Frequently Asked Questions About Medical Weight Loss Treatment
What is Semaglutide? What is Tirzepatide?
Compounded semaglutide or simply “semaglutide” contains the same active ingredient as Ozempic™ & Wegovy™. Compounded tirzepatide or simply “tirzepatide” contains the same active ingredient as Monjouro™ & Zepbound™.
Don’t take our word for it. Read the active and inactive ingredients list on page 17 and 36 of the FDA label for WEGOVY™ and on page 24 of the FDA label for Zepbound™ to read for yourself. If you want more information, read the FDA PR release for WEGOVY™ and FDA PR release for Zepbound™.
Is Semaglutide the Same Thing as Ozempic™ & Wegovy™? Is Tirzepatide the Same Thing as Monjouro™ & Zepbound™?
Ozempic™ and Monjouro™ are the brand name versions of semaglutide and tirzepatide that are FDA-approved for diabetes. Wegovy™ and Zepbound™ are the brand name versions of semaglutide and tirzepatide that are FDA-approved for weight loss. Due to their blockbuster success and popularity, there is an ongoing national shortage of these brand name versions that is unlikely to resolve in the foreseeable future, so FDA has permitted certain qualified facilities to compound generic versions for the time being.
Does Full Potential HRT Clinic Prescribe the Brand Versions?
Not at this time. Due to the national shortage of the brand name drugs Wegovy®, Ozempic®, Mounjaro™, and Zepbound™, we currently prescribe ONLY compounded generic semaglutide and tirzepatide. We are NOT WILLING to spend our time and energy to source the brand name versions of these medications. When the national drug shortage is resolved and these brand name versions become available, we will begin to prescribe them. We currently source these medications from a state-of-the-art US-certified compounding pharmacy that guarantees the safety and purity of these products. These compounding pharmacies have been given permission by FDA to compound generic versions of these medications while there is a national shortage, and they are on FDA’s “drug shortage list.”
Will the National Shortage of Wegovy®, Ozempic®, Mounjaro™, and Zepbound™ Continue?
Unfortunately there is no way to know for sure whether the national shortage of these medications will continue. Right now the demand for these medications has seriously outpaced the production and supply. Most individuals working in the industry currently expect that the national shortages of these medications will continue for the foreseeable future. It is fair to say that at some point eventually the production will catch up with the demand. Once there is enough of the brand name versions available FDA will remove them from the “drug shortage list” and the compounding pharmacies will no longer be permitted to compound their generic equivalents. This will unfortunately increase the cost of these medications for patients.
How Effective is Semaglutide: Clinical Trials Results
The largest randomized, double-blind, placebo-controlled trial enrolled adults without diabetes who were on average 46 years old and who had on average a body weight of 231 lbs to receive either Wegovy™ or placebo for 68 weeks. The patients taking Wegovy™ lost on average 12.4% of their body weight, which was about 28.6 lbs or 0.42 lbs per week. 50.5% of the participants in the Wegovy™ group lost more than 34 lbs. 69.1% of the participants lost more than 28 lbs. 14% did not lose more than 12 lbs. Unfortunately, this means that semaglutide by itself isn’t going to work for everyone. The good news is that semaglutide doesn’t need to be prescribed by itself. This is why we prescribe semaglutide in conjunction with a comprehensive weight loss treatment plan.
Does Semaglutide Work for Everyone?
No, semaglutide doesn’t work for everyone. According to the above study for example 14% of patients who took Wegovy™ for 68 weeks did NOT lose more than 12 lbs during that period of time. Unfortunately, this means that semaglutide by itself isn’t going to work for everyone. The good news is that semaglutide doesn’t need to be prescribed by itself. This is why we prescribe semaglutide in conjunction with a comprehensive medical weight loss treatment plan. When it comes to medicine, unfortunately there is never a guarantee that any medical treatment is going to work for everyone. That’s just not the way medicine is. The reason is because each person’s chemistry is a little bit different and sometimes it can be a lot different. This is the reason why cookie cutter approaches to weight loss (or testosterone or hormone replacement therapy) don’t work. The doctor must be able to consider the patient as an individual and determine a customized plan that is best for the individual. When this is done there is a much greater chance of successful and maintained weight loss.
How Effective is Tirzepatide: Clinical Trial Results
The largest randomized, double-blind, placebo-controlled trial enrolled adults without diabetes who had on average a body weight of 231 lbs to receive either Zepbound™ or placebo for 72 weeks. The patients taking Zepbound™ lost on average 18% of their body weight, which was about 41.5 lbs or 0.58 lbs per week. Enrollees taking the highest dose (15 mg) once weekly lost on average 48 lbs, while those on the lowest dose (5 mg) once weekly lost on average 34 lbs. 1 in 3 enrollees taking 15 mg once weekly lost more than 58 lbs (>25% body weight). Unfortunately, this means that tirzepatide by itself isn’t going to work for everyone. The good news is that tirzepatide doesn’t need to be prescribed by itself. This is why we prescribe tirzepatide in conjunction with a comprehensive weight loss treatment plan.
Does Tirzepatide Work for Everyone?
No, tirzepatide doesn’t work for everyone. According to the above study for example there were some patients in the study who didn’t lose a significant amount of weight after being on Zepbound™ for 72 weeks. Unfortunately, this means that tirzepatide by itself isn’t going to work for everyone. The good news is that tirzepatide doesn’t need to be prescribed by itself. This is why we prescribe tirzepatide in conjunction with a comprehensive medical weight loss treatment plan. When it comes to medicine unfortunately there is never a guarantee that any medical treatment is going to work for everyone. That’s just not the way medicine is. The reason is because each person’s chemistry is a little bit different and sometimes it can be a lot different. This is the reason why cookie cutter approaches to weight loss (or testosterone or hormone replacement therapy) don’t work. The doctor must be able to consider the patient as an individual and determine a customized plan that is best for the individual. When this is done there is a much greater chance of successful and maintained weight loss.
How Do Semaglutide & Tirzepatide Weight Loss Medications Work
Semaglutide is known by the brand name Ozempic™ or Wegovy™. It is a synthetic version of the peptide hormone called GLP-1 (glucagon-like peptide 1). Tirzepatide is known by the brand name Monjouro™ or Zepbound™. It is a synthetic version of the peptide hormone called GIP (glucose-dependent insulinotropic polypeptide). In normal and healthy and lean individuals both of these peptide hormones are immediately produced in abundance naturally in intestinal cells in response to eating, and they stimulate the brain, stomach, pancreas, liver, and other tissues of the body to help people to feel full mentally, emotionally, and physically full, and over time this causes people to eat less and to produce less overall glucagon and insulin while becoming less insulin resistant, and therefore to burn more fat and lose weight and maintain weight loss.
How is Semaglutide Taken? How is Tirzepatide Taken?
Because the half-life of both semaglutide and tirzepatide is about one week it is possible to reach stable levels of these peptide hormones after only two months with just one easy subcutaneous injection each week. The medications are in your system for the entire week and are activated and have their beneficial effects as soon as someone starts to eat!
Sometimes we split the dose in half and have a patient self-administer their subcutaneous injections of semaglutide or tirzepatide twice weekly in order to increase safety and efficacy.
Will I Have to Keep Taking Semaglutide or Tirzepatide in Order to Maintain Lost Weight?
Some patients are able to discontinue the medication once they have reached their desired or healthy weight, while other patients need to gradually decrease their dose of the medication over a period of 6 – 12 months.
Once our patient has reached their desired or healthy weight, their doctor will discuss with them whether they should simply discontinue the semaglutide or tirzepatide or be transferred to our Maintain Weight Loss Treatment Membership. What we have observed during the last few years is that our patients do best when they spend another 6 – 12 months gradually decreasing the dose of their semaglutide or tirzepatide while making sure that they are maintaining their weight loss before they completely discontinue the medication. This increases the likelihood that the patient will be able to maintain their lost weight after discontinuing the medication. Also keep in mind that patients who initiate TRT or HRT are more likely to be able to discontinue their weight loss medication without regaining their lost weight.
Who is a Candidate for Our Medical Weight Loss Treatment with Semaglutide or Tirzepatide?
It is extremely important that a patient is determined through proper evaluation to be a good candidate for these medications. What generally makes a patient a good candidate for this membership and treatment is that they have 20 or more pounds of fat to lose in order to reach a desirable and healthier weight. What makes a patient an even better candidate is that they have already made changes to their lifestyle, including diet and exercise, yet have been unable to lose weight or maintain weight loss. Furthermore, patients who are able to understand and follow their prescribed treatment plan, including making sure to follow up with their doctor regularly, are good candidates for treatment.
Who is Not a Candidate for Our Medical Weight Loss Treatment with Semaglutide or Tirzepatide?
We are unable to prescribe these treatments to the following patients or patients with the following conditions:
- Patients who are under the age of 18 years old
- Pregnant patients or patients who are trying to get pregnant
- Patients who are breastfeeding
- Family or personal history of medullary thyroid cancer
- Family or personal history of multiple endocrine neoplasia syndrome type 2
- Diabetic patients who suffer from diabetic retinopathy or diabetic macular edema
- History of gallstones or cholecystitis
- History of pancreatitis
- Anorexia or Bulimia, or other Eating Disorders
- History of attempted suicide or suicidal thoughts or behaviors
Who is Not a Good Candidate – Special Circumstances:
While many patients are able to drink a small amount of alcohol regularly, many patients become unable to drink alcohol while taking these medications. It is extremely important that a patient be able to stop drinking alcohol if necessary while using these medications or they can cause themselves to suffer acute pancreatitis as a result of the combination of alcohol while using these medications. Acute pancreatitis is a true medical emergency requiring immediate hospitalization in order to prevent potential death.
Unable to afford to use this medication long-term
It is important that all prospective patients are aware that gradually decreasing the dose of these medications over 6-12 months increases the chances of being able to eventually completely discontinue these medications and for successful long-term maintained weight loss. If the patient is unable to afford to taper the dose down over time then this could increase the chances that lost weight may be regained once the medication is discontinued.
Eventually these medications will only be available in their trademarked forms, which are more expensive. It is important that all prospective patients are aware that once the national shortage has resolved FDA will no longer permit less costly generic versions of these weight loss medications and we will be required to prescribe only the costly brand name versions. I patients have to suddenly discontinue this medication because they’re unable to afford the brand name versions of this medication then that could contribute to the possibility that the patient may have a harder time maintaining their lost weight.
Some Cases of Type 1 and Type 2 Diabetes
Having either Type 1 or Type 2 Diabetes does NOT by itself make a patient ineligible for our weight loss treatment with semaglutide or tirzepatide. However, in some cases, when the diabetes and health of the patient is very serious, we may not feel comfortable managing the case.
If a patient is using insulin then the patient must know how to check their blood sugar throughout the day and actually check it throughout the day daily and have clear and quick communication and cooperation with their other doctor who is prescribing their insulin, so that the patient can make adjustments to their insulin dose as needed in order for our clinic to be able to manage their semaglutide or tirzepatide dose.
We do not treat diabetics with diabetic retinopathy or diabetic macular edema with weight loss medications due to the potential for vision-related complications.
We will not manage insulin dosing.
Does Full Potential HRT Clinic Accept or Bill Insurance?
No. We don’t accept or bill insurance. This is a good thing because it allows us to provide our patients with the medical follow-up and treatment that maximizes their likelihood of experiencing successful long-term weight loss and maintained weight loss and minimizes their likelihood of experiencing short-term adverse events or long-term risks. Unfortunately, when it comes to these kinds of treatments, health insurance doesn’t cover services and treatments that will be ideal for patients. Health insurance companies seem more concerned with increasing their profits, especially in the short-term. Furthermore, in addition to being able to provide our patients with better medical care, by opting out of accepting or billing health insurance we are also able to save a lot of money by avoiding the hassle of working with health insurance companies, and we pass these savings onto our patients.
Will Health Insurance Cover the Weight Loss Medications?
No. Health insurance will not cover the cost of the generic compounded semaglutide or tirzepatide. Unfortunately, currently, most insurance companies do not cover the cost of Ozempic™ & Wegovy™ or Monjouro™ & Zepbound™. This is because these are brand name medications and they are newly-patented and therefore extremely expensive. Health insurance companies don’t want to increase their costs by covering new and expensive medications that decrease their profits in the short-term. It is possible that one day in the future health insurance companies may start to cover these medications, but they would likely create obstacles and dictates to restrict their usage and dosage.
Fortunately, although these compounded generic versions are not covered by conventional health insurance they almost always cost significantly less money out of pocket compared to how much would need to be spent out of pocket if they were “covered by insurance.” This is because their brand name counterparts Ozempic™ & Wegovy™ and Monjouro™ & Zepbound™ are extremely expensive right now.
Does Full Potential HRT Clinic Prescribe Other Weight Loss Medications?
Currently the GIP and GLP-1 receptor agonists (Wegovy™ and Zepbound™ also known as semaglutide and tirzepatide) are the front-line treatments for medical weight loss treatment. Due to the mechanisms of action of all of the other available medications that can be prescribed to help patients lose weight we have serious concerns for short-term adverse effects and health risks for these medications.
For example, combination phentermine-topiramate is an option for males or postmenopausal females who are overweight or obese, but it tends to cause hypertension and coronary heart disease, as well as psychiatric and cognitive adverse effects, in addition to being contraindicated for pre-menopausal women due to its risk of causing fetal malformations. Orlistat is another medication that is often prescribed and it works by preventing the pancreas from making fat-digesting enzymes, but this causes serious GI adverse effects and isn’t well-tolerated by patients. Combination bupropion-naltrexone is another medication that is sometimes prescribed, but the bupropion alters neurologic and cognitive function in addition to causing headaches and sleeping disorders.
We prefer to prescribe medications and treatments that address problems without causing new problems. For this reason, when it comes to weight loss medications we prefer to stick with the front-line medications Wegovy™ and Zepbound™ also known as semaglutide and tirzepatide and we combine these medications with other approaches to improve their efficacy. For example, we often prescribe IV ozone therapy and testosterone and other hormone replacement therapies for our patients. For patients who do not tolerate either semaglutide or tirzepatide we do sometimes prescribe low-dose naltrexone, and this medication is a great alternative that does seem to work very well for some patients without causing new problems.
We used to prescribe several weight loss medications that worked very well and were very safe, but FDA regulated them out of existence when Wegovy™ and Zepbound™ were approved in order to protect the profits of Big Pharma, so we’re not able to prescribe them anymore.
Does Full Potential HRT Clinic Perform Liposuction or Other Procedures?
We do not perform any invasive weight loss treatments, including liposuction, intragastric balloon systems, or bariatric surgery. We can discuss potential referral for these treatments with patients who aren’t able to successfully reach their desired or healthy weight on our medical weight loss treatment with either semaglutide or tirzepatide or other pharmacologic or naturopathic or lifestyle approaches.
We do not offer medications without a prescription. We do not prescribe medications unless there is a valid diagnosis and doctor-patient relationship.
There is no such thing as a guarantee when it comes to weight loss or any other medical treatment. Results vary based on many factors. Although the clinical trials showed semaglutide also known as Wegovy® or Ozempic®, and tirzepatide also known as Mounjaro™ or Zepbound™ to be effective for most patients there is no guarantee that these medications will work for each and every patient in terms of speed of results or magnitude of overall results.
The FDA-approved brand name drugs, Wegovy® and Ozempic® are exclusively available from the Novo Nordisk™ company. The FDA-approved brand name drugs, Mounjaro™ and Zepbound™ are exclusively available from Eli Lilly and Company™. Full Potential HRT Clinic does not claim any affiliation with, or endorsement from, the abovementioned products or entities. Currently, we do not prescribe any of the abovementioned products due to a NATIONAL SHORTAGE of these trademarked products.
Schedule Initial Weight Loss Evaluation & Consultation – Call Now or Complete Online Form for a Call Back Later
The good news is that the clinical trials testing Ozempic™ & Wegovy™ and Monjouro™ & Zepbound™ have proven that most people who are overweight or obese and who cannot lose weight despite diet and lifestyle changes are actually suffering from a chronic severe hormone deficiency of the peptide hormones GLP-1 and GIP.
It’s really important that you see a doctor with expertise and successful experience evaluating overweight and obese patients and managing their medical weight loss treatment. Our team of doctors has more than 10 years of experience successfully treating patients near Portland, Oregon helping them to successfully lose weight and to live and perform to their full potential quality of life, health, and longevity.Schedule Your Initial Medical Weight Loss Evaluation & Consultation. Call 503-406-8066 now or complete our online form for a call back later.