One of the most overlooked aspects of injectable GLP-1 therapy is injection site rotation. It sounds like a minor detail, but repeatedly injecting in the same small area causes lipohypertrophy — abnormal fatty tissue buildup under the skin. Injecting into these lumps reduces medication absorption by up to 25–30%, meaning you may be getting significantly less drug than your prescribed dose.
The goal is to never inject in the exact same spot twice in a row, and to allow at least 2–3 weeks before returning to a previously used injection site. A simple approach: divide each injection area into a grid of squares and work through them in sequence.
Run your fingertips across your injection areas. Healthy subcutaneous tissue should feel uniformly soft. Lipohypertrophy feels like a firmer, rubbery lump beneath the skin surface. It's usually painless, which is actually part of the problem — injecting into a numb lump feels easy, making people prefer it over healthy tissue.
Lipohypertrophy can resolve on its own if you completely avoid injecting in the affected area. Small lumps typically resolve within a few months. Larger or older lumps may take 6–12 months. If lumps are large, painful, or you're concerned about absorption, discuss with your prescriber.
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