Weight loss medications vary substantially in price. Without insurance, the newer 'weight loss shots' can cost upwards of $1,300 per month, while the older more established medications can be less than $20 per month! Due to the extreme financially restrictive nature of these medications cost does play a large role in deciding which medication is right for you. I will do everything I can to work with your insurance provider to get the medications at the lowest price possible. I do not compound or sell medications or supplements myself.
While it is tempting to want to dish out the hefty fee as long as you get the best medication, remember, these medications take 68-72 weeks to reach their peak effect, and often need to be continued even longer. Without reliable insurance coverage, I will likely recommend a less expensive, but still well studied and effective medication.
Weight loss medications can be a valuable tool for anyone experiencing even early health consequences of excess body weight. Typically medications are reserved for individuals with a Body Mass Index (BMI) of 30 and higher, or 27 and higher if they also have weight-related health conditions such as high blood pressure, type 2 diabetes, or high cholesterol. However, it is possible that you may meet other metabolic criteria (such as visceral or abdominal adiposity, genetic predisposition, or serious metabolic health risks) that indicate the need for medication. Additionally, those who are dealing with the health consequences of excess weight and need a more structured, medical approach to weight loss could benefit from these medications. This is why I perform a comprehensive weight wellness visit for every patient starting at my practice.
Certain weight loss medications can inadvertently lead to muscle loss due to a reduction in overall body mass, including both fat and lean muscle. This is because when your body is in a calorie-deficit state, it may use muscle tissue for energy, especially if not enough protein is consumed. It's essential to pair these medications with a balanced diet and regular physical activity, specifically resistance and strength training exercises, to protect and build muscle mass while losing weight.
Weight loss medications work by altering certain biological pathways or processes related to appetite, metabolism, or fat absorption. Once you stop taking the medications, those pathways or processes may revert back to their previous state, which generally leads to weight regain. Just as how chronic conditions like hypertension or diabetes may require lifelong medication for optimal management, so too might obesity. Therefore, for some individuals, maintaining weight loss may involve long-term use of weight management medications as part of a comprehensive treatment plan. Remember, each person's treatment plan is unique, and the duration of medication use should always be guided by an expert.
For the safety and welfare of my patients, I firmly advocate the use of FDA-approved medications, such as Wegovy, from regulated pharmacies, rather than compounding pharmacies. Compounding pharmacies, although they can provide valuable services in certain circumstances, lack the stringent oversight and consistent production processes that come with FDA-approved pharmaceuticals. This can lead to variations in dosage and purity, which could affect efficacy and safety. As for selling my own medications, it could potentially create a conflict of interest. My primary role is to provide you with the best medical advice, not to sell you products. Thus, I believe prescriptions should be filled independently to maintain the integrity of our patient-physician relationship.
Prescribing the right weight management medication is an art that requires in-depth knowledge and understanding of each patient's unique health and social profile. It's not a 'one-size-fits-all' approach. Each medication has its own unique mechanism of action, potential side effects, and interactions. Additionally cost and coverage issues can be an unfortunate limiting factor. As an expert in this field, I consider various factors such as your medical history, current health status, lifestyle, personal preferences, and insurance coverage/costs when choosing the most suitable medication for you. The goal is to optimize efficacy while minimizing potential risks, to support your journey towards sustainable weight loss and improved health.