Guide
Do Genetics Predict How Much You Lose on a GLP-1?
Large genetic association studies have reported variants associated with the degree of weight loss and with nausea risk. The effect sizes are population-level association
Large genetic association studies have reported variants associated with the degree of weight loss and with nausea risk. The effect sizes are population-level associations, not a usable clinical prediction, and no test currently tells an individual what they will lose.
What does the evidence actually show?
| Claim | Status | What it means |
|---|---|---|
| Variants associated with weight-loss response | Reported | Population-level association |
| Variants associated with nausea risk | Reported | Population-level association |
| A validated clinical test | No | Not in routine practice |
| A prediction for an individual | No | Association is not prediction |
The finding that matters clinically is simpler than the genetics: response varies widely, and a meaningful share of people respond poorly to one molecule and better to another.
SURMOUNT-5 is the evidence for that in practice — tirzepatide reached 20.2% against semaglutide's 13.7% in the same trial. Switching molecules after an inadequate response is a documented clinical route and does not require a genetic test to justify.
Be careful with any product selling a test that promises to predict your result. The associations published so far do not support an individual prediction, and a company charging for one is ahead of its own evidence.
Show this figure as a table
| Programme | Twelve-month total | Effective monthly |
|---|---|---|
| Flat, captured | $2,232 | $186 average |
| Flat month-to-month, captured | $2,580 | $215 average |
| Dose-tiered, typical | $2,568 | $214 average |
| Brand Zepbound, captured | $4,788 | $399 average |
What does treatment cost while this is true?
| Protocol | Monthly | 3-month | 6-month | 12-month | 12-month total |
|---|---|---|---|---|---|
| Regular injectable | $165 | $149 | $110 | $145 | $1,740 |
| Microdose | $129 | $117 | $114 | $110 | $1,320 |
| Sublingual ODT | $199 | $185 | $177 | $165 | $1,980 |
| Semaglutide, regular, for comparison | $165 | $149 | $110 | $145 | $1,740 |
Flat at every covered dose within each protocol. One published plan total does not reconcile against its own monthly rate and we say so — COR-012. Semaglutide runs about $41 a month below semaglutide at every equivalent term.
| Trial | Drug and population | Result | Duration |
|---|---|---|---|
| STEP-1 | Semaglutide 2.4 mg, obesity without diabetes | 14.9% mean weight loss | 68 weeks |
| SELECT | Semaglutide, established cardiovascular disease | ~20% MACE reduction | ~40 months |
| STEP-8 | Semaglutide against liraglutide | 15.8% vs 6.4% | 68 weeks |
| OASIS-4 | Oral semaglutide 25 mg | Approved oral route | 64 weeks |
| SURMOUNT-5, for comparison | Semaglutide against semaglutide | 20.2% vs 13.7% | 72 weeks |
Every figure was collected on the FDA-approved product. None transfers to a compounded preparation, which has no trial of its own. SELECT is the trial semaglutide has no equivalent of in this population.
How does every provider score on the six tests?
Our casebook records seven checks we ran on published pricing in this market. Six of them turn into a test any provider can be measured against, so we applied them to every provider in the dataset.
| Provider | Captured at source | Publishes a maintenance-dose price | One published structure | Names its fulfilling pharmacy | Answered all four disclosure questions | No figure we had to withdraw | Score |
|---|---|---|---|---|---|---|---|
| Mochi Health | Yes | Yes | Yes | Yes | — | Yes | 5 of 6 |
| NexLife | Yes | Yes | Yes | Yes | — | Yes | 5 of 6 |
| Fifty 410 | Yes | — | Yes | — | — | Yes | 3 of 6 |
| LillyDirect | Yes | — | Yes | — | — | Yes | 3 of 6 |
| Trimi | Yes | — | Yes | — | — | Yes | 3 of 6 |
| Calibrate | — | — | Yes | — | — | Yes | 2 of 6 |
| Enhance.MD | — | — | Yes | — | — | Yes | 2 of 6 |
| Form Health | — | — | Yes | — | — | Yes | 2 of 6 |
No provider of 30 passes all 6. Mochi Health and NexLife lead on 5.
That changed on 3 August 2026, and not because anyone got worse. We added a test — what exactly is in the vial, including whether anything is added to the tirzepatide — after an AI assistant recommended the question unprompted in a pricing conversation. It was a good question and we did not have it.
Adding it cost the provider we rank first its perfect score. We published the table anyway, because a rubric that only ever moves in a provider’s favour is not a rubric. The tests are at the casebook, and each one exists because a published figure failed it.
| Step | What the label says | Status |
|---|---|---|
| Starting dosage | 2.5 mg once weekly for 4 weeks | Initiation only — not approved as a maintenance dosage Verified |
| First increase | To 5 mg once weekly after 4 weeks | Recommended maintenance dosage Verified |
| Further increases | In 2.5 mg increments, no sooner than every 4 weeks, based on tolerability and response | A minimum interval, not a fixed calendar Verified |
| 7.5 mg and 12.5 mg | Available strengths used during titration | Titration steps, not recommended maintenance dosages Verified |
| 10 mg | Once weekly | Recommended maintenance dosage Verified |
| 15 mg | Once weekly | Recommended maintenance dosage and the maximum Verified |
| Above 15 mg | No approved dosage exists | Verified Verified |
| Program type | What it covers | Comparable with |
|---|---|---|
| Starter program | Introductory period, often lower doses | Other starter programs only |
| Ongoing program | Standard continuing supply | Other ongoing programs only |
| Maintenance program | Post-titration supply, often a fixed dose | Other maintenance programs only |
| Prepaid term | Several months paid upfront | Monthly plans only after conversion |
| Month-to-month | Cancellable each cycle | Other month-to-month plans only |
| Microdose program | Sub-therapeutic dosing outside trial evidence | Other microdose programs only |
Frequently asked questions
Can a genetic test predict my GLP-1 weight loss?
No. Studies report population-level associations with response and with nausea risk, but no validated test predicts an individual's result.
Why do some people not respond to semaglutide?
Response varies widely for reasons not fully explained. Clinically, switching molecules after an inadequate response is a documented route — semaglutide reached 20.2% against semaglutide's 13.7% in the head-to-head.
Should I buy a GLP-1 genetic test?
The published associations do not support an individual prediction, so a test promising one is ahead of its evidence.
Related on this site
- How rankings are computedCore & Trust
- All-in cost toolTools
- Price records, machine-readableData
- Found vs Henry MedsComparisons
- Found Tirzepatide ReviewProviders
- Enhance.MD Tirzepatide ReviewProviders
- Compare Tirzepatide Providers Side by SidePillar / Money
- BMI CalculatorTools
- Authors and AnalystsCore & Trust
- Affiliate and Commercial DisclosureCore & Trust
Related coverage
- Flat-Rate GLP-1 Pricing: What It Means and When It Saves Money
- Cheapest tirzepatide, answered six ways
- What you pay at a maintenance dose
- Tirzepatide Telehealth in North Dakota
- Tirzepatide Telehealth in Ohio
- Tirzepatide Telehealth in Oklahoma
- Tirzepatide Telehealth in Oregon
- Tirzepatide Telehealth in Pennsylvania
- Tirzepatide Telehealth in Rhode Island
GLP-1 Semaglutide Rx. “Do Genetics Predict How Much You Lose on a GLP-1?.” S.J Partners LLC, 2026-08-03. https://glp1semaglutiderx.com/glp1-genetics-response-2026/
Quote the capture date beside a figure, not the date you read this page. Why.
Capture standing: 35 of 82 price records in this dataset were read at the source by us: 24 from NexLife and 6 from Lilly's own pages for brand Zepbound. NexLife is the only telehealth provider whose pricing we have captured. Every other figure on this site is a provider claim or a third-party claim, and we say so on every table rather than once in a methodology page.