In-office and telemedicine
weight loss
Frequently Asked Questions
What is semaglutide?
Semaglutide is a modified molecule our bodies make, called a GLP-1 analog. It works by increasing insulin
production and lowering glucagon secretion as well as targeting areas in the brain that regulate appetite and food intake. A small change in the molecule allows the drug to last weeks in our bodies rather than the natural version our bodies make, which lasts minutes.
How does semaglutide work?
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It delays how quickly our stomachs digest food, leading to a feeling of fullness and satisfaction with smaller meal sizes. It slows intestinal motility so you will feel fuller longer after meals.
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It lowers blood sugars, in part by reducing the production of sugar in the liver.
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It stimulates insulin secretion by the pancreas.
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It decreases inflammation throughout the body, which leads to adiponectin release and fat lipolysis.
What is tirzepatide?
Tirzepatide is a once-weekly injectable dual glucagon-like peptide 1 (GLP-1) receptor and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist. It works by increasing insulin production and lowering glucagon secretion as well as targeting areas in the brain that regulate appetite and food intake. A small change in the molecule allows the drug to last weeks in our bodies rather than the natural version our bodies make, which lasts minutes.
How does tirzepatide work?
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It delays how quickly our stomachs digest food, leading to a feeling of fullness and satisfaction with smaller meal sizes.
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It slows intestinal motility so you will feel fuller longer after meals.
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Dual action receptors allow for lower blood sugars, in part by reducing the production of sugar in the liver.
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It stimulates insulin secretion by the pancreas.
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GIP increases energy expenditure, resulting in weight loss.
How effective is this new FDA-approved medication?
For perspective: the average placebo-adjusted weight reductions with older anti-obesity medications that are currently approved by the FDA for the treatment of obesity are approximately 3.0 to 8.6%. One notable study, the STEP (Semaglutide Treatment Effect in People with obesity) program, reported that patients taking semaglutide achieved an average weight loss ranging from 14.9% to 18.5% of their body weight over 12-18 months. This is in comparison to a 2.4% weight loss in the placebo group. Similarly, the New England Journal of Medicine reported in 2022 (N Engl J Med 2022; 387:205-216) that at full tirzepatide dosing, the mean change in body weight for patients at 18 months was over 20%, with a mean reduction in total body fat of 33.9%. It's important to note that individual responses to medications can vary, and the results may not be the same for everyone. Additionally, any decision to use these medications for weight loss should be made in consultation with a healthcare professional who can assess your specific health condition and provide personalized advice.
How fast will I see results?
Usually, patients will feel a reduction in their appetite and an increase in satiety in the first few days of taking these medications. Medication dosing is usually slowly ramped up toward full dosing over the course of a few months, so effects will increase with dosing.
How much weight can I expect to lose?
Results vary for every patient. That being said, If patients take these medications as prescribed and escalate to full dosing, studies indicate that the majority of patients can expect to see 10-20% loss of body weight over 18 months.
What is in the medication?
These medications are peptides, similar to proteins occurring naturally in your body produced by the GI tract. Natural production of these peptides decrease with age and may be reduced in patients who are overweight. The functional protein in semaglutide is called GLP-1 (Glucagon-Like-Peptide-1). The functional proteins in tirzepatide are GLP-1 (Glucagon-Like-Peptide-1) and GIP (glucose-dependent insulinotropic polypeptide). We have also blended B-12 with the medication which can increase your energy and support your metabolism.
Will I get my daily nutrition?
Although these medications are usually effective even without working to change your diet, best results from any weight loss program are optimized when combined with a healthy diet including enough protein and vegetables to supply your body with the tools it needs. Some patients find supplementation of protein and vitamins helpful to ensure they do this.
What are the patient qualifications?
Since these medications mimic a naturally occurring protein, there are few contraindications to their administration. Among those who are not candidates are patients with a personal or family history of Thyroid cancer, Multiple Endocrine Neoplasia, or frequent pancreatitis. Your provider will discuss these issues with you and will ultimately decide if you are a good candidate for these medications.
Will I have side effects?
The side effect profile is usually minimal with these medications, but the more frequent side effects noted by patients taking semaglutide or tirzepatide include loose stools (more common the first few weeks), nausea, occasional constipation, mild indigestion. Very few patients find these symptoms to be significant enough for them to desire to stop taking the medications. One of the best ways to minimize these side effects is to “start low and go slow”. Starting at very low doses of these medications and proceeding only as recommended by your physician is crucial. Additionally, we routinely at B12 supplementation to our medication to reduce nausea. Should you still find nausea to be an issue, your physician can prescribe you an anti-nausea medication to the pharmacy of your choice. In some locations, we have partnered with top providers of mobile IV services and can extend discount pricing for you if concierge administration of IV fluids and/or medication is desired! Though experts stress every person’s tolerance for foods is unique, they believe that through trial and error, people can find out which foods are most tolerable so they can get the important nutrients they need while reducing side effects from semaglutide and tirzepatide through diet. High-fat foods — like fried or greasy foods — and alcohol are the two most important groups to avoid to help decrease side effects. It’s also a good idea to avoid high glycemic index foods, ultra-processed foods, and high sugar foods and drinks. Lastly, we have also noticed that tirzepitide not only seems to be a bit more effective at decreasing patient’s body weight than semaglutide, but it also may be associated with fewer unwanted side effects. Unfortunately, tirzepatide is a more costly medication that semaglutide because it is newer and because it contains two separate peptides instead of the single peptide present in Semaglutide.