Medical weight management
If losing weight feels harder than it used to, you are probably not imagining it.
Hormonal changes, insulin resistance, sleep, stress, medications, changes in appetite signaling, and loss of muscle can all change the way your body responds to the same things that worked before.
We look at what may be working against you, then build a medical weight-loss plan around your metabolism, hormones, health history, and goals.
Choose your side
What to know about weight loss
- 01Our medical weight-loss program begins with a comprehensive evaluation, baseline labs, individualized treatment, and regular medical follow-up.
- 02We look beyond the number on the scale, including body composition, appetite, food noise, metabolism, hormones, sleep, muscle, and what may have changed in your body over time.
- 03If anti-obesity medication is appropriate, we will explain exactly what you are taking, why we are recommending it, and whether it is sourced from a commercial manufacturer or through a compounding pharmacy.
- 04Treatment is adjusted based on your progress, response, side effects, hunger, cravings, and goals. Your treatment plan should evolve as your body does.
- 05Protecting muscle matters. The goal is not simply to make the number on the scale smaller. We want to improve body composition while helping you maintain strength.
- 06Weight management does not end when you reach your goal. Obesity is a chronic disease, which is why we begin planning for maintenance from the start.
What actually changes in midlife
You can eat the same way. Exercise the same way. And suddenly your body does not respond the same way.
Changing hormones, including estrogen and progesterone in women and testosterone in men, can affect sleep, muscle mass, insulin sensitivity, appetite, energy, and where your body stores fat.
Muscle also becomes harder to maintain as we age. Less muscle can mean lower energy expenditure and changes in body composition, even when the number on the scale has not changed dramatically.
Then add poor sleep, stress, medications, thyroid dysfunction, insulin resistance, sleep apnea, or years of repeated dieting, and losing weight may become significantly harder than it was in your twenties or thirties. We want to understand what changed and what is driving it now.
The constant mental pull toward food
Food noise is the constant thinking about food, planning the next meal, fighting cravings, negotiating with yourself, grazing when you are not physically hungry, or feeling like food takes up far more mental space than it should.
For some patients, GLP-1-based treatment reduces appetite and cravings and makes it easier to recognize fullness. Weight regulation involves biology, not just willpower.
Using medical treatment isn’t cheating. Medication, when appropriate, is one tool we can use while building nutrition, strength, sleep, and habits that support long-term health.
A program, not just a prescription
Your care is led by Elizabeth G. Bagan, APRN.
Your treatment plan is based on your medical history, medications, weight history, previous weight-loss attempts, symptoms, goals, and lab results.
Treatment may include nutrition and activity support, medication, evaluation and treatment of contributing hormonal or metabolic conditions, and strategies to preserve muscle.
We plan for maintaining your results from the beginning, not after the weight is already gone.
What the first three months look like
Initial consultation and baseline labs
We start with your history, medications, previous weight-loss attempts, current concerns, and baseline labs drawn in-house.
Eligibility and treatment options
We review which treatment options make sense for you, what to expect, possible side effects, and how we will monitor your progress.
Starting and adjusting treatment
If medication is appropriate, we explain the starting dose and how treatment adjustments are made based on your response, side effects, hunger, cravings, and progress.
Ongoing follow-up
We review your progress, appetite, nutrition, medication response, and side effects, then adjust your treatment when needed.
Planning for maintenance
Obesity is a chronic disease, so we begin planning for maintenance from the start. Your long-term plan may include continued medication, dose adjustments, nutrition, resistance training, and ongoing follow-up.
Losing fat while protecting strength
Lean mass loss can occur during weight loss, which is why protecting muscle is an important part of our program. Our goal is to help you lose excess body fat while preserving as much strength and muscle as possible.
That means adequate protein, resistance training, good sleep, recovery, and an appropriate pace of weight loss. We may also recommend nutritional support such as a quality multivitamin or creatine when appropriate based on your health history, medications, kidney function, and individual needs.
truFlex muscle stimulation is also available as an additional tool for patients who want to incorporate muscle stimulation into their plan.
Cardio is important for your heart. Resistance training is what tells your body to hold on to muscle.
The main options, compared
| Option | What it involves | Monitoring | Main trade-offs |
|---|---|---|---|
| Nutrition and activity support alone | A structured plan without medication | Reviewed at follow-up | No medication side effects. Slower, and harder to sustain without support |
| GLP-1 based medicine | Injectable or oral medication, with the dose adjusted gradually based on response and tolerance, alongside nutrition and activity support | Baseline labs, then about every 6 months, individualized to your treatment | Can support significant, sustained weight reduction. Common side effects can include nausea, constipation, diarrhea, and acid reflux, particularly when starting treatment or increasing the dose. These often improve over time. Not everyone experiences side effects, and not having side effects does not mean the medication is not working. |
| Other approved anti-obesity medicine | Oral or injectable, based on your history | Same schedule | A different side effect profile. May suit where a GLP-1 is not appropriate, or be used in conjunction with GLP-1s |
| Treating a contributing condition | For example sleep apnea, thyroid disease, or a medication that promotes weight gain | Depends on the condition | Treated in conjunction with GLP-1 medicines, and frequently overlooked |
| Bariatric surgical assessment | Referral to a surgical service | Managed by that service | A larger and more durable effect for some people, with surgical risk |
Eligibility depends on your health history, current medications, weight history and relevant lab results.
Knowing exactly what you are taking
Semaglutide and tirzepatide are the active ingredients, but the product matters. Semaglutide is the active ingredient in both Wegovy and Ozempic. Wegovy is FDA approved for long-term weight reduction and maintenance in appropriate patients with obesity or overweight, while Ozempic is approved for type 2 diabetes and certain cardiovascular and kidney-risk indications in adults with type 2 diabetes. Wegovy prescribing information, FDA
Tirzepatide is the active ingredient in both Zepbound and Mounjaro. Zepbound is FDA approved for long-term weight reduction and maintenance and for moderate to severe obstructive sleep apnea in adults with obesity. Mounjaro is approved to improve blood sugar control in people with type 2 diabetes. Zepbound prescribing information, FDA
Before anything is prescribed, we tell you exactly what you are receiving and why we are recommending it. We also provide the appropriate patient information so you understand the medication, potential side effects, and what to expect.
Results vary by medication and by person. Rather than giving you one average number, we talk through the clinical trial results for the treatment we are considering and what a realistic response may look like for you.
Benefits, risks, alternatives and candidacy
Before you decide, we want you to understand the benefits, risks and alternatives clearly.
What it may do
- For appropriate candidates, GLP-1-based medications can be an effective tool for meaningful, sustained weight loss when combined with nutrition, activity, and ongoing medical care.
- Weight loss can improve blood pressure, blood sugar, cholesterol, sleep apnea, and joint pain.
- Response varies from person to person. Some people respond very well, while others have a more modest response or may not respond as expected. We monitor that along the way.
Risks and side effects
- Nausea, vomiting, diarrhea, constipation, and reflux are common, particularly when starting treatment or increasing the dose.
- Less common but more serious risks can include pancreatitis, gallbladder disease, and kidney injury related to dehydration. Some medications also carry a warning about thyroid C-cell tumors seen in animal studies; it is not known whether this occurs in humans.
- Lean mass loss can occur during weight loss, which is why adequate protein, resistance training, and muscle-preservation strategies are part of our approach. truFlex muscle stimulation may also be incorporated when appropriate.
- Weight regain can occur after stopping treatment, which is one reason we plan for long-term weight management from the beginning.
- If a compounded medication is part of your treatment plan, we clearly identify it as compounded and explain why it was chosen.
Other treatment options
- Structured nutrition and activity support without medication.
- Treating contributing conditions such as sleep apnea, thyroid disease, or medications that may promote weight gain.
- Other classes of anti-obesity medication, oral or injectable.
- Referral for bariatric surgical evaluation when that is a more appropriate option.
- Choosing not to pursue treatment at this time, with appropriate monitoring.
Who may not be a candidate
- Pregnancy or planning pregnancy, a personal or family history of medullary thyroid carcinoma or MEN2, a history of pancreatitis, certain gastrointestinal conditions, and some medication combinations are among the situations that may change whether a GLP-1-based medication is appropriate.
Answered before you ask
Am I a candidate for medical weight loss?
We start by looking at your weight history, medical history, medications, previous weight-loss attempts, symptoms, and lab results.
There is no single treatment that is right for every woman. Your first visit helps us understand what may be contributing to your weight and determine which options are appropriate for you.
What does the first visit cost?
Your initial weight-loss evaluation is $399 and includes your consultation, baseline lab work, and your first round of medication when medically appropriate.
Beginning in month two, our $380 monthly membership includes ongoing medical management, follow-up visits, monitoring, and medication.
À la carte options are also available for patients who prefer not to enroll in a monthly membership.
Do I have to take medication?
No. Medication is one tool, not the entire program.
We also look at nutrition, activity, sleep, hormones, insulin resistance, medications, muscle loss, and other health conditions that may be affecting your weight.
If medication is appropriate, we will explain your options and why we are recommending them.
Which medication will I be prescribed?
There is no one medication that is right for everyone.
The choice depends on your health history, goals, previous treatment, other medications, potential side effects, and how your body responds.
If medication is prescribed, you will know exactly what you are taking and why we chose it.
How much weight can I expect to lose?
Results vary by medication, dose, treatment duration, starting point, and individual response.
We review the clinical trial data for the treatment we are considering and talk with you about what a realistic response may look like for you.
We use those numbers as a guide, not a promise. Your progress is based on how your body responds over time.
How quickly will I lose weight?
The pace varies, and it usually changes throughout treatment.
Weight loss may be faster at some points and slower at others, especially as you get closer to your goal.
We focus on steady progress while supporting nutrition, strength, and muscle preservation rather than setting one fixed number you are expected to lose every week.
Will I lose muscle?
Some lean mass loss can occur during weight loss. Our goal is to preserve as much muscle and strength as possible.
Adequate protein, resistance training, recovery, and an appropriate pace of weight loss all matter.
truFlex muscle stimulation is also available as an additional muscle-support option when appropriate.
What side effects should I expect?
Side effects depend on the medication.
With GLP-1-based treatment, common side effects can include nausea, constipation, diarrhea, vomiting, reflux, or feeling full sooner than expected.
They are often more noticeable when starting treatment or increasing the dose. We adjust treatment based on how you are responding.
Not everyone experiences side effects, and side effects are not required for the medication to be working.
How often are labs repeated?
Lab monitoring is individualized based on your treatment, medical history, medications, symptoms, and previous results.
We explain your monitoring schedule when you begin care, and additional testing may be ordered when clinically appropriate.
Can follow-up visits be virtual?
Yes. Many follow-up visits can be completed virtually for established patients located in Florida.
We use these visits to review your progress, medication response, side effects, dosing, and anything that may need to be adjusted.
Some examinations or testing may still require an in-person visit.
Does regular follow-up make a difference?
Yes. Regular follow-up allows us to see how you are responding and make changes when needed.
We review your progress, medication response, side effects, nutrition, activity, and any plateaus or concerns along the way.
Weight management should not be a prescription followed by months of figuring it out on your own.
Do I need to follow a special diet?
No crash diets or extreme plans.
We focus on adequate protein, balanced nutrition, hydration, and eating habits you can realistically maintain.
Resistance training is also important because preserving muscle matters during weight loss.
The goal is not simply to eat less. It is to support your health while you lose weight.
Do you use compounded medications?
When clinically appropriate, compounded medication may be one of the options we discuss.
If compounded medication is recommended, we will tell you clearly that it is compounded, what you are receiving, and why it was selected.
Compounded medications are not FDA-approved. FDA-approved medications may also be used when appropriate.
How long will I need medication?
That depends on your response, your health, and what helps you maintain your results.
Obesity is a chronic disease, and some patients benefit from long-term medication as part of their maintenance plan.
Others may eventually use a lower dose, a different medication, or a different strategy.
We make that decision with you based on effectiveness, side effects, health needs, and your ability to maintain progress.
What happens if I stop medication?
Appetite and cravings may return, and weight regain can occur.
That does not mean every patient will regain weight, but it is one reason we do not treat goal weight as the finish line.
We plan for maintenance before you get there, so if medication is reduced or stopped, there is already a strategy in place to support your results.
What happens when I reach my goal weight?
Reaching your goal weight is not the end of treatment.
Obesity is a chronic disease, and your maintenance plan may include continued medication, dose adjustments, nutrition, resistance training, and ongoing monitoring.
We begin talking about maintenance before you reach your goal because the goal is not simply to lose the weight.
It is to help you maintain it.
What if I have already tried everything?
That history matters.
Previous diets, medications, programs, plateaus, and weight regain give us useful information about what has and has not worked for you.
You are not starting over.
We use that history to build a better plan moving forward.
Who oversees my care?
Elizabeth G. Bagan, APRN, oversees your evaluation, treatment, and maintenance care.
Could hormones be affecting my weight?
Hormonal conditions can affect weight and body composition. We assess relevant symptoms and testing alongside nutrition, activity, sleep, and medications to identify factors that may need treatment.
Where this information comes from
Primary sources only: regulator publications, specialty society patient guidance and manufacturer information. Not marketing pages.
- 01U.S. Food and Drug Administration, Wegovy (semaglutide) prescribing information
- 02U.S. Food and Drug Administration, Zepbound (tirzepatide) prescribing information
- 03U.S. Food and Drug Administration, FDA's Concerns with Unapproved GLP-1 Drugs Used for Weight Loss
- 04National Institute of Diabetes and Digestive and Kidney Diseases, treatment for overweight and obesity
- 05World Health Organization, Obesity and overweight fact sheet
- 06Federal Trade Commission, Health Products Compliance Guidance
Start with a conversation
You do not need to know exactly what you need before you come in. Tell us what has changed and what you would like help with. Your first appointment is where we listen, evaluate the full picture, and talk through what may be contributing and what your options are.