“Dr Yoder's weight loss program has so far changed my life and given me hope! I have been struggling with my weight ever since my 20's and having children. I have fluctuated consistently between 220-240 lbs for the last 15+ years. Since my first visit with Dr Yoder, she had inspired me that weight loss was possible. I began the tirzepatide compound on April 2nd weighing 232, and almost 9 weeks later, I have shed 22 pounds! I am very excited to continue this journey to a healthy weight!”
Your Weight Can’t Wait!
The number of Americans who are overweight now exceeds 27% in women and 34% in men. The number of Americans obese is 41.9% (1). Being overweight is characterized by having a BMI of 25.0-29.9. For example, a 5’6” thirty four year old female weighing 174 pounds would have a BMI of 26.0. A 6’0” man weighing 207 pounds would have a BMI 28.0. Remember, BMI’s don’t account for bone structure or muscle mass, and therefore need to be taken with a grain of salt.
Normal Weight
Normal weight BMI 18.5- 24.9
Overweight
Overweight BMI 25- 29.9 (without high blood pressure, prediabetes or diabetes, sleep apnea or increased waist circumference)
Obesity With BMI >30
Obesity is defined as a BMI of >30 with high blood pressure or elevated cholesterol or diabetes
Obesity With BMI >35.0
Obesity is defined as a BMI >35.0 with or without another health condition.
Morbid Obesity
Morbid obesity BI >35.0
Gaining Weight Leads To Metabolic Syndrome And Other Diseases. Diuretics, High Blood Pressure Medicine, Cholesterol Reducers, Aspirin And Diabetic Medications Are Often Prescribed For Individuals With Metabolic Syndrome. Reversing Metabolic Disease Will Reduce Your Need For Prescription Drugs. Signs You Have Metabolic Syndrome:
Men- waist circumference > 40 inches*
Women- waist circumference >35 inches*
Triglycerides >/= 150mg/dl
HDL cholesterol <40 in men; <50 in women
Blood pressure >130/85
Fasting glucose >110 mg/dl
*Wall Test- stand in front of a wall with your toes touching the wall. Does your stomach touch the wall before your nose touches the wall?
Assign one point to each criterion you answer “Yes” to. If your score is 0-2, you do not have metabolic syndrome. If your score is 3-5, you do have metabolic syndrome.
How Your Health Is Negatively Affected Being Overweight
The health ramifications of being overweight are well known. They include:
Fatigue
Water Retention
Altered Metabolism
High Blood Pressure
Increased Bad Cholesterol
Reduced Good Cholesterol
High Insulin Levels
Increasing Blood Sugar Leading To Prediabetes And Diabetes
Subsequent Thyroid Problems
Real World Examples In My Practice
Too often in my practice I see medications added one right after another to treat the side effects of being overweight. It starts with a diuretic being prescribed to reduce the excess water retention contributing to high blood pressure. If the diuretic doesn’t do the trick, then a true blood pressure medication is prescribed. Next comes a “statin” medication to control high cholesterol. Then out comes the aspirin. Aspirin is added to thin the blood, so the platelets aren’t sticking to inflamed vessel walls causing plaque buildup. Plaque buildup can break off the vessel walls and cause heart attacks and strokes. If weight isn’t dealt with, diabetes often ensues. Treating diabetes is a whole can of worms itself. Treating diabetes type 2 starts with oral medications and there is a large toolbox of meds to choose from. Unfortunately, if the oral medications don’t work, insulin is prescribed. The sad thing about insulin treatment in a type 2 diabetic is it makes weight loss nearly impossible. Insulin is a fat hormone. Sounds like all doom and gloom! And it is doom and gloom if you don’t act. But there is HOPE.
The downward spiral described above is due to diet and lifestyle. IT IS REVERSIBLE. The good news is this trajectory can be turned around. You can take control and reclaim your health. Let us help you!
Answers
As we all know, losing weight is not simple. Everyone has a different metabolism, diet, attitude toward food, and activity level. The usual mantra of “eat healthy and exercise” doesn’t cut if for many people whose metabolism has been wrecked by the standard American diet and sedentary lifestyle brought about by the electronic devices we use all the time. Besides, for some individuals, emotional and mental well-being gets intricately involved in the struggle with weight and being healthy.
Being healthy is a multi-faceted endeavor and there is no “one size fits all” or “cure all” approach. Here at Telehealth NP, we focus on four pillars for weight loss. These four pillars are medications, supplements, community support, and spiritual reliance. For the purpose of this page, we are focusing on pharmaceutical treatment.
Simply put, the efficacy of medications used to assist with weight loss in the past have been mediocre. But, this is changing. The compounds semaglutide (Wegovy and Ozempic) and tirzepatide (Mounjaro) have been game changers for those attempting to lose weight.
SEE A DRUG COMPARISON FOR WEIGHT LOSS VIDEO HERE.
Weight Loss Medications: GLP-1 Agonists And GIP Agonists
How I like to explain it to my patients:
These drugs mimic peptides in the small intestine that send chemical messages to the brain, digestive tract, liver and pancreas.
Brain
Tells your brain you are satisfied with less food, quiets hunger and food talk.
Digestive Tract
Slows down food digestion, feel fuller longer.
Liver
Keeps your liver from producing excess sugar (from glucagon), thus reducing blood sugar levels in your blood stream.
Pancreas
Helps your body use insulin to get energy and sugar into the cells so the insulin does not stay in the blood stream .
Medication Side Effects
Because these medications work to slow down the digestive tract, the most common side effects are:
- Nausea
- Constipation
- Reduced appetite
- Early satiety
- Weight loss
The first two side effects are not experienced by everyone. If you get nausea or constipation, they are easily treated with over-the-counter supplements or medications. The last 3 side effects are desirable and why people use these mediations. Other natural side effects are upset stomach, burping, gas, bloating, increased heart rate.
Serious Side Effects
Serious side effects can occur from semaglutide and tirzepatide. If you experience significant abdominal pain, throat or swallowing problems, or changes in urination (loss of urine production), then reach out to your provider.
Berberine is a yellow plant extract used in Ayurvedic and Chinese medicine. Its bioactive compound is found in variety of plants. If you want to add a supplement to your weight loss efforts, Berberine helps
- regulate glucose (sugar) and lipid (fat) metabolism
- reduces blood sugar in the body without causing hypoglycemia
- increases insulin release from the pancreas when needed
- increases fatty acid oxidation (burning fat)
- decreases steatosis (fatty liver)
- anti-inflammatory affects
- modulates gut microbiota
Should You Take These Medications?
Some individuals should not use semaglutide or tirzepatide. If you have any of the following, these medications are not for you:
Type 1 Diabetes
Medullary Thyroid Cancer (Family Or Personal History)
Multiple Endocrine Neoplasia Syndrome Type 2 (Mens2)
Pregnant Women Should Not Take Oral Semaglutide
History Of Pancreatitis
Known Hypersensitivity To Any Ingredient In The Drug
Pharmaceutical Companies And Cost
Novo Nordisk developed semaglutide in 2012. Semaglutide is sold as Ozempic (injections), Wegovy (injection) and Rybelsus (oral). Lilly developed tirzepatide, sold as Mounjaro. While these medications are effective at weight loss, they are very expensive if not covered by insurance or a pharmaceutical coupon. Prior authorizations requested by insurance companies are frequently denied. Out of pocket costs for patients range $900-$1,100/month for the medication alone. This doesn’t cover provider visit costs.
The good news is compounding pharmacies do make semaglutide and tirzepatide in certified sterile facilities. They compound these medications with B12 or B6 to mitigate some of the nausea that can be experienced when first starting your medication or increasing your dose.
Here at Telehealth NP, we can help you with your weight loss journey! We work with compounding pharmacies to provide you with a VERY AFFORDABLE option for medical assisted weight loss. In addition to prescribing these medications, we provide resources for the mental, emotional, and nutritional aspects of your weight-loss journey.
Tirzepatide W/B6
- Direct ship to house
- Pricing includes provider fee/consults, prescribing, medication, cold packed shipping, syringe supplies.
Dosing
- 2.5mg $325/month
- 5mg $375/month
- 7.5mg $425/month
- 10mg $475/month
- 12.5mg $525/month
- 15mg $575/month
Semaglutide W/B6
- Direct ship to house
- Pricing includes provider fee/consults, prescribing, medication, cold packed shipping, syringe supplies.
Dosing
- 0.25mg $225/month
- 0.5mg $250/month
- 1mg $275/month
- 1.7mg $300/month
- 2.5mg $325/month
PLEASE NOTE:
- Prices do not include Push Health's $15 initial fee or $5 subsequent fees.
- If you are losing weight at a pace that is reasonable and satisfactory to you, do not need to increase your dose! The goal is weight loss and not a specific dose. Save your $$$ 😊