Semaglutide, Beyond the Hype

They’re all over Twitter, Instagram, and TikTok; fashion magazines are talking about them. Many have started a conversation around unrealistic beauty standards set by celebrities using Ozempic® and other drugs to lose weight. But what’s the hype? Is there a healthy way of using them? 

So, What's the Hype all About?

GLP-1 (Semaglutide, Ozempic ®, Wegovy ®) and GIP (Tirzepatide, Mounjaro ®)  agonists are a class of medications that have recently gained a lot of attention for their potential as weight loss treatments. These drugs were initially developed in 2016 to manage Type 2 Diabetes Mellitus, but a revealing secondary outcome was its effect on weight loss, an area in which it provided unbelievable results. 

Understanding Weight Loss Medications

These drugs work by mimicking the effects of the hormones GLP-1 and GIP, which are naturally produced in the gut and play a role in regulating glucose metabolism and appetite. They specifically activate the receptors in the body responsible for regulating insulin secretion and glucose metabolism. By increasing insulin secretion and decreasing glucose production by the liver, these drugs can help lower blood sugar levels and reduce the amount of food consumed. These drugs can also suppress appetite by activating receptors in the brain that control hunger and satiety. Overall, GLP-1 and GIP agonists have been shown to be effective at helping people lose weight.

The Pravan Approach

Since day one, our approach to medicine has promoted personalized prevention and wellness. And regarding weight loss, we have always focused on optimizing nutrition and physical activity to maintain a healthy body weight. However, we recognize that sometimes eating well and exercising are not enough. Therefore doctors have been advised to complement these efforts with medications available to help our patients reach a healthy weight and fight obesity. Defined as a BMI of 30 or more, obesity is considered a chronic disease but it is much more nuanced regarding the effects on your body. As part of our treatment plan, we wanted to go beyond simply recommending Ozempic® and similar drugs. We also offer full support in their weight loss journey by focusing on weight, nutrition, exercise, and psychological aspects.

Good Results From Our Pilot Program

There are multiple clinical trials on the effectiveness of GLP-1 and GIP agonists that show the medications work. However, we noticed that, while we were already following guidelines to prescribe the appropriate medications for our patients, they needed additional support and accountability. We decided to create a Weight Loss Program pilot in our clinic with Pravan patients interested in starting weight loss medications. After following the program for three months, most of our pilot patients lost at least 5% of their initial weight, accomplishing the minimal requirement for the medication. 

Effective Weight Loss and Expectation Management

Weight loss is not just about losing weight; it’s about sustaining a healthy lifestyle. Healthy weight loss to maintain a good body composition is recommended at 1 to 2 lbs per week. All patients in the initial cohort managed to attain this steady decrease in weight, which was achieved by both medications, professional monitoring, increased physical activity, and nutritional support. The most important part of the process was establishing attainable goals for patients based on their current weight and BMI and how to transition to changes in their lifestyle they could maintain once off the weight loss program. 

So, What's the Program Structure?

It’s a three-month commitment that consists of close follow-up with your primary care physician (PCP) and our nutritionist. Given pilot results, it’s important to highlight that patients who want to achieve lasting results are encouraged to follow the three-month program protocols described below. 

• Initial Orientation (telemedicine):  a 30-minute appointment to discuss your current weight and goals. Patient’s previous weight loss programs are also explored to understand how – or if – they affect other medical conditions. Then, we discuss the option of adding medication to determine if any of them are a good fit for you. We discuss contraindications and interactions of the medications. In this orientation call, we also provide additional program details and answer any questions regarding weight management.
  
  
• Initial appointment (in person): a 30-minute intake appointment to take your weight, take your vitals, perform key body measurements, take initial photos, and perform the Bioimpedance test. Then patients will discuss their goals with their PCP based on their current body composition results. Finally, PCP discusses consent forms and prescribes medications based on recommendations and patient preferences. If we decide to provide medications, we will thoroughly discuss the side effects data with you.
  
  
• Nutrition appointments (telemedicine): their duration varies since we discuss meal plans along with further support in sleep and physical activity recommendations. These appointments need to be at least monthly.
  
  
• Weight check appointments and injection appointments (in person): we have in-person weight checkups available depending on patient goals and preference. And if you opt to add medications to your plan, you can get them injected by one of our registered nurses weekly at Pravan.
  
  
• Follow up appointments with PCP for Weight Loss Program: a 30-minute appointment to repeat vitals and track weight and discuss indicated medication adjustments based on recent results and goal optimization.
  
  
• 3-month appointment with PCP: 30-minute in-person appointment to repeat all markers to determine if you achieved your  3-month goals. 

Further appointments are made on a monthly basis.

Given its effectiveness and if you’re interested, we added the Weight Loss Program as part of the Pravan membership at no additional cost. However, charges will apply if the patient wants to add medication. Our clinic will have Semaglutide injections available for a monthly fee of $500 (including four weekly injections for a dose of up to 1mg). Doses of 1.5-2.5 mg will cost up to $1000 per month.

Carla Tamayo, MD
Internal Medicine Physician

Dr. Carla Tamayo is a Primary Care Physician at Pravan Health and the Director of Weight Loss Program at the Clinic.