Medical Weight Management
Obesity is a chronic disease. We treat it like one.
Appetite is regulated by hormones, not willpower. GLP-1 and dual-agonist medications work on that biology — and they work best inside a program that also protects your muscle, tracks your labs, and adjusts your dose based on how you actually feel.
What your membership actually includes
- Initial 30-minute video visit with a licensed physician or nurse practitioner
- Personalized treatment plan and prescription when clinically appropriate
- Unlimited secure messaging with your care team
- Monthly follow-up visits
- Dose titration and side-effect management
- Nutrition and resistance-training guidance to protect lean mass
- Prescriptions sent to the pharmacy of your choice
What it does not include
- The cost of medication — you pay your pharmacy directly
- Laboratory fees — billed by the lab at transparent cash rates
- Any service requiring an in-person examination
On medication cost — the honest version
Brand GLP-1 medication is expensive. Without insurance coverage, monthly cash prices commonly run several hundred dollars or more, depending on the product, the dose, the pharmacy, and any manufacturer savings program you qualify for.
We will tell you the realistic range for your specific situation before you pay us anything. If the cost does not work for you, we will say so rather than sell you a membership you cannot use.
We do not prescribe compounded GLP-1s
Compounded semaglutide and tirzepatide are not FDA-approved and are not reviewed for safety, effectiveness, or quality. The FDA shortage declarations that permitted broad compounding of these molecules have ended. We prescribe manufacturer-produced product only.
Protecting muscle is part of treatment
A substantial share of weight lost on these medications is lean mass. Your plan includes a protein target and a resistance-training prescription. We consider this a clinical requirement, not a wellness upsell.
Your first 12 weeks
What happens, and when
Week 0
Eligibility check, baseline labs (A1c, CMP, lipids, TSH, pregnancy test where applicable), 30-minute video visit, and your Good Faith Estimate.Weeks 1–4
Starting dose. Weekly portal check-in on weight and side effects. Message us any time — nausea is manageable and we would rather adjust than have you quit.Weeks 4–8
First dose escalation only if you tolerated the current step. Protein and resistance-training plan reviewed.Week 12
Repeat A1c and CMP. Full clinician review. If you have lost less than 5% of your starting weight on a maintenance dose, we change the plan rather than continue on autopilot.
Published clinical protocol
Medical Weight Management
Physician-supervised obesity care combining nutrition, activity, behavioral support, and — when indicated — incretin-based pharmacotherapy. Anti-obesity medication is an adjunct to lifestyle therapy, never a substitute for it.
Who is eligible
- Age 18 or older.
- BMI ≥ 30 kg/m², OR BMI ≥ 27 kg/m² with at least one weight-related comorbidity (hypertension, dyslipidemia, type 2 diabetes, obstructive sleep apnea, metabolic dysfunction-associated steatotic liver disease, osteoarthritis, or established cardiovascular disease).
- Physically located in Illinois, Indiana, or New York at the time of each visit.
- Able to participate in a synchronous audio-video encounter.
- Verified government-issued photo identification on file.
Labs we require
- Hemoglobin A1c · baseline
- Comprehensive metabolic panel (renal + hepatic) · baseline
- Fasting lipid panel · baseline
- TSH · baselineScreens for thyroid contributors to weight change.
- Pregnancy test · baselineRequired for patients of childbearing potential before initiation and as clinically indicated.
- Lipase · as indicatedIf abdominal pain develops.
- A1c + CMP · 3 months
- Full metabolic reassessment · annual
Absolute contraindications
If any of these apply, we will not prescribe. No exceptions.
Personal or family history of medullary thyroid carcinoma
Boxed warning: GLP-1 receptor agonists caused thyroid C-cell tumors in rodents. Human relevance undetermined.
Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
Shares the boxed warning above.
Prior serious hypersensitivity reaction to the agent
Anaphylaxis and angioedema reported.
Pregnancy, attempting conception, or breastfeeding
Weight loss offers no benefit in pregnancy and may cause fetal harm. Discontinue at least 2 months before a planned pregnancy for semaglutide.
Requires extra evaluation
- History of pancreatitis — Acute pancreatitis reported post-marketing. Requires documented risk/benefit discussion and heightened symptom counseling.
- Gastroparesis or severe gastrointestinal motility disorder — Incretins delay gastric emptying and may worsen symptoms.
- Diabetic retinopathy — Rapid glycemic improvement has been associated with transient worsening. Requires ophthalmology co-management.
- Active or historical eating disorder — Requires behavioral health assessment before initiation; screened at intake with the SCOFF instrument.
- Symptomatic cholelithiasis — Rapid weight loss increases gallstone risk. Counsel on symptoms.
- Significant renal impairment (eGFR < 30) — Volume depletion from GI losses can precipitate acute kidney injury.
- Concurrent insulin or sulfonylurea — Hypoglycemia risk; requires dose reduction and glucose monitoring coordination with the prescribing clinician.
Medications on protocol
semaglutide (once-weekly injection)
Brands: Wegovy, Ozempic — trademarks of Novo Nordisk A/S
Route: Subcutaneous, once weekly
FDA-approved for
- Wegovy: chronic weight management in adults with BMI ≥30, or ≥27 with a weight-related comorbidity; cardiovascular risk reduction in adults with established CVD and overweight/obesity.
- Ozempic: glycemic control in type 2 diabetes mellitus, and associated cardiovascular risk reduction.
Off-label: Ozempic prescribed for weight management is an OFF-LABEL use and is disclosed to the patient as such in the consent.
Boxed warning
Risk of thyroid C-cell tumors. Contraindicated with personal/family history of medullary thyroid carcinoma or MEN 2.
Titration
- 0.25 mg weekly × 4 weeks
- 0.5 mg weekly × 4 weeks
- 1.0 mg weekly × 4 weeks
- 1.7 mg weekly × 4 weeks
- 2.4 mg weekly maintenance
- Hold escalation for intolerable GI effects; extend any step as needed.
tirzepatide (once-weekly injection)
Brands: Zepbound, Mounjaro — trademarks of Eli Lilly and Company
Route: Subcutaneous, once weekly
FDA-approved for
- Zepbound: chronic weight management; moderate-to-severe obstructive sleep apnea in adults with obesity.
- Mounjaro: glycemic control in type 2 diabetes mellitus.
Boxed warning
Risk of thyroid C-cell tumors. Contraindicated with personal/family history of medullary thyroid carcinoma or MEN 2.
Titration
- 2.5 mg weekly × 4 weeks
- 5 mg weekly × 4 weeks
- 7.5 mg → 10 mg → 12.5 mg → 15 mg weekly, escalating no faster than every 4 weeks as tolerated
metformin, bupropion/naltrexone, phentermine (state-dependent)
Brands: Glucophage, Contrave, Adipex-P — trademarks of Respective manufacturers
Route: Oral
FDA-approved for
- Agent-specific. Phentermine is a Schedule IV controlled substance and is NOT prescribed via telehealth on this platform.
Titration
- Per individual package insert and Medical Director standing protocol.
How we monitor you
- — Weekly patient-reported weight and side-effect check-in through the portal for the first 12 weeks.
- — Clinician review at weeks 4, 8, and 12, then at least every 3 months.
- — Escalate dose only after documented tolerance at the current dose.
- — Reassess at 12 weeks on the maintenance dose: if weight loss is < 5% of baseline, reassess the regimen rather than continuing indefinitely.
- — Counsel on protein intake (≥ 1.0–1.5 g/kg ideal body weight) and resistance training to preserve lean mass.
- — Screen for depression and suicidality at baseline (PHQ-9) and at each quarterly review.
When to stop and get help immediately
- Severe persistent abdominal pain radiating to the back → stop medication, obtain lipase, refer for urgent evaluation.
- Signs of anaphylaxis or angioedema → stop immediately, 911.
- Suspected bowel obstruction (persistent vomiting, no flatus) → emergency department.
- Any pregnancy → stop immediately, contact clinician same day.
- Suicidal ideation on PHQ-9 item 9 → same-day behavioral health protocol, 988 resources provided.
Protocol weight-management · version 1.0 · last reviewed 2026-09-14 · approved by the Medical Director. Clinicians may deviate from protocol with documented clinical rationale.
Questions people actually ask
Will I qualify?
You need a BMI of 30 or higher, or 27 or higher with a weight-related condition such as high blood pressure, prediabetes or diabetes, high cholesterol, or sleep apnea. The free eligibility check calculates this and tells you immediately.
Is Ozempic® the same as Wegovy®?
Same molecule — semaglutide — but different FDA-approved indications and dosing. Wegovy® is approved for weight management; Ozempic® is approved for type 2 diabetes. Prescribing Ozempic® for weight loss is off-label. Legal, common, and disclosed to you in writing before you consent.
What happens if I stop?
Most people regain a substantial portion of the weight. That is physiology, not failure. These medications treat a chronic condition and are intended for long-term use. We will tell you this before you start, not after.
Can I use my HSA or FSA?
Generally yes — medical care from a licensed clinician is typically a qualified expense. We provide itemized receipts. Confirm with your plan administrator.
Do you take my insurance?
No. We bill no insurance of any kind, including Medicare and Medicaid. You may submit our itemized receipt to your insurer yourself for possible out-of-network reimbursement, but we make no promises about whether they will pay.
What if the medication is out of stock?
We will work with you on alternative pharmacies and, if clinically appropriate, an alternative agent. We will not substitute a compounded version.