01 / The first weeks
The first weeks
Appetite changes are usually noticed first. Meals feel finished earlier. GI side effects cluster in the days after any dose increase.
Treatment snapshot
At a Glance
- Before you start
- Medical history review, labs, and a candidacy discussion
- Visit rhythm
- Regular check ins for dose, tolerance, and monitoring
- Medication
- Prescription only, after evaluation, and not appropriate for everyone
- How dosing works
- Started low, increased gradually to limit side effects
- Program cost
- $450 medical management fee, plus medication priced separately
What This Program Is
This is a medical program, not a product. You are evaluated, your history and labs are reviewed, a plan is written, and a licensed provider follows and adjusts it. Medication may be part of that plan. It is prescribed only when a provider determines it is appropriate, and never handed across a counter on request.
GLP-1 receptor agonists imitate a gut hormone released after eating. That hormone signals fullness to the brain, slows how quickly the stomach empties, and influences insulin release in response to glucose. Appetite signaling changes: meals feel finished sooner, and food related preoccupation often quiets.
Dual GIP and GLP-1 receptor agonists act on that same receptor and on a second incretin receptor, GIP, affecting appetite and glucose handling through more than one pathway. Which class suits you, if either does, depends on your history, other medications, and tolerance. That is what the evaluation is for.
We publish no outcome figures here. Response varies considerably between individuals, and a number drawn from a trial population tells you little about your own course.
Who This Is For
The free consultation exists so this gets answered before you spend anything. It tends to fit adults who:
- Have had weight changes or persistent difficulty losing fat despite consistent effort, a concern our consult form asks about directly
- Want oversight, labs, and a provider following them rather than an online form and a shipped vial
- Are managing markers such as blood sugar or lipids alongside weight
- Have noticed weight changes alongside perimenopause or menopause symptoms
- Have regained weight after previous attempts and want to understand the physiology
It is not for everyone. Pregnancy, certain personal and family medical histories, and some medication combinations rule it out. Those limits are listed below and applied at evaluation, not buried as fine print.
A closer look
What the Program Includes
Evaluation. Full history, current medications and supplements, prior attempts, GI history, and what you are trying to accomplish.
Laboratory testing. Initial labs required for the weight loss program are included in the medical management fee. Ongoing laboratory monitoring is an extra charge only if required and is not typically needed.
Prescribing and dose management. If medication is appropriate, your provider selects it and adjusts the dose based on tolerance and response.
Monitoring. Scheduled check ins covering side effects, dose, blood pressure, and lab values, so problems are caught early.
Nutrition and lifestyle work. Protein intake, resistance training, sleep, and alcohol all affect what happens on these medications, particularly preservation of lean mass during reduced eating. Discussed at every visit, not handed over as a printout.
Accountability. A consistent point of contact who knows your chart.
Plan the visit
How It Works at LouWellSpa
Free consultation
Your history, goals, and questions. You leave knowing whether you are a candidate, what the program involves, and what it costs in total. No obligation to start.
Labs and review
Baseline testing is ordered. Your provider reviews results with you and confirms whether medication is appropriate and which one.
Start and titration
If you begin medication, you start low. Doses increase gradually on a schedule your provider sets, because escalating quickly drives GI side effects.
Ongoing visits
Tolerance, dose, side effects, nutrition, and activity are reviewed, and doses are held, reduced, or advanced accordingly.
Ongoing laboratory monitoring
is ordered only if required. It is an extra charge and is not typically needed.
Plan review
Periodically you and your provider decide whether to continue, adjust, or taper, and what maintenance looks like.
What to expect, Medical Weight Loss
What to Expect
02 / Side effects to plan for
Side effects to plan for
Nausea, constipation, reflux, burping, diarrhea, and fatigue are the common ones. Most are dose related and manageable: eat smaller and slower, prioritize protein and fluid, keep fat and alcohol moderate, and treat constipation early. Tell your provider before you stop on your own.
03 / Titration
Titration
Dose escalation is deliberately slow. Moving faster is not a shortcut. Holding at a tolerated dose longer is a normal clinical decision.
04 / What does not change on its own
What does not change on its own
Muscle mass, protein intake, sleep, and stress still need attention. Eating substantially less without adequate protein and resistance training risks losing lean tissue with the fat.
05 / Individual response varies
Individual response varies
Some tolerate these medications easily, some not at all, and some need a different approach entirely.
What Happens If You Stop
This is worth asking before you start. These medications work while they are being taken. When they stop, the appetite signaling goes away and appetite generally returns toward its prior baseline. Weight regain after discontinuation is well described in the medical literature, and any program implying otherwise is not being straight with you.
That does not mean stopping is a failure or that you are on them permanently. It means the exit plan is part of the plan. Some patients taper to a maintenance dose. Some stop and keep the habits built during the program. Some restart later. What matters is deciding deliberately with your provider rather than because a vial ran out.
Pricing
Clear numbers, before treatment.
| Service | Price |
|---|---|
| Consultation | Free |
| Medical management fee, including initial required labs | $450 |
| Medication, charged separately | Discussed at consultation |
The program cost is the medical management fee plus the cost of medication. Medication is charged separately and discussed at your consultation. Initial labs required for the weight loss program are included in the medical management fee. Ongoing laboratory monitoring is an extra charge only if required and is not typically needed.
How the two charges relate. The consultation is free. The medical management fee is $450. The program cost is the medical management fee plus the cost of medication. Medication is charged separately and discussed at your consultation. Initial labs required for the weight loss program are included in the medical management fee. Ongoing laboratory monitoring is an extra charge only if required and is not typically needed.
Initial labs included. Initial labs required for the weight loss program are included in the medical management fee. Ongoing laboratory monitoring is an extra charge only if required and is not typically needed.
Medication cost depends on your prescribed treatment. Your provider discusses the separate medication charge at consultation.
Prices are subject to change and this page is not inclusive of all services, products, and discounts. See the full price list.
Fit, limits, and risk
Safety, Candidacy, and Who Should Not Take These Medications
These are prescription medications with real contraindications, dispensed only after evaluation by a licensed provider.
You should not take a GLP-1 or dual GIP and GLP-1 receptor agonist if you have
a personal or family history of medullary thyroid carcinoma, a personal or family history of Multiple Endocrine Neoplasia syndrome type 2, a known hypersensitivity to the medication or its components, or if you are pregnant, trying to conceive, or breastfeeding.
Tell your provider if you have
a history of pancreatitis, gallbladder disease, severe gastrointestinal disease or gastroparesis, diabetic retinopathy, kidney disease, an eating disorder history, or if you take insulin, a sulfonylurea, or other glucose lowering medications, since those doses may need adjustment.
Also disclose
oral contraceptive use, any planned surgery or procedure requiring sedation, and every other medication you take. Delayed gastric emptying affects both.
Contact a provider promptly
for severe or persistent abdominal pain, particularly pain radiating to the back, persistent vomiting or inability to keep fluids down, or signs of dehydration.
Response and tolerance vary. No outcome is guaranteed, and a medication that suits one patient may be inappropriate for another.
Why this practice
Why Patients Choose LouWellSpa for This
Evaluation before prescribing
Labs, history, and candidacy are settled first. If you are not a candidate, we say so at the consultation.
A provider who follows you
Dose decisions come from someone who knows your chart, not a refill queue.
Transparent, separated pricing,
with the medical management fee and medication cost explained at consultation.
Metabolic context
Hormone optimization and lab testing sit on the same menu, which matters when weight, energy, and hormonal changes overlap.
A sister primary care practice, Neighborhood NP, operates in the same space
Questions, answered plainly
Frequently Asked Questions
What does medical weight loss cost at LouWellSpa?
The consultation is free. The medical management fee is $450. The program cost is the medical management fee plus the cost of medication. Medication is charged separately and discussed at your consultation. Initial labs required for the weight loss program are included in the medical management fee. Ongoing laboratory monitoring is an extra charge only if required and is not typically needed.
Is the medication included in the $450 fee?
No. The consultation is free. The medical management fee is $450. The program cost is the medical management fee plus the cost of medication. Medication is charged separately and discussed at your consultation. Initial labs required for the weight loss program are included in the medical management fee. Ongoing laboratory monitoring is an extra charge only if required and is not typically needed.
How do these medications work?
GLP-1 receptor agonists imitate a gut hormone released after eating. That hormone signals fullness to the brain, slows stomach emptying, and influences insulin release in response to glucose. Dual GIP and GLP-1 receptor agonists act on that receptor and on a second incretin receptor, GIP, as well.
How much weight will I lose?
We do not publish that, and you should be skeptical of any clinic that does. Response varies considerably based on starting physiology, dose tolerated, medication, nutrition, activity, sleep, and other conditions. Your provider discusses realistic expectations for your situation rather than applying an average to you.
What are the most common side effects?
Nausea, constipation, reflux, burping, diarrhea, and fatigue are the ones most patients encounter. They tend to cluster in the days after a dose increase and ease as the body adjusts. Smaller slower meals, adequate protein and fluid, moderate fat and alcohol, and treating constipation early all help.
Who should not take these medications?
Anyone with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2, anyone pregnant, trying to conceive, or breastfeeding, and anyone with known hypersensitivity. A history of pancreatitis, gallbladder disease, gastroparesis, or an eating disorder requires careful evaluation first.
What happens when I stop taking it?
The medication works while it is being taken, so appetite signaling generally returns toward its prior baseline after stopping, and weight regain after discontinuation is well described. That is why an exit plan is part of the program. Some taper to a maintenance dose, some continue with habits built during treatment, some restart later.
Do I need lab work?
Yes. Initial labs required for the weight loss program are included in the medical management fee. Ongoing laboratory monitoring is an extra charge only if required and is not typically needed. Your provider reviews your history and initial results before deciding whether medication is appropriate.
Why not just order this online?
Online prescribing typically means a questionnaire, a shipped vial, and nobody following your labs, your dose tolerance, or your other medications. This program is built around evaluation, monitoring, and a provider who knows your chart. That is what makes dose adjustment and early problem detection possible.
Important information
This page is for general education and is not medical advice. GLP-1 medications are prescription medications, dispensed only after evaluation by a licensed provider who determines that treatment is appropriate for you. They are not appropriate for everyone and carry contraindications described above. This program is not a treatment for any disease and no outcome is guaranteed. Individual response and tolerance vary. Initial labs required for the weight loss program are included in the medical management fee. Ongoing laboratory monitoring is an extra charge only if required and is not typically needed. Prices are subject to change and this page is not inclusive of all services, products, and discounts.