Weight Loss with Semaglutide
(Ozempic, Wegovy)
Semaglutide for Weight Loss
(Published by: UCLA Health; Jan 2023): The search for effective and safe weight loss treatment seems never-ending. But the newest anti-obesity medication, Semaglutide, is still making waves more than a year after its 2021 approval by the U.S. Food and Drug Administration.
The injectable drug, initially only used as diabetes medication, is the first drug since Saxenda (2014) approved to treat chronic weight management in the 70% of American adults who are obese or overweight. Research continues to show the effectiveness of Semaglutide injections for weight loss. It also highlights the value of treating obesity as a chronic metabolic disease instead of expecting people to rely solely on willpower and lifestyle changes to manage their condition. But Semaglutide is not a miracle drug and it’s not for everyone.
“It is important to remember that obesity is heterogenous, chronic and complex,” says Vijaya Surampudi, MD, physician nutrition specialist and assistant director of the UCLA Weight Management Program (RFO). “There is no cure for obesity. It requires lifelong treatment that’s not one size fits all.”
What You Need to Know
What is Semaglutide?
Semaglutide belongs to a class of medications known as glucagon-like peptide1 receptor agonists, or GLP-1 RAs. It mimics the GLP-1 hormone, released in the gut in response to eating. One role of GLP-1 is to prompt the body to produce more insulin, which reduces blood sugar (glucose). For that reason, health care providers have used Semaglutide for more than 15 years to treat Type 2 diabetes.
But GLP-1 in higher amounts also interacts with the parts of the brain that suppress your appetite and signals you to feel full. When used in conjunction with diet and exercise, it can cause significant weight loss — and a reduced risk of cancer, diabetes and heart disease — in people who are obese or overweight.
Semaglutide Injections for Weight Loss
Currently, Semaglutide is only approved for weight loss under the brand name Wegovy. The typical dose for weight loss is 1 to 2.4 milligrams, administered weekly as subcutaneous (under the skin) self injections. But as interest in Semaglutide for weight loss continues to grow, health care professionals are finding ways to manage the demand. Many prescribe other brands of Semaglutide, such as Ozempic and Rybelsus, off-label (using a drug that is FDA-approved for a different reason).
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There have been several anti-obesity medications that help suppress appetite and achieve weight loss. But Semaglutide performs on a new level. An early study of 2,000 obese adults compared people using Semaglutide plus a diet and exercise program with people who made the same lifestyle changes without Semaglutide. After 68 weeks, half of the participants using Semaglutide lost 15% of their body weight, and nearly a third lost 20%. Participants who incorporated only lifestyle changes lost about 2.4% of their weight.
Since then, additional studies have shown similar results. But they’ve also revealed that participants tend to regain the weight lost when they stop taking Semaglutide. “The fundamentals of obesity management will always be changes to diet and exercise,” Dr. Surampudi says. “But having anti-obesity medications is another tool in the toolbox — depending on the person’s clinical history.”
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The side effects of Semaglutide are typically mild — especially when compared to the complications associated with overweight and obesity. People taking Semaglutide for weight loss may experience:
• Dizziness
• Fatigue
• Gastrointestinal issues, such as diarrhea, constipation and gassiness
• Headache
• Stomach issues, including nausea, vomiting, pain or distension (bloat)
Gastrointestinal issues are the most common complaint among people just starting Semaglutide. But you may be able to reduce the side effects by beginning with a lower dose and then slowly increasing the amount you take.
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The FDA recommends Wegovy (Semaglutide) for weight loss if you meet one of the following criteria:
• Have a body mass index (BMI) of 27kg/m2 or greater and at least one weight-related condition, such as high blood pressure, Type 2 diabetes or high cholesterol.
• Have a BMI of 30kg/m2 or greater.
Avoid Semaglutide if you have:
• History of medullary thyroid cancer
• History of gallbladder disease
• History of pancreatitis
• Multiple endocrine neoplasia syndrome type 2 (MEN2)
The Details
Weekly visits with one of our trained staff members to assist with injections and dose changes. Each visit you will be weighed and vital signs will be taken. At weigh-ins, multiple Body Composition markers will be measured and recorded. We also ask that you take weekly body measurements at home to help track your progress. A paper record will be provided along with free app options.
Visits may be conducted by multiple members of our team specifically trained in our weight loss program.
Medical visits are required at intervals determined by your healthcare provider, which may be outside the prescheduled plan.
Some patients may be required to have further medical evaluations or clearances prior to starting this plan, which will be determined by our Nurse Practitioner at the initial consultation.
MBIT Structured Weight Loss Program
Our structured program is, at minimum, a 6-month program that provides you with the support needed to achieve your weight goals through the individualized treatment plan developed for you incorporating medication supplementation, nutrition, and exercise.
How Does it Work?
A free phone consultation with one of our trained staff members to go over any questions you may have about the program and to discuss eligibility. Those that are eligible and would like to proceed with the program will then be sent our consent forms and be required to make a non-refundable deposit of $200. This amount will be applied to your plan total once you are determined eligible.
Prior to the initial visit you will be asked for lab work to be drawn and completed by the time of your first appointment. If you have had recent bloodwork done within the last 45 days, we require copies to be faxed to our office prior to the first appointment. (FAX: 440-256-8664) We will review and determine if other tests still need to be drawn prior to the first appointment. For those that need lab work drawn, we use Lab-Corp for our lab orders. If you go to one of their sites, you may utilize your insurance for these lab tests. They also offer a discount for those that choose to pay out of pocket at the time of their lab draw.
Please make your initial appointment after you have had your bloodwork drawn. This will avoid having to cancel your initial consultation. Repeat lab work will also be ordered every 3 months or sooner if indicated.
At your initial visit with our Nurse Practitioner, we will discuss your health history and lab work. Once all health history and lab work have been reviewed, a final decision on eligibility will be decided. Your weight loss goals will be discussed and you will make the final decision to move forward with our program. From there, you will come in once a month to follow-up with our Nurse Practitioner to evaluate your progress. At each visit, prescriptions will be refilled at the time of visit. No shows or non-compliance will result in no refills on prescriptions and possible dismissal from the program (this is detailed further in our consent forms). Payment for each month will be due on the day of your office visit with our Nurse Practitioner.
At the completion of your first 3 months in the program, your progress we be re-evaluated. This will be completed every three months that you are part of this program.
After your initial appointment with our Nurse Practitioner and both parties (patient and Nurse Practitioner) agree to proceed, you will be scheduled for your 30-minute virtual consultation with our Nutrition Coach. You will be asked to record what you eat every day for one week prior to your consultation with our Nutrition Coach. This will allow us to better guide you on your journey to success. An individual assessment on eating habits and education on calorie reduction and healthy food choices by our Nutrition Coach will be performed at the start of the program. You will then receive bi-weekly 15-minute virtual check in appointments for 3 months, unless otherwise indicated. A food and beverage diary should be utilized as often as possible to help track eating habits. A paper journal will be provided along with free app options. Additional nutrition coaching plans are available for those who would like more involvement or continued assistance. Please inquiry directly with our Nutrition Coach for pricing and details.
In your third month, an initial virtual consultation will be scheduled with our Personal Trainer. Our trainer is offering three different plan options, which are broken down below. You are required to choose one option. Depending on what option you choose will determine the cost, which is also listed below. You will pay the trainer directly and setup an account with her personal app at the time of the initial consultation. This will take place towards the end of month 3, with the intention of starting your exercise program at the beginning of month 4. The first three months of our program we focus on adjusting diet and finalizing the Semaglutide dosing needed per patient, which allows for you to acclimate to these changes prior to starting an exercise regimen. Exercise can still be utilized in those first 3 months, and we encourage you to do so if able.
Pricing
Each plan will include ALL of the following:
Initial consultation with our Nurse Practitioner and monthly
follow-up visits for a total of 6 months.Weekly injections, weigh-ins, and vital signs for 6 months.
Initial Nutrition Coach 30-minute consultation, and bi-weekly
virtual 15-minute check-ins for 3-months.Monthly Semaglutide prescription for a duration of 6 months.
Initial consultation with our Personal Trainer.
Educational materials.
Personal trainer plan (REQUIRED, options listed below).
Initial deposit of $200, PLUS a 6-month plan = $2800.00.
Financing is available through Advance Care Card, who will determine eligibility/approval. First month of the plan you will be charged $800. This is in addition to the $200 non-refundable deposit and then $360 for each of the remaining months of your 6-month plan. You can choose to pay all at once or monthly. HSA/FSA cards can also be used at our facility. A credit card is required to be kept on file for the monthly plan option. If you are paying monthly, there are no refunds.
The exercise plan is a separate charge. Once you chose one from the options below, you will start paying for that plan at the end of month 3, and you will pay directly to our Personal Trainer.
If you chose to stop the program and have paid in full, the refund policy is as follows: if a refund is to be issued it will be only on months that you have not yet started. For example, if you paid all at once and decide to stop in the first few days into month 3, you will only be refunded for months 4, 5 and 6. Each new month starts 30 days after your last visit with the nurse practitioner.
Personal trainer plan options (one option is required):
Option to renew at the end of each session with previous tier or a different level tier.
Tier 1 - $240
In person at her studio located in Geneva.
8 sessions at 30 minutes each.
Will also include her app for all homework to be done on your own as well as weekly check-ins and accountability.
Tier 2 – $175
4 sessions, 45 min. each, once a week for 1 month.
These will be done via FaceTime or Facebook messenger. This allows you to be at your house with your own equipment or in a gym local to you. This will also include her app with homework to do own your own.
Tier 3 – $110
2 months of weekly homework via her app. Weekly check-ins with a 15-minute call for questions.