Compounded semaglutide, prescribed with care.

In the STEP 1 trial, published in the New England Journal of Medicine in 2021, 1,961 adults with obesity were followed for 68 weeks. Average weight loss on 2.4 mg weekly was 14.9 percent of starting body weight, compared with 2.4 percent for placebo, and roughly one in three participants lost more than 20 percent. Those are trial conditions, not a promise. Real-world results vary with nutrition, activity, and how long you stay on therapy. Most of our patients land in the 10 to 15 percent range over the first year. Where you fall inside that range depends heavily on what happens between doses, which is the part the medication cannot do for you.

Most people notice reduced appetite within the first two weeks, often within days of the starting dose. Visible weight loss usually begins around week four to six and continues steadily as the dose titrates upward. Many patients see two to four pounds per week during the early titration phase, though that pace is not constant and should not be expected to be. The biggest changes typically happen between months three and nine, once you have settled into a working dose and eating patterns have genuinely shifted. The slow-and-steady pattern is deliberate. It is part of why the medication is tolerated as well as it is, and it is why we do not rush titration to chase a faster number.

Nausea, reflux, constipation, and early fullness are the most common, and they are almost always dose-related rather than a sign something is wrong. Most patients feel some mild nausea or fullness in the first week or two, and it almost always improves by week three. We titrate slowly for exactly this reason, and we resist compressing the schedule even when patients push for faster results, because the gradual ramp is part of the safety profile. We also send practical guidance on meal timing, hydration, and protein targets from the start, and we have a detailed toolkit for managing each symptom. If something is not settling, tell us at your four-week check-in rather than quietly pushing through it.

Rarely, GLP-1 therapy can trigger pancreatitis, cause gallbladder disease, or worsen preexisting gastroparesis. These are uncommon, but they are real, and they are the reason we insist on labs and follow-up instead of shipping a vial after a questionnaire. We screen for those risks at your initial visit and teach you exactly which symptoms to report and how quickly. Some patients are not candidates at all, including anyone with a personal or family history of medullary thyroid cancer or MEN2, active pancreatitis, or severe GI disease, and the program is not for patients who are pregnant or breastfeeding. Nutritional deficiencies are another reason ongoing lab work matters. Your labs catch most issues before they become problems.

No, they are not the same product. Ozempic, for diabetes, and Wegovy, for weight loss, are brand-name products manufactured by Novo Nordisk. What we prescribe is a compounded formulation prepared by a licensed US 503A or 503B compounding pharmacy. The active ingredient is identical, and we dose it to match the titration schedule used in the STEP clinical trial program, but a compounded preparation and a brand-name product are not the same thing and we do not present them as interchangeable. The practical difference for most patients is cost, since the compounded version is typically significantly more affordable. Every vial ships to your door only after your provider has cleared you, with syringes and alcohol swabs included.

Monthly program pricing covers the compounded medication, the supplies you need, and your monthly provider follow-up. The exact figure depends on your dose, so we quote real numbers at your consultation once we know where you are starting. In general, program cost lands meaningfully below the out-of-pocket price of brand-name Wegovy when insurance denies coverage. Baseline labs are billed separately at wholesale cost. We do not bill insurance directly for compounded medications, though we can provide superbills for HSA or FSA reimbursement. CareCredit is available if you would rather finance a full twelve-month program up front. Nothing gets added to the number later in the program without a conversation first.

Many patients taper to a maintenance dose once they hit their target rather than stopping outright. Here is the honest part: stopping abruptly often leads to appetite returning and weight regain within three to six months, because the medication was doing real work on hunger signaling the whole time. So we wean down gradually under supervision and watch what happens to appetite and weight as the dose drops. If regain starts, we can adjust before it becomes a problem. This is also why the program is built around six to twelve months of care and long-term behavior change rather than a short course. The medication creates room to change habits. The habits are what hold the result.

In most cases yes, but we review your complete medication list at the consultation before anything is prescribed. Several interactions need accounting for, including oral contraceptives, certain diabetes medications, and thyroid replacement. If you are taking insulin or a sulfonylurea, your dosing needs careful adjustment. Bring your actual bottles or an up-to-date list, supplements included, rather than trying to remember doses in the room. Because semaglutide slows gastric emptying, how your body handles some oral medications can change as well. This is one of the practical reasons an in-person visit beats an online form, and it is why we ask for the full list instead of the highlights. We cannot manage interactions we were never told about.

A plateau around month six is common and it is not a sign the medication has failed you. We troubleshoot the fixable things first: protein intake, overall nutrition, activity, sleep, and whether your current dose is genuinely optimized or just familiar. Plenty of stalls resolve once one of those is corrected. If you have plateaued despite that work, we may move you to compounded tirzepatide, which acts on a second receptor pathway as a dual agonist and gives us a different mechanism to work with. That decision gets made at a visit with your labs and your history in front of us, not over a message thread. Switching is a clinical call, and we make it when the chart supports it.

Oliver Morris, DO is the prescribing physician and Medical Director of the practice. You meet him at your first in-person visit, where he reviews your history, your weight-loss goals, and your current medication list before deciding with you whether semaglutide is the right fit. He orders your baseline labs and builds the dosing plan, and he is who you see for follow-up every four weeks through titration and into maintenance. Same physician every visit, with a direct line by text or phone between appointments. That continuity is the point. A prescriber who has watched your labs and your side effects over months makes better dosing decisions than a questionnaire does. His full bio is on the Oliver Morris, DO page.