GLP-1 weight loss injections at a med spa: what patients need to know

GLP-1 receptor agonists — semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro, Zepbound), and compounded alternatives — have become one of the most requested services at medical spas and weight management clinics. With that demand has come a wide range in provider quality: practices doing this right, and practices doing it in ways that put patients at risk. Here's how to tell the difference.

What GLP-1 medications actually do

GLP-1 (glucagon-like peptide-1) receptor agonists work by mimicking a hormone released after eating. They:

Slow gastric emptying — food moves through the stomach more slowly, producing prolonged fullness
Reduce appetite — act on hypothalamic receptors to reduce hunger signals
Lower blood glucose — originally developed for type 2 diabetes management (hence Ozempic)
Promote weight loss — clinical trials show 10–22% body weight reduction over 68 weeks for semaglutide; similar or greater for tirzepatide

These are prescription medications. They are not supplements, wellness shots, or aesthetic treatments — they are drugs with real mechanisms and real side effects that require clinical monitoring.

Branded vs. compounded GLP-1

The FDA-approved branded medications (Ozempic, Wegovy, Mounjaro, Zepbound) are manufactured under strict quality standards. During the shortage period that began in 2022, compounding pharmacies have produced alternative formulations:

Compounded semaglutide — not FDA-approved but legal during shortage periods; quality varies significantly by pharmacy
Compounded tirzepatide — same situation; compound pharmacies must be 503A or 503B facilities in good standing

What to ask: "Which formulation do you use, and from which pharmacy? What is that pharmacy's accreditation status?"

A legitimate provider can answer this immediately. Vague answers ("our proprietary blend," "pharmaceutical grade") are red flags.

What proper clinical oversight looks like

This is where med spas vary most. A responsible GLP-1 protocol includes:

At intake:
Body weight, height, BMI
Medical history review — contraindications include personal/family history of medullary thyroid carcinoma or MEN2 syndrome, pancreatitis history
Basic labs (at minimum: HbA1c, fasting glucose, lipid panel, comprehensive metabolic panel, thyroid panel)
Blood pressure assessment
Current medications review (GLP-1s interact with other diabetes medications)
Discussion of realistic expectations and side effects

During treatment:
Monthly (or at minimum quarterly) check-ins
Lab monitoring as indicated
Side-effect management guidance (nausea, vomiting, and constipation are common in the first 4–8 weeks; there are protocols to manage these)
Dose escalation supervised by a clinician

A practice that prescribes GLP-1 medications after a 10-minute intake form with no labs is not practicing safely.

Side effects to know

Common (first 4–12 weeks, often improving over time):
Nausea (most common; 20–44% in trials)
Vomiting
Constipation or diarrhea
Fatigue
Injection site reactions

Less common but serious:
Pancreatitis — stop medication and seek care if you develop severe abdominal pain radiating to your back
Gallstones — rapid weight loss increases risk; abdominal pain after fatty meals should be evaluated
Gastroparesis — severely slowed gastric emptying; can occur with extended use
Muscle loss — weight loss on GLP-1s includes some muscle mass; resistance training and adequate protein (1.2–1.6g/kg) significantly mitigate this

What "Ozempic face" actually means

"Ozempic face" refers to facial hollowing and volume loss that some patients experience with significant weight loss on GLP-1s. This is not a drug-specific side effect — it's a consequence of rapid weight loss from any cause. Fat redistributes from the face along with the rest of the body.

Patients on GLP-1s who experience facial volume loss may benefit from filler consultations once their weight stabilizes. This is one reason med spas offering both GLP-1 programs and injectables are positioned to provide comprehensive care — though it shouldn't be the primary reason you choose a provider.

Questions to ask before starting

"What labs do you require before prescribing?"
"Which formulation do you use, and from which compounding pharmacy?"
"Who is the supervising prescriber, and what are their credentials?"
"What's the check-in schedule during treatment?"
"What do I do if I experience significant side effects?"
"Is this compounded or branded medication?"

A practice that can't answer all of these questions clearly should not be managing your medication.

---

Looking for a weight management provider? Browse wellness providers on MedSpot and check profiles for clinical credentials and GLP-1 program details.