I have been a nurse for thirty-two years and have given hundreds of injections. In late September 2025, my GP, my primary care doctor here in Australia, sent me an electronic prescription for tirzepatide. I collected it from the pharmacy and gave myself the first injection. I did not read the leaflet. I knew how to give an injection, so I gave it.
Two days later, my tongue was sticking to the roof of my mouth.
Before prescribing, my doctor asked why I wanted treatment. I told him I had prediabetes, that five members of my family had type 2 diabetes, and that I wanted to protect my health and be present for my children. We discussed my reasons for starting. What I remember missing was a conversation about my surgical history and existing deficiencies, what I understood about treatment, and how we would recognize problems.
I would have asked those questions of a patient. Somehow, when I became the patient, I did not insist on them for myself.
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My history before the prescription
I had a gastric band in 2014, a sleeve gastrectomy in 2021, and a mini-gastric bypass later that year. Nobody asked about those operations when I started tirzepatide. When I later raised concerns about thinning hair, poor sleep, lethargy, brain fog, and having no appetite, my surgical history was not revisited.
Other patients also come to these medicines with a history of bariatric surgery. A JAMA Surgery cohort study of 112,858 adults found that 14 percent started a glucagon-like peptide-1 (GLP-1) medicine after bariatric surgery during the study’s follow-up. The study did not establish how well their nutritional needs were assessed.
My hemoglobin and ferritin were low in October 2024 and again in August 2025, a month before I started treatment. In March 2026, my doctor sent me to the emergency department, where I needed a blood transfusion. My anemia began before tirzepatide, and I cannot say the medicine caused it. My concern is that I started another treatment without understanding how my existing deficiencies and surgical history should shape my follow-up.
I spent the week before that transfusion at home, telling myself I just needed a couple more days. I knew what anemia could do. Even with that knowledge, I kept waiting to feel better.
What I understood about treatment
I knew the basics about slower stomach emptying and feeling full sooner. I did not understand how those changes would affect eating and everyday life. The pharmacist asked whether I needed needles. I do not remember being asked to explain what I would watch for or when I would seek help.
My nursing background did not make that conversation unnecessary. It may have made it easier for me to believe I could manage without it. I should have read the leaflet, but reading it would not have replaced a discussion about my own history and circumstances.
A 2026 NORC survey found that 85 percent of U.S. adults would turn to a medical professional to learn more about GLP-1 medicines. Yet among respondents who had heard of the drugs, only 22 percent had actively sought information from a medical professional. In my hardest months, I turned to YouTube, where much of what I watched skipped the parts I was struggling with.
I needed someone to check my understanding, explain what required urgent attention, and tell me whom to contact. Asking me to describe that plan in my own words would have revealed more than asking whether I had any questions. It would also have given me permission to admit how much I did not know.
What changed beyond my weight
Over the year, I went from a size 20 to a size 10. My clinicians asked about my weight. Nobody asked about my strength. I noticed the difference when I helped my mother weigh her two 23-kilogram suitcases for a flight. Lifting the first took everything I had. The weights I lift at the gym have almost halved.
That experience does not establish why I became weaker. My anemia and nutritional history also needed consideration. But difficulty doing something familiar deserved a clinical conversation, whatever the scale showed.
In a 160-person body-composition substudy of SURMOUNT-1, approximately one-quarter of the weight lost with tirzepatide was lean mass, a similar proportion to placebo. Lean mass is not synonymous with skeletal muscle, and these measurements cannot explain my loss of strength. They reinforce the need to look beyond total weight when assessing treatment.
Working in aged care has made me especially aware of what reduced function can mean for independence. I have encountered older people taking these medicines mainly for diabetes who did not understand their treatment, and staff who were unsure what to watch for. A patient’s ability to manage everyday tasks deserves attention alongside weight and blood results.
Before the next prescription
My last HbA1c was normal. My symptoms have improved on a lower dose of tirzepatide, and I remain on treatment. If you ask whether it was worth it, my honest answer is yes and no. I value the improvement in my blood sugar. I also wish I had been better prepared for the difficulties I am still living with.
I have spent thirty-two years caring for patients. I needed someone to ask these questions of me, too, and help me leave with a clear plan for monitoring symptoms and getting support. Before the next prescription, I would ask clinicians to ask three questions and make time to discuss the answers:
- Have you had weight-loss surgery, and what complications, nutritional deficiencies, or follow-up needs should we review?
- What do you understand about this medicine, including its side effects, and when and how would you seek help?
- What everyday activities do you want to keep doing, and how will we monitor your strength and nutrition during treatment?
Patience C. Ennis is a registered nurse, author, Results Coach, glucagon-like peptide-1 (GLP-1) user, and the founder of Body Compass, an education and navigation platform for people living with, considering, or moving beyond GLP-1 treatment. A graduate of King’s College London, she draws on more than three decades of clinical experience across emergency, community, palliative, and aged care, bringing together clinical knowledge, lived experience, and patient education to address the questions that often sit beyond the prescription.
Through Body Compass, she develops evidence-informed resources, books, practical tools, news updates, and non-clinical coaching support designed to help people understand changing appetite, side effects, strength, food noise, treatment adaptation, maintenance, and stopping. Her work is grounded in clarity, dignity, and honest interpretation of evidence, without hype, shame, or false certainty. Her aim is not to tell people what to decide, but to help them understand the terrain, ask better questions, and navigate metabolic health with greater confidence in everyday life and care.
She is the author of When GLP-1 Feels Different: Plateau, Food Noise, Adaptation and the Fear of “Resistance” (2026), available on Amazon and through Body Compass. Her other titles include Living Well on GLP-1 Medication: A Practical Guide to Everyday Life Beyond the Prescription, The Body Compass 30-Day Navigation Diary: A Reflective Daily Companion for GLP-1 Treatment, and The 30-Day GLP-1 Navigation Companion: Observation, Reflection, Preparation, Navigation.
She shares updates on LinkedIn, Facebook, the Body Compass Facebook page, Instagram, X, TikTok, and YouTube.
