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• Semaglutide (brand names Wegovy for weight loss and Ozempic for diabetes) and Tirzepatide (brand name Mounjaro for diabetes and Zepbound for weight loss) are injectable medications originally designed to treat type 2 diabetes.

• Both medications help control appetite and promote weight loss by mimicking natural hormones in the body that regulate hunger and blood sugar. They work by slowing the movement of food through your stomach, helping you feel full longer and reducing cravings.

• Semaglutide mimics the hormone GLP-1, while Tirzepatide works on both GLP-1 and GIP, which makes it more powerful for some people in terms of weight loss.

Both medications:

• Decrease hunger and food cravings.

• Slow down gastric emptying, meaning you feel full longer after eating.

• Reduce “food noise”, or constant thoughts about food.

The end result is eating less without feeling deprived or hungry, making weight loss easier and more manageable.

1. Start the Program:
   If you choose to move forward, we will process payment for your medication. Your medication will be shipped directly to your home via FedEx or UPS.

2. Weekly Injections:

   • You will inject the medication once a week. Most clients start with a low dose, then gradually increase based on how well they tolerate it.

   • The injection is simple and can be done in the abdomen, outer thigh, or upper arm. We will provide clear instructions on how to prepare and administer the injection.

3. First Month:

   • For semaglutide, you will start with your customized number of units for the first 4 weeks, then we can increase if there are no significant side effects.

   • For tirzepatide, you will start with your customized number of units weekly for at least 4 weeks. Then if needed we can increase your dose.

4. Monthly Check-In:
   Every 3-4 weeks, you will complete a check-in form to report your weight, any side effects, and whether you’d like to adjust your dose. Based on your feedback, we will arrange for your next medication shipment and adjust your dose if needed. Please watch for these forms in your email. If we do not hear from you, we assume no news is good news and will continue at your current dose.

5. Phone or Telehealth Follow-up:

   We recommend a voice or telehealth visit every 3-6 months to assess your progress and address any questions that may arise.

1. Mild Side Effects (often temporary):

   • Nausea (common when starting the medication and changing doses)

   • Fatigue, diarrhea, or constipation may also occur.

2. Serious Side Effects (very rare):

   • Pancreatitis (inflammation of the pancreas), especially if you have a history of pancreatitis.

   • Thyroid cancer: This was observed in rats in early studies but has not been seen in humans in significant numbers. It is most often a concern with long-term use.

   • Gallbladder issues may occur with rapid weight loss.

• It is highly recommended that we obtain metabolic lab work at the beginning and month 6 after starting these medications. Beyond that, annually is often sufficient. Labs are drawn through LabCorp for a discounted fee.

• Pancreatitis: We will discuss your medical history, especially any past issues with your pancreas.

• Thyroid Cancer: If you or your family have a history of thyroid cancer, we will carefully evaluate the risks.

• Ongoing Communication: You can message us through the Practice Better app or email at info@couturemedical.health if you experience any issues or need support throughout the program. We will also review your progress regularly and adjust the treatment as needed.

• Duration of Use: Most people stay on semaglutide or tirzepatide for 6-12 months. We focus on using the lowest effective dose to minimize side effects while still achieving significant weight loss.

• Follow-Up: After 3-6 months, we will schedule a check-in to review your progress and make any necessary adjustments.

• Ongoing Communication: You do not have to wait for your follow-up to reach out with questions or concerns. We want to be your teammate in this process! Message us on the app or email with any needs between visits. If it is extensive and requires a call, we will schedule it. Most issues can be resolved through messaging.

• If you’re ready to start, we will charge your card and place your order at the end of the consultation.

• Your medication will arrive via FedEx or UPS. Your emailed protocol will guide you through your first injection. Please reach out for ANY questions or concerns before injecting!

• You will complete check-in forms regularly, and we are always available to answer any questions or concerns you may have.

• Refrigeration: Store the medication in the refrigerator.

• Inspect Medication: Check the vial upon arrival. If it's broken, report it to the pharmacy within 24 hours.

• Expiration: FDA requires compounded medications to have a vial expiration date 28 days after the first puncture. This allows for 5 weeks of shots per vial. We recommend any leftover medication be discarded.

• Dose Adjustments: We recommend that you stay at the lowest effective dose. If you're losing 4-6 lbs per month without side effects, maintain your dose. If you plateau for several weeks, request a dose increase. Use your check-in forms to communicate your desire to increase or stay at your current dose. 

  • NO NEWS IS GOOD NEWS: If you do not fill out your check-in form or message us, we will order the same dose as your previous vial, assuming that you are happy with your current regimen.

• Maintain PCP Relationship: Continue seeing your primary care provider for any medical concerns.