 120 lb | 65 to 85 g | 3 meals with 25 g each |
| 150 lb | 80 to 110 g | 3 meals with 30 g, one snack |
| 180 lb | 100 to 130 g | 3 meals with 35 g, one snack |
| 200 lb+ | 110 to 145 g | 3 meals with 35 g, two snacks |
Based on 1.2 to 1.6 g of protein per kg of goal weight, the range used in the 2025 joint nutrition advisory for people on GLP-1 medication. Kidney condition? Ask your clinician for your number.
Protein cheat sheet
| Chicken breast, 4 oz | 35 g |
| Greek yogurt, 1 cup | 20 g |
| Cottage cheese, 1 cup | 25 g |
| Protein shake, 1 scoop | 20 to 30 g |
| Eggs, 2 large | 12 g |
| Canned tuna, 1 can | 25 g |
| Shrimp, 4 oz | 24 g |
| Black beans, 1 cup | 15 g |
| Queso fresco, 2 oz | 10 g |
| Tofu, firm, 5 oz | 14 g |
A sample day
- Breakfast: 2 scrambled eggs with black beans and a corn tortilla, or Greek yogurt with berries. About 25 g
- Lunch: grilled chicken over cooked vegetables with a small scoop of rice. About 35 g
- Snack: cottage cheese, a cheese stick, or a protein shake. About 15 to 25 g
- Dinner: baked fish or lean ground turkey, roasted zucchini, half a sweet potato. About 30 g
Total: about 105 to 115 g. Not hungry at dinner? Have the shake instead and keep the protein.
Easier on the stomach
- Eggs
- Shredded chicken
- White fish
- Broth soups
- Greek yogurt
- Oatmeal
- Cooked carrots and zucchini
- Bananas
- Rice
- Cold or room-temp food
Go easy on these
- Fried and greasy food
- Very spicy food
- Big raw salads at first
- Sugary drinks
- Alcohol
- Large meals late at night
These are the usual nausea and heartburn triggers. Nothing is banned; portions and timing matter most.
Drinks
Water
Aim for 64 to 80 oz a day (about 8 to 10 cups), more on shot day. Sip between meals rather than with them so you do not fill up on water. Add electrolytes if you feel dizzy or get headaches.
Coffee and tea
Fine. If coffee gives you heartburn, try it after food, or cold brew. Ginger or peppermint tea helps a queasy stomach.
Alcohol
Go easy. On this medication alcohol often hits faster, upsets the stomach, and makes nausea and low blood sugar more likely. If you drink, keep it to one with food.
Can I have protein shakes, yogurt, kefir or creatine?
Yes to all four for most people. Shakes and kefir are an easy way to hit your protein on low-appetite days. Creatine (3 to 5 g a day) is widely used with strength training; mention it to your clinician if you have a kidney condition.
Should I take a multivitamin, B12 or fiber?
Food first. Your tirzepatide is prepared with vitamin B12. A daily multivitamin and vitamin D are reasonable if you are eating very little. For fiber, add it slowly with plenty of water. Ask your care team in Chat before adding anything new, so it is in your record.
I stopped eating and the scale stopped moving
This is common and it is a signal to eat more, not less. Eating too little slows your body down, costs you muscle, and makes you tired and foggy. Get back to three protein-first meals a day, even small ones, and message your care team if you cannot keep food down.
What helps today, and when to message us
Stomach symptoms are most common in the first weeks and after each dose increase, and they usually ease as your body adjusts. Here is what to try today. Your care team can also prescribe help, so tell us.
| What you feel | Why it happens | What helps today | Message us if |
|---|---|---|---|
| Nausea | Your stomach empties slower, strongest on days 1 to 2. | Small cold meals, protein shake instead of a big meal, ginger or peppermint tea, sip water, stop eating at the first sign of fullness. | It lasts more than a few days, or you cannot keep fluids down. |
| Heartburn, reflux, sulfur burps | Food sits in the stomach longer. | Smaller meals, nothing within 3 hours of bed, less greasy and spicy food, sleep with your head raised. | It happens most days, or over-the-counter antacids do not help. |
| Constipation | Slower digestion plus less food and water. | Water first, a daily walk, oats, beans, berries, chia or psyllium added slowly, magnesium at night if your clinician agrees. | No bowel movement in 4 days, or pain with bloating. |
| Bloating and gas | Slower gut and fiber that your gut is not used to. | Cooked vegetables over raw, smaller portions, skip carbonated drinks and sugar-free gum, walk after meals. | Your belly is hard, swollen and painful. |
| Tired, dizzy, headache | Usually too little food, water or salt. | Eat something with protein, drink 16 oz of water with electrolytes, stand up slowly. | Dizziness keeps happening, or you faint. |
| Hair shedding | Fast weight change can shift hair into a resting phase for a few months. | Hit your protein number, take a multivitamin, be patient; it usually settles. | You see bald patches or it continues past 6 months. |
| Red bump at the injection site | Normal skin reaction. | Rotate spots, let the alcohol dry fully before injecting, cool compress. | It is hot, spreading, or lasts more than 3 days. |
Anti-nausea medication can be prescribed when needed. Ask in Chat; please do not wait until you feel awful.
Lift something, 3 times a week
When you lose weight fast, some of it can be muscle. Strength training 2 to 3 times a week plus walking is the proven way to keep the muscle and lose the fat. Ten to fifteen minutes counts. No gym needed.
| Week | Do this 3 days (rest a day between) | Walk |
|---|---|---|
| Week 1 | Chair squats 2 × 8 · Wall push-ups 2 × 8 · Chair-supported row with a band or water jug 2 × 8 · Glute bridge 2 × 10 | 10 min after one meal a day |
| Week 2 | Same moves, 3 sets each | 15 min, most days |
| Week 3 | Squats to a lower chair 3 × 10 · Incline push-ups on a counter 3 × 10 · Rows 3 × 10 · Bridges 3 × 12 · Add a 20-second plank | 20 min, most days |
| Week 4 | Add weight: hold a jug or dumbbell for squats, use a heavier band for rows. 3 × 10 to 12. | 30 min, 5 days (that is the 150 minutes a week doctors recommend) |
Timing tips
- Do your hardest session on days 5 to 7, when energy is highest.
- Eat a little protein within an hour after lifting.
- On shot day, a walk is enough.
Stomach-friendly swaps
- Chest-supported or seated rows instead of bent-over rows (less nausea).
- No fast floor-to-standing moves if you get dizzy.
- Stop and sip water if you feel lightheaded.
Already in a gym?
- Keep lifting; it is the single best thing you can do on this medication.
- Expect to lift a little less while you are eating less. That is normal.
- Prioritize protein on training days.
New to exercise, pregnant, or living with a heart condition, diabetes, or joint problems? Message your care team first so they can tailor this.
When the scale stalls
Progress is never a straight line. Weigh once a week, same day and time, and look at the month, not the day. If nothing has moved for 3 to 4 weeks, run this list before you worry.
- Protein hitting your number?
- Eating 3 meals, not 1?
- Water 64+ oz?
- Strength training 2 to 3 times?
- Sleeping 7 hours?
- Alcohol crept up?
- Period, travel or stress this month?
- Same dose for 8+ weeks?
If the basics are in place and you have been at the same dose for a while, message your care team. A dose change is a clinical decision, and your clinician will tell you what they recommend and why.
Will the weight come back if I stop?
Appetite usually returns when the medication stops, so most people keep results by keeping the habits here (protein, strength training, regular meals) and by planning the step down with their clinician rather than stopping suddenly. Talk to your care team before pausing or stopping.
Traveling or moving?
Message us at least a week before your next shipment to change the address. Carry your vial in a small cooler pouch; it is fine at room temperature for the day of travel. Keep the pharmacy label with it.
Everyday help alongside your treatment
Lower estrogen can bring hot flashes, broken sleep, mood swings, joint aches and weight that settles around the middle. These habits help your treatment do its job.
Hot flashes and night sweats
- Dress in layers; keep the bedroom cool and a fan nearby.
- Common triggers: alcohol, caffeine late in the day, spicy food, hot rooms, stress.
- Slow breathing (6 breaths a minute for 5 minutes) when one starts.
Sleep, mood and energy
- Same wake time every day; dim screens an hour before bed.
- Morning daylight and a walk steady mood and sleep.
- Alcohol fragments sleep even when it helps you fall asleep.
Eating and moving for this stage
- Protein at every meal (25 to 35 g) and strength training protect muscle and bone.
- Calcium from food (yogurt, cheese, leafy greens, sardines) and vitamin D.
- Fiber-rich plants and olive oil support heart health.
Using your patch, gel or cream
- Patch: apply to clean, dry skin on the lower belly or buttock, below the waistline. Rotate spots. Change it on the days your label says, usually twice a week. If it lifts, press it back down; if it falls off, apply a new one.
- Gel: apply to clean, dry skin on the arm or thigh as directed, let it dry before dressing, wash your hands after. Keep others, especially children and pets, away from the area until it is dry.
- Progesterone capsule: take at bedtime, as it can make you sleepy.
- Vaginal cream: use the applicator at bedtime as directed.
On tirzepatide and hormone therapy at the same time?
Many women are. Tell your care team about everything you take so they can watch for interactions and adjust timing. Tirzepatide slows how fast your stomach empties, which can change how some pills are absorbed; your clinician will tell you if any timing matters for you. Patches, gels and creams are not affected.
When to message your care team
Bleeding after menopause, breast lumps, leg swelling or pain, chest pain or shortness of breath, severe headaches, or mood changes that worry you. Call 911 for chest pain, trouble breathing, or signs of a stroke.
Put Direct Wellness on your home screen
Install the app
iPhone: open my.directwellness.co in Safari, tap the Share button, then Add to Home Screen.
Android: open it in Chrome, tap the three dots, then Add to Home screen.
You get a full-screen app with Chat, Shots and this guide, no app store needed.
Track your shots and food
Log each injection in Shots in the menu so your care team sees your schedule. For protein and food tracking, patients like Shotsy (built for weekly injections) and MyFitnessPal, which has a GLP-1 plan with protein and fiber targets.
Shipping, refills and your plan
Where is my package?
You get a tracking email when the pharmacy ships. Delivery usually takes about 2 days after that. No email after 3 business days? Message us in Chat with your name and we will check with the pharmacy.
When does my next refill ship?
Refills ship on your plan schedule after your check-in. Your clinician confirms your dose each cycle. If you are running low, message us 7 days before you need it.
Price, dose and plans
Your price stays the same at every dose. Shipping is free on every plan. Nobody is charged until a clinician prescribes.
Update my address or card
Open Manage account in the menu. Moving soon? Message us too, so the next shipment goes to the right place.
Pausing or stopping
Message your care team first. They will tell you the safest way to pause and what dose to restart at, which depends on how long you were off.
Still need help?
Fastest: open Chat in the menu. We answer during business hours, usually the same day.
Call or text (626) 761-0021 · Email care@directwellness.co
This guide is general education from Direct Wellness and is not a substitute for advice from your clinician. Follow your pharmacy label and your care team's instructions. Figures for protein, fluids and exercise follow the 2025 joint advisory from the American College of Lifestyle Medicine, American Society for Nutrition, Obesity Medicine Association and The Obesity Society on nutrition during GLP-1 therapy.