Semaglutide and Tirzepatide GLP-1 Drugs for Weight Loss-Our Experience

To learn more about our medical weight loss programs please click here:  Medical Weight Loss and Diet Program.

At Optimal Wellness MD, we have been prescribing these new weight loss medications since 2022 with outstanding results, but we have also learned a few things that patients should be aware of:

1.  These medications MUST be combined with a strict diet plan for good results.  The diet should be high in protein, with very low fat and carbohydrates to achieve fat loss.  If patients do not follow a strict diet and just inject the medications, they will reduce their appetite, but then they just stop eating and lose mostly muscle-not fat as well as run the risk of dehydration and muscle cramps.  This is not the result you want.  For this reason, we have all our weight loss clients work with our nutritionist to make sure they are losing fat and not muscle, staying hydrated, and taking a mineral supplement.  We offer weekly weigh-ins and coaching in person or by telemedicine using a home scale to  measure body fat.
2. In-person evaluation by a doctor and in-person coaching by a nutritionist delivers better results than the online sources or a medspa and is actually more cost-effective.  The goal is to lose the fat quickly and retain muscle.  While paying for a doctors visit costs money, as does a weight loss food program, it delivers quicker results and therefore costs you less in the long run.  Our clients lose about 20 pounds of fat per month; patients who just do an online program or get the drugs from a med spa and don’t work with a doctor or nutritionist and pay upwards of $200/month may not actually see much fat loss and may end up using the drugs for many months, spending far more money than doing it the right way-by seeing a doctor and working with a nutritionist.  Also, what about patients who may have side-effects?  Good luck with an online program that communicates by text or a med spa.  You need to be able to see an experienced doctor in his office to be checked and have your treatment plan adjusted or your medication dose changed.  While rare, these drugs can cause allergic skin reactions, nausea and vomiting, pancreatitis, and even thyroid issues.  These potential problems need to be checked out by a doctor in person.
3. The cost of using these drugs does not have to be high.  If you are obese, we can  often get insurance to pay for the medicine, so you will have a fairly low co-pay.  However, insurance will only pay for these drugs if a patient is considered obese, defined as BMI over 35.  However, many patients are still relatively over weight and may even be pre-diabetic and will benefit from these medicines but are not considered obese.  In that case, we  have found that insurance wont pay, but compounding pharmacies can help by producing these medicines at a much lower cost, so that the patient can gain access to these medicines for about $150/month instead of the $1500.00/month to buy the brand name products without insurance.
4. Besides fat loss due to loss of appetite, we have observed that many patients also experience a loss of interest in alcohol, smoking, even behaviors such as gambling.  It seems these medicines are working on the brain to reduce cravings of all types, not just for high calorie foods.
5. What can you expect from these medicines when used properly in our program?  Rapid fat loss, often 20 or more pounds of fat per month, minimal to no side effects.  We have seen some minor gastrointestinal side effects such as feeling bloated or slightly nauseous, but these typically subside with a dose reduction.
6. Patients often ask what happens after they lose the weight.  Do they need to stay on these medicines?  This really depends on the individual patient.  Some patients seem to be able to stop the drugs and maintain weight loss, particularly if they have been working with our nutritionist and learn how to eat a proper weight-loss diet.  Others seem to need periodic dosing to maintain their weight loss, perhaps at a lower dose ever 2 weeks.
7. Other benefits from these medicines are the reduction in risk of a heart attack, probably due to the improved metabolic health associated with eating a low carb/low fat diet and the resulting weight loss.  We typically see improvements in  blood tests such as triglycerides and cholesterol as well as reductions in blood pressure.