Glossary
The vocabulary nobody explains.
Medication, insurance and pharmacy words, in plain English. Definitions, not directions: what to do with any of it is a conversation with your care team.
Medication words (what they mean, not what to do)
GLP-1
Short for glucagon-like peptide-1, a hormone your gut releases after you eat. GLP-1 medications mimic it: they slow how fast the stomach empties and turn down appetite signals. “Being on a GLP-1” means being on one of these medications.
GIP
Another gut hormone. Some newer medications act on both GIP and GLP-1 receptors, which is why you’ll see “dual agonist” on the box.
Agonist
A drug that switches a receptor on, the way the real hormone would. The “-tide” drug names (semaglutide, tirzepatide, liraglutide) are GLP-1 agonists.
Starting dose, titration, maintenance dose
Most people begin on a low dose and step up over weeks (titration) until they reach the dose they stay on (maintenance). How fast, how far and whether to pause is a care-team decision, not a blog decision.
Pen
The injector most of these medications come in. A single-dose pen is used once; a multi-dose pen is dialled to the dose and reused for a set number of injections.
Compounded
A version mixed by a compounding pharmacy rather than made by the drug’s manufacturer. Different rules apply, and availability changes. Questions about compounded versions go to your prescriber and pharmacist.
Food noise
The constant background hum of thinking about food: planning the next meal while eating this one, the 2 am fridge standoff. For many people it is the first thing a GLP-1 quiets. We named a whole topic after it.
Side effects
Nausea, constipation, fatigue and a few others are common, especially around a dose change. What is normal, what to wait out and what to call about is your care team’s call. The week six sheet has a script for that conversation.
Insurance and pharmacy words
Prior authorization (PA)
Your plan saying “before we pay for this, your prescriber has to show us you meet our criteria.” Not a denial; a pause with paperwork. Your prescriber’s office files it. Translated here.
Formulary
The list of medications a plan covers, usually sorted into tiers. If a drug is “not on formulary,” the plan doesn’t cover it as standard and a PA or exception is needed.
Tier
Where a drug sits on the formulary, which sets your copay. Lower tier, lower cost. Specialty tiers are the expensive end.
Step therapy
A plan rule that you try a cheaper drug first and show it didn’t work before they cover the one your prescriber wants.
Quantity limit
A cap on how many pens or doses the plan will cover per month. Dose changes can trip it, which shows up as the pharmacy saying “the claim rejected.”
Deductible, copay, coinsurance
Deductible: what you pay before the plan starts paying. Copay: a flat amount per fill. Coinsurance: a percentage of the price. Which one applies depends on the plan and the tier.
Savings card / copay card
A manufacturer program that lowers your out-of-pocket cost on a commercial plan. Terms and eligibility change; the manufacturer’s site and your pharmacist have the current version.
Appeal
Formally asking the plan to reverse a denial. Your prescriber usually writes the letter; you can write one too. The one I wrote.
Backorder / shortage
The pharmacy can’t get the dose you need right now. What helped when it happened to me.
Open enrollment
The window, usually in the fall, when you can change plans for next year. Formularies change in January; check before then.
Getting Quiet words
The quiet part
What the appetite used to drown out: who you eat with, what you do with an evening, who you are once food isn’t running the show. Also the name of the blog.
Low Volume
The newsletter. One email, most weeks. Low volume by design.
The after chapter
Life past goal weight: maintenance, identity, belonging. The part most programs stop at. The quiz tells you which stage of it you’re in.
Maintenance
Keeping the result. It has no finish line, which is the problem and the point. We don’t use “goal weight” as a destination here.
Tiny appetite
The appetite of a polite houseguest. Recipes written for four hungry people don’t fit it. The cookbook does.
Care team
Your prescriber, pharmacist, dietitian, therapist: whoever is actually responsible for your treatment. When we say “ask your care team,” we mean it literally.