Priorities
Weight that won’t come off
Weight that stalls or keeps coming back, and a medical option that may help.
For many people, weight loss stalls or reverses despite consistent effort with diet and exercise. Weight comes off for a while and then plateaus, or it returns. The standard advice to eat less and move more isn’t wrong, but for a lot of people it’s incomplete.
Here’s what to know about the medical option: who it’s for, how it works, and what it doesn’t do.
What we'd want you to know
Losing the weight and tightening the skin are two separate steps
This is a once-weekly injection of semaglutide or tirzepatide, prescribed and monitored by our nurse practitioner for adults with a BMI of 30 or more, or 27 or more with a weight-related condition. Every patient starts with a consultation and bloodwork before any prescription is written.
After significant weight loss, skin that has been stretched for years doesn’t always tighten on its own. That’s addressed separately, later in the process.
How we decide
We’ll start with your height, weight, and BMI, a medical history, current medications, and bloodwork. We’ll also check for anything that rules it out: a personal or family history of medullary thyroid carcinoma, MEN2, pancreatitis, pregnancy or planning a pregnancy, and a few others the prescribing information lists.
Here’s what the research shows. In the STEP 1 trial, semaglutide 2.4 mg averaged 14.9 percent of body weight lost at 68 weeks, compared with 2.4 percent on placebo, per Wilding and colleagues in the New England Journal of Medicine. In SURMOUNT-1, tirzepatide averaged up to 20.9 percent at 72 weeks, per Jastreboff and colleagues. Those are trial averages with structured support behind them. Individual results vary, often considerably.
Nausea is the most common side effect, and it’s usually worst when the dose steps up. For most people it settles, which is why we increase the dose slowly.
Your questions, answered
Is this Ozempic?
It’s the same drug family. Ozempic and Wegovy are both semaglutide, and Mounjaro and Zepbound are both tirzepatide. The brand names differ mainly by what they’re approved for and how they’re dosed. What we prescribe is decided at your consultation, not before it.
Do I qualify?
The starting point is a BMI of 30 or more, or 27 or more with a weight-related condition such as high blood pressure, type 2 diabetes, or sleep apnea. Your bloodwork and history decide the rest. Some people who want it won’t be candidates, and if that’s you, we’ll explain why.
What happens to my face and my skin?
Faces often change with significant weight loss, most noticeably through lost volume. If volume loss in your cheeks bothers you afterward, that has its own page. We’d suggest reaching your weight goal first and then assessing your face.
Will you keep prescribing if it isn't working?
No. If you’re not responding after a fair trial at an adequate dose, we’ll stop, since continuing would add cost without benefit.
