Your initial consultation includes baseline labs and a comprehensive health assessment to ensure this program is right for you.
- Baseline labs required: fasting glucose or HbA1c, comprehensive metabolic panel, lipid panel, TSH, and CBC
- Biometrics recorded: body weight, BMI, waist circumference, blood pressure, and heart rate
- Complete medication review — bring a list of all prescriptions, supplements, and OTC medications. Certain medications require dose adjustments when starting GLP-1 therapy
- Disclose your full medical history, especially: thyroid conditions, pancreatitis, gallbladder disease, gastroparesis, eating disorders, kidney disease, or diabetes medications
- Oral contraceptives (Tirzepatide only): Tirzepatide may reduce the effectiveness of oral hormonal birth control by approximately 20% at program start and each dose increase. Use backup contraception for at least 4 weeks after each dose escalation
You will be trained on proper injection technique before your first self-administered dose.
- Remove pen from refrigerator 15–30 minutes before injection — allow it to warm to room temperature (cold injections cause more discomfort)
- Inspect the solution: it must be clear and colorless. Discard if cloudy, discolored, or contains particles
- Check the expiration date on your pen
- Wash hands thoroughly with soap and water
- Clean the injection site with an alcohol swab and allow it to dry for 10 seconds before injecting
- Approved injection sites: abdomen (at least 2 inches from navel), front or outer thigh, or back of upper arm
- Rotate sites weekly — space each injection at least 1 inch from the prior site in the same zone. Do not inject into scarred, bruised, tender, or irritated skin
- Always use a new needle — never reuse or share needles or pens
GLP-1 receptor agonists mimic natural gut hormones that signal fullness to the brain, slow gastric emptying, and suppress appetite. They are not stimulants.
What to Expect
- Weeks 1–4: Initial dose — appetite changes may be subtle. This is the adjustment period
- Weeks 4–12: Appetite suppression strengthens with each dose escalation
- Weeks 8–16: Significant weight loss typically begins
- Months 9–15: Peak weight loss results
- Weight plateaus are normal and expected, especially after month 9–12 — this is physiology, not treatment failure
Dose Escalation — Semaglutide (Wegovy)
- Weeks 1–4: 0.25 mg • Weeks 5–8: 0.5 mg • Weeks 9–12: 1.0 mg
- Weeks 13–16: 1.7 mg • Week 17+: 2.4 mg (maintenance)
Dose Escalation — Tirzepatide (Zepbound)
- Weeks 1–4: 2.5 mg • Weeks 5–8: 5.0 mg • Weeks 9–12: 7.5 mg
- Weeks 13–16+: 10 mg • Optional: 12.5 mg, then 15 mg
Any escalation step can be held for an additional 4 weeks if side effects are not tolerable. We will never escalate through severe nausea.
Most side effects occur during dose escalation weeks and improve as your body adjusts:
- Nausea — the most common side effect (affects 40–70% of patients), typically strongest days 1–3 after each dose increase
- Decreased appetite and early fullness — this is the intended therapeutic effect
- Constipation or diarrhea — usually resolves with dietary adjustments
- Mild fatigue or headache — often related to reduced caloric intake or dehydration
- Burping, acid reflux, and a feeling of slow digestion
- Injection site reactions: small bump, mild redness, brief itching — resolves within 24 hours
- Temporary hair thinning — a response to rapid weight loss (not the medication itself); resolves with adequate protein intake over time
Please notify us if any of the following apply:
Cannot Start Program
- Personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN2)
- Active or history of pancreatitis
- Pregnancy — discontinue immediately if pregnancy is confirmed
- Breastfeeding — insufficient safety data
- Severe gastroparesis or GI motility disorders
- Type 1 diabetes
- Severe kidney disease (Stage 4–5 CKD)
- Known hypersensitivity to semaglutide, tirzepatide, or any formulation components
Require Discussion and Monitoring
- Gallbladder disease or history of gallstones
- History of eating disorders (anorexia, bulimia)
- Heavy alcohol use — must cease before starting
- Current insulin or sulfonylurea use (hypoglycemia risk — doses will be adjusted)
- Mild to moderate kidney disease (Stage 1–3b CKD)