BRAND NEW & REVAMPED AFFORDABLE WEIGHT LOSS PROGRAM OPTIONS

It is whatever you would like! Most patients love the virtual & telemedicine option; however, we always do offer in-office visits if you prefer. 

First, please know that every one is different and therefore, the needs of medication are different. For example, emotional eating, metabolic syndrome, etc. 

Here is a breakdown of medication uses and average results:

• Phen/Top is a stimulant appetite suppressant. It works immediately to reduce hunger and cravings. Weight loss is approximately 6-10%. Tolerance to this medication is built up quickly so effectiveness decreases over time. We do start on a low dose and titrate up to help avoid this. 
• Bup/Nal is a non-stimulant appetite suppressant. It works semi-immediately to reduce hunger and cravings. Weight loss is approximately 3-5%. We start on a low dose and titrate up. 
• Phentermine only is a short-term stand alone appetite suppressant. Weight loss is approximately 6-8% when used alone. Tolerance to this medication does occur quickly without combining with the topiramate. 
• Semaglutide/Ozempic/Wegovy is a GLP-1 injection. It works by delaying gastric emptying, making you feel full longer and faster, increases insulin sensitivity and works on a biological and metabolic level to promote weight loss and reverse/prevent certain diseases. Weight loss is approximately 15-20%. We start on a low dose and titrate up to max dosing. 
• Tirzepatide/Mounjaro is a GLP-1 and GIP injection. This works the same way semaglutide does but with an extra hormone that increases the effectiveness. Weight loss is approximately 20-30%. We start on a low dose and titrate up to max dosing. 

All appointments are self-scheduled online.

For your first visit, you will schedule under Initial Weight Loss appointment if you are a new patient.

For your monthly visits (aka renewal visit), you will schedule under "Weight Loss Med Refill" 

For monthly Lipo Fat Burning & Energy B12 injection, you will schedule online under "Injection Only."

All appointments online are self-scheduled for telemedicine. If you prefer an in-office visit, please let us know (we have to schedule you). 

This is an individualized answer; everyone is different and is based on medication. 

The injections are approved for long-term use. We recommend continuing until you have hit goal weight and then weaning down to ensure you can maintain. Remember, it takes these injections about 4-6 weeks to even hit a therapeutic level for effectiveness.  Consistent and long-term weight loss typically does not occur until max dose is reached.

For the capsules, tolerance is built up over time so effectiveness starts to decrease after several months. 

The GLP and GLP/GIP medications are NOT immediate; unlike what social media has made it seem like. The first several weeks of low dose administration are what is preparing your body for the therapeutic level. Once you hit the therapeutic level, you will notice the biggest changes. This level is when you have hit max dosing (2mg) which is on or around week 8. That is not to say you will not lose weight or have appetite suppression in the first 8 weeks, but the results are typically slow going while we titrate your dose. Many patients ask if they can titrate sooner and increase the dose themselves. This is NOT allowed as the consequences are too great. Rome was not built in a day-be patient-it will happen! 

A compounding pharmacy is a special type of pharmacy that is able to "make" or compound medications specifically for a person and their individual needs. The ingredients they use are the same active ingredient found in brand name  medications. They are able to add ingredients to make medications more effective (like adding B12, etc) or by removing ingredients that are harmful (like dyes, gluten, etc). 

We have been using compounding pharmacies for over 2 decades (they are not new) and are highly regulated and sterile.  Each pharmacy and each medication that is compounded will have extensive sterility and quality control checks. 

The reason we use compounding pharmacies for weight loss medications is because #1 they are able to compound the active ingredient in the brand name medications at a much cheaper price (because generics are not yet available for Ozempic/Wegovy (semaglutide) or Mounjaro (tirzepatide); #2 there is no issues with insurance denying medications because it is self pay at an affordable cost; #3 while slight delays can happen (average of 2 weeks based on volume), these medications are available and never on back order; #4 we can customize dosing to fit our patients individual needs. 

Compounding pharmacies are sterile and highly regulated. They are completely safe. 

The active ingredients in these medications are the "generic" forms for the brand name. They are effective and produce the same results as the brand names.  Most brand name medications have a generic. When they do not, it means that the patent is not yet available. HOWEVER, the patient is for the ingredient itself. Compounding pharmacies are NOT permitted by law to compound a medication that is commercially available unless there is a manufacturer back order OR if the main i/active ingredient is being compounding with another ingredient. In the case of these weight loss medications, compounding pharmacies typically will compound the active ingredient with B12, L-carnitine or another similar  co-ingredient. 

There are close to 10,000 compounding pharmacies licensed in the US; however, we only use a handful that have the highest sterility, quality control and efficacy. Currently our preferred pharmacies are (in no particular order): Olympia, Magnum, South Lake, CPA, Shields, Empower, MetroMeds. 

As you can imagine, the weight loss craze is hot right now. Just like everyone else, compounding pharmacies are being inundated with orders from doctors nationwide and they process them in the order in which they receive. They have to compound medications as they receive orders (they are not stockpiled) and then they go through sterility checks before they can be shipped out. The normal turn time to receive medications has always been about 3-5 business days. Currently with the high volume, intermittent delays may occur for up to 14 business days.  We do recommend planning ahead for refills. No, there is nothing we can do to expedite their process. 

First, you will want to order insulin syringes; we recommend through Amazon. I would search for a 100 unit insulin syringe with 31g x 5/16" needle. Also grab some alcohol pads.

When you get your vial of medication, please be sure to read instructions on storage. Some are to be stored in the freezer and others in the frig (read YOUR  vial each time and do not rely on what your friends are doing; everyone has different meds). 

If you have never injected yourself before, please contact our office for guidance for your first administration.

If you have injected yourself before, you will follow the instructions on how to dose yourself and then inject either into the fat on your abdomen, fat of your thigh or fat on your arm. This must go into the fat and not muscle. 

I also recommend drawing up your dose over the carpet or counter/sink to avoid dropping and shattering the vial. YIKES!

Capsules: should be stored at room temperature.

Injections: each medication and pharmacy is different. Please READ your labels on your package to learn if it is to be stored in the FREEZER or REFRIGERATOR. It will never be left out.  Most of the pharmacies now are using refrigerator stored vials. 

Great question! We do not recommend any diets that have a name to it, like Keto, Paleo, etc. In order to achieve REAL long-term results, you have to eat REAL food! We believe in eating whole foods and meals that are balanced and portioned for you. 

We will guide you through appropriate daily intake and even give you tips, tricks and sample lists. Every patient is different so daily intake will vary from patient to patient. 

You do not have to deprive yourself either! However, there is a time for when you are able to occasionally treat yourself. 

However, we do not recommend drinking alcoholic beverages. We don't recommend drinking ordinarily if you are trying to lose weight and get healthy but weight loss medications and wine, beer, or other alcohol do not go well together. 

SOME insurance plans will cover Ozempic, Wegovy, or Mounjaro IF you meet their criteria. All plans are different so please check with your plan. In order for us to consider you as a candidate for insurance use, you must have : Type 2 Diabetes, Pre-diabetes, PCOS, Insulin Resistance, Metabolic Syndrome, Hypertension, Hyperlipidemia, Non-alcoholic Fatty Liver Disease or other Cardiovascular Disease WITH proven failure to other treatments (this is not our criteria, but insurance criteria). 

We do not process prior authorizations!

Please note, there are no guarantees of insurance authorizations OR that the pharmacy will even have the medication in stock. The fee is non-refundable. We recommend you take advantage of our affordable compounded options if that happens.

Medication is only written for 30 days at a time. We do not write for 90 days, even if insurance requires this. This is to appropriately monitor and adjust dosing on a regular basis for best outcomes, responsible prescribing and patient care. There are no exceptions.

This is VERY common. 

Insurance has a very strict criteria that needs to be met (as defined above). If you do not meet the health criteria and/or have tried and failed a number of different medications first, it is likely to be denied. 

Also, many retail pharmacies like CVS, Walgreens, etc does have the right to refuse sale of these medications without an uncontrolled diabetes diagnosis; despite a prior authorization approval.  Yes! This happens a lot. 

If this happens, we strongly encourage you to take advantage of our very affordable compounded options. You will not have to worry about insurance or availability at the pharmacy. You can also use HSA/FSA cards. 

We do require our patients to complete their prior authorization request to their insurance (as we are out of network); however, if you would like our assistance or if we must get involved, there is a $50 prepaid, non-refundable fee for our time. 

Medicare does not cover these medications at this time.