Wellness Institute for Sleep & Health
Your WISH Weight Management
Program — What to Know
Dosing, side effects, storage, timelines, refills — everything you need in one place, reviewed and kept current by a WISH physician. If you’re looking for something specific, use the links throughout to jump straight to the detailed guide.
What Happens After You Submit
Your intake form has been received and your payment information is saved securely. No charge has been made yet.
A WISH physician reviews your health information within 1–3 business days. Flagged submissions may take a little longer.
If approved, your card is charged and you receive a confirmation email with order details. If not approved, your card is never charged.
Your medication ships via 2-day cold-chain delivery from our licensed 503A pharmacy. Tracking information will be emailed to you.
Side Effects — What to Expect and How to Manage Them
GLP-1 and GIP/GLP-1 medications are well-tolerated by most patients, especially when starting at a low dose and titrating gradually. Most side effects occur in the first few weeks and improve with time.
Common (Most Patients)
Nausea — typically most noticeable in the first 1–2 weeks after starting or increasing dose. Take with food. Avoid large, high-fat meals. Usually improves after week 2–3.
Vomiting — if persistent, contact us. Usually mild and brief.
Diarrhea or constipation — stay well hydrated. Both are common and generally resolve.
Injection site discomfort — rotate sites each week: abdomen, thigh, or upper arm.
Less Common
Fatigue in first 1–2 weeks — typically improves as your body adjusts.
Reduced appetite — expected and part of the medication’s mechanism.
Stomach fullness or bloating — eat smaller meals, chew slowly, avoid carbonated drinks.
Hair thinning — occasionally reported with rapid weight loss (not a direct medication effect); typically self-limiting.
Rare but Important — Contact Us or Seek Care
Severe abdominal pain radiating to the back — stop medication and seek medical care. May indicate pancreatitis.
Severe allergic reaction (rash, throat swelling, difficulty breathing) — call 911.
Vision changes — contact your eye doctor.
Severe vomiting with inability to keep fluids down — contact us or seek urgent care.
Gallbladder symptoms (right-side upper abdominal pain after eating) — seek medical evaluation.
This is not a complete list of possible side effects. For a fuller breakdown by medication and week, see our Side Effects & Management guide. Always read the information provided with your medication, and contact us at [email protected] or your local emergency services if you have concerns.
Dosing Schedule and Dose Progression
Your program starts at the dose your physician approves. Most new patients begin at Level 1 (the starter dose) and increase gradually based on tolerability and progress. You do not need to advance on a fixed schedule — your physician guides dose changes at each refill.
Tirzepatide Dosing
Tirzepatide is injected once weekly, subcutaneously (under the skin).
| Level | Vial | Weekly Dose | Monthly Supply |
|---|---|---|---|
| Level 1 (Starter) | 10 mg/mL · 1 mL | 2.5 mg/week | 4 injections |
| Level 2 | 10 mg/mL · 2 mL | 5 mg/week | 4 injections |
| Level 3 | 10 mg/mL · 3 mL | 7.5 mg/week | 4 injections |
| Level 4 | 10 mg/mL · 4 mL | 10 mg/week | 4 injections |
| Level 5 (Forte) | 15 mg/mL · 4 mL | 15 mg/week | 4 injections |
Typical progression: most patients stay at each level for 4 or more weeks before considering escalation. Your physician will guide any dose changes. For full vial and titration detail, see our Vial Size & Dose guide.
Semaglutide Dosing
Semaglutide is injected once weekly, subcutaneously.
| Level | Vial | Weekly Dose | Monthly Supply |
|---|---|---|---|
| Level 1 (Starter) | 2.5 mg/mL · 1 mL | 0.625 mg/week | 4 injections |
| Level 2 | 2.5 mg/mL · 2 mL | 1.25 mg/week | 4 injections |
| Level 3 | 2.5 mg/mL · 3 mL | 1.875 mg/week | 4 injections |
| Level 4 | 2.5 mg/mL · 4 mL | 2.5 mg/week | 4 injections |
| Level 5 (DS) | 5 mg/mL · 3 mL | 3.75 mg/week | 4 injections |
Typical progression: most patients stay at each level for 4 or more weeks before considering escalation. Your physician will guide any dose changes. For full vial and titration detail, see our Vial Size & Dose guide.
Storage, Preparation, and Injection Technique
Storage
- Keep refrigerated at 36–46°F (2–8°C). Do not freeze.
- Protect from light. Keep in original packaging until use.
- Do not use after the beyond-use date (BUD) printed on the label. Hallandale assigns a 90-day BUD from the fill date.
- Medication may be left at room temperature for up to 30 minutes before injection. Do not leave out for extended periods.
Injection Steps
- Wash hands thoroughly.
- Remove the vial from the refrigerator 20–30 minutes before injecting.
- Inspect the solution — it should be clear to slightly yellow. Do not use if cloudy or contains particles.
- Draw the correct dose into a syringe (syringes included in your first-order kit).
- Choose your site: abdomen (at least 2 inches from navel), outer thigh, or upper arm.
- Rotate sites each week — do not inject in the same spot consecutively.
- Pinch the skin, insert needle at 45–90°, inject slowly, withdraw.
- Dispose of syringe in an approved sharps container. Do not recap needles.
Your injection kit includes a printed reference guide, and our full Storage & Injection guide covers technique in more detail. Questions? Contact us at [email protected].
What to Expect — Month by Month
A quick-reference timeline. For a deeper walkthrough of what happens after your intake — including what a typical week looks like at each stage — see our What to Expect guide.
First 2–4 Weeks
- Appetite reduction typically begins within days to weeks.
- Nausea is most common in this window — usually mild and manageable with the strategies above.
- Weight changes may be modest early on. This is normal.
- Focus on staying hydrated and eating smaller, lower-fat meals.
Months 2–3
- Most patients notice meaningful appetite reduction by now.
- Side effects typically diminish significantly after the first 4–6 weeks.
- Steady weight loss is more apparent. Individual results vary.
- If tolerating well and not seeing progress, discuss dose escalation at your refill.
Ongoing
- GLP-1 medications work best with sustainable lifestyle habits — hydration, protein-forward meals, consistent movement.
- Weight loss tends to plateau over time as your body adapts. This is normal and can be addressed with your physician.
- Do not stop medication abruptly without discussing with your physician — weight can return.
When to Contact Us vs. When to Seek Immediate Care
Contact WISH
- Questions about your prescription or dose
- Side effects that are bothersome but not severe
- Request a refill or dose change
- Questions about delivery or pharmacy
- Any non-urgent clinical question
Email: [email protected]
Response within 1 business day, Mon–Fri.
Seek Emergency Care — Call 911 or Go to ER
- Severe abdominal pain radiating to the back
- Severe allergic reaction (throat swelling, difficulty breathing)
- Loss of consciousness or confusion
- Inability to keep any fluids down for more than 24 hours
- Any situation you believe is a medical emergency
How Refills Work
Submit your refill request at wishcares.org/weight-management/refill/ when your vial is running low. We recommend submitting 7–10 days before you run out.
A physician reviews your refill within 3–5 business days. If approved, the card on file is charged automatically for the approved dose — no separate payment step.
Once approved, your card on file is charged automatically. Your next order ships within 1–2 business days via 2-day cold-chain delivery.
Frequently Asked Questions
The questions patients ask most often about how the program itself runs. For pricing, eligibility, and medication-specific questions, see our full FAQ page.
Will my card be charged when I submit the intake form?
No. Your card is saved securely but is only charged if a physician approves your prescription. If your prescription is not approved, your card is never charged.
How long until I hear back?
A physician reviews new intakes within 1–3 business days. You will receive an email when your review is complete.
What if I have side effects?
Most side effects are mild and improve within the first few weeks. Contact us at [email protected] if side effects are persistent or concerning. For severe symptoms, seek emergency care immediately.
Can I change my dose?
Your physician determines your dose based on your health information. Dose changes can be requested at your refill — the physician will review and approve or adjust based on your progress and tolerability.
How do I know when to reorder?
We recommend requesting a refill 7–10 days before your supply runs out to account for physician review time (3–5 business days) and shipping (2 business days). Submit at wishcares.org/weight-management/refill/.
What if my prescription is not approved?
You will receive an email with options, including scheduling a telehealth consultation. Your card is never charged if your prescription is not approved.
What pharmacy fills my prescription?
Hallandale, a licensed 503A compounding pharmacy. Compounded medications are not FDA-approved — they are patient-specific preparations compounded under physician oversight. Orders ship directly to your address within 1–2 business days of approval.
What if I need to cancel or pause?
Contact us at [email protected]. We do not have a subscription — each order is separate and requires physician approval. You may stop at any time.
Questions? We’re Here.
Reach our WISH weight management team at [email protected].
We typically respond within 1 business day, Monday through Friday.
For medical emergencies, call 911 or go to your nearest emergency room.
Want to learn more before your next refill? Visit our Learning Hub for articles on nutrition, injection technique, and managing side effects.