MEDICAL WEIGHT MANAGEMENT – Lapband Solutions

Medical Weight Management services include: Medical Weight Management (with injectable compounded semaglutide/glycine/vitamin B12), nutrition education, and the provision of effective strategies for achieving a healthier lifestyle.

The addition of Vitamin B12 to the compound helps with the potential nausea side effect associated with semaglutide use and glycine with the preservation of muscle mass that can occur with weight loss.

PRICING

($300) for NEW or ESTABLISHED PATIENTS WITHOUT A LAP-BAND for Medical Weight Management (office visit includes a 1-month supply of compounded semaglutide/glycine/vitamin B12 pre-filled syringes)

($300) for ESTABLISHED LAP-BAND PATIENTS for Medical Weight Management ONLY (office visit includes a 1-month supply of compounded semaglutide/glycine/vitamin B12 pre-filled syringes WITHOUT a Lap-Band adjustment)

($385) for ESTABLISHED LAP-BAND PATIENTS for Medical Weight Management AND a Lap-Band Adjustment (office visit includes a 1-month supply of compounded semaglutide/glycine/vitamin B12 pre-filled syringes AND a Lap-Band adjustment)

The cost of each subsequent Medical Weight Management monthly office visit is $300 (which will include BOTH the consultation with a nurse practitioner AND a 1-month supply of compounded semaglutide/glycine/vitamin B12 pre-filled syringes to be self-administered once weekly).

The subcutaneous dosage initiation and monthly titration will be based on the prescribing guidelines outlined by the pharmaceutical manufacturer to a maximum dose of 2.4 mg per week (see FAQ area below for additional details).

SCHEDULE AN APPOINTMENT

Lapband Solutions & Medical Weight Management offers convenient online scheduling for all Medical Weight Management appointments.

A CONFIRMATION E-MAIL/TEXT will be issued immediately once an appointment has been scheduled
Cancelling or rescheduling of an appointment can be conveniently done from the CONFIRMATION E-MAIL/TEXT that you receive upon scheduling

* Cancellations MUST be made 12 hours in advance to avoid a $25 Late Cancellation Fee*

**Sorry, there are NO EXCEPTIONS**

Book an Appointment

PAYMENT POLICY AND CANCELLATIONS

Lapband Solutions & Medical Weight Management DOES NOT accept or bill any type of health insurance (including Medicare). It is a fee-for-service clinic that solely accepts cash, debit/credit cards, and most HSA/FSA card payments. A credit card must be provided to RESERVE and schedule an appointment online via Square.

PLEASE NOTE: Your debit/credit card WILL NOT be charged at the time of booking an appointment, this debit/credit card is only used to RESERVE the appointment through Square.

Payment is due at the time of service whereby you choose your method of payment with cash, debit/credit card, or most HSA/FSA accounts. *Personal checks are not accepted*

**We require a MINIMUM 12 Hour Cancellation Notice for all appointments. If cancelling within 12 hours of a reserved appointment, a $25 Late Cancellation Fee will be charged to the debit/credit card used to schedule the appointment**

**Sorry, there are NO EXCEPTIONS**

COMPOUNDED SEMAGLUTIDE/GLYCINE/VITAMIN B12

Healthy weight loss takes time, consistency, and personal effort. It takes about 5 months (20 weeks) to reach the target dosage of semaglutide. During this time, adults taking it in clinical trials lost an average of about 10% their starting body weight. They lost an additional 8% of their body weight through week 68.

Semaglutide is an FDA approved treatment for chronic weight management in adults who are obese (BMI ≥30) and overweight adults (BMI ≥27 who also have at least one weight-related comorbid condition (ie. hypertension, type 2 diabetes mellitus, or dyslipidemia).

It mimics a naturally occurring peptide in the body called GLP-1 (that helps regulate appetite) and has been shown to be effective in diminishing food cravings, decreasing appetite, and improving blood sugar control. Used in conjunction with lifestyle changes (including exercise, dietary habits, reduced calorie diet), semaglutide can help achieve weight loss.

The addition of vitamin B12 aids in the treatment tolerance of GLP-1 agonists like semaglutide. One of the most common adverse side effects of semaglutide use is nausea and some studies have shown nausea to be reduced when used in conjunction with Vitamin B12.

Semaglutide works by:
• Mimicking a hormone called glucagon-like peptide-1(GLP-1) in the body that targets areas of the brain that
regulate appetite. When a person eats, GLP-1 signals to the brain that they are full
• Slowing gastric emptying, decreasing appetite
• Improving insulin resistance and reducing food cravings
• Improving A1c and reducing risk of cardiac events

Benefits of semaglutide use may include:
• Promotion of lipolysis (the process by which fats are broken down in our bodies through enzymes and water)
• Lowering A1c (your average blood sugar level over 3 months)
• Decrease risk of cardiovascular events (ie. heart attacks and strokes)
• Lower BMI
• Reduction in plaque hemorrhage
• Lowering glucose levels in the bloodstream by assisting in pancreatic insulin release

More than 70% of Americans are overweight or obese, nearly half of adults in the U.S. have hypertension, and more than 1 in 3 have pre-diabetes. Semaglutide has already improved the lives of chronically overweight and obese patients.

Being overweight or obese is often the root cause of chronic diseases, including:

Cardiovascular disease
Type 2 diabetes
Stroke
High blood pressure
High cholesterol
Fatty liver
Certain types of cancers
Osteoarthritis
Sleep apnea
Hormone disorders, including insulin resistance
Alzheimer’s or dementia
Depression and other mood disorders
Joint pain

A landmark clinical trial published in The New England Journal of Medicine in 2021 found that semaglutide led to a 15% reduction in body weight, on average. (See full article under Resource section below)

Program Recommendations during semaglutide/vitamin B12 compounded treatment:

Diet: For the BEST results, we encourage you to reduce your caloric intake to 1,200-1,800 calories on a wholesome diet while on semaglutide. The following recommendations will allow you to create a more sustainable diet:

Eat healthy proteins (ie. chicken, fish, beef, pork turkey, tofu)
Eat healthy fats (ie. avocados, olive/avocado oil, nuts, chia seeds, and ground flax seed)
Limit trans/saturated fats (ie. lard, butter, ghee, milk fat, ice cream, pastries, coconut/palm oils)
Avoid refined sugars and processed foods (made with trans fat from partially hydrogenated oil)
Avoid fried food/fast food (consider use of air fryer)

*The BEST way to manage obesity is to make the necessary lifestyle changes to maintain a healthy weight*

Exercise: 150 minutes per week (ie. 30 minutes, 5 days/week)

Walking is an excellent form of exercise (ie. “Walk at Home” on You Tube)
Incorporate strength training into your routine (ie. light weights, resistance bands, body weight exercises)

Contraindications

While semaglutide is appropriate for most, there are some contraindications that would prevent its use. These include:

Personal or family history of medullary thyroid cancer or multiple endocrine neoplasias
Personal or family history of parathyroid cancer or pancreatic cancer
Being pregnant, trying to get pregnant, or breastfeeding
History of anorexia, bulimia, or body dysmorphic disorder
Type 1 diabetes
Diabetic retinopathy
Renal insufficiency
Vitamin B12 allergy
History of pancreatitis or pancreatic disease
History of gallbladder disease (NOTE: If your gallbladder has been removed, you can be considered for semaglutide use)

Common Side-Effects

As with any medication, there are some common potential side effects from semaglutide use. These side effects may include nausea, diarrhea, and vomiting. Although generally mild to moderate in severity, these effects are likely to improve as you adjust to the injectable compounded medication.

FREQUENTLY ASKED QUESTIONS

What is the difference between brand names of semaglutide, Wegovy and Ozempic?

Wegovy and Ozempic are once-weekly injections that contain the same active ingredient: semaglutide. Wegovy is approved for weight loss and Ozempic is approved to treat type 2 diabetes mellitus.

Will semaglutide start working right away?

Healthy weight loss takes time and personal effort. It takes about 5 months (20 weeks) to reach the target dosage of semaglutide. During this time, adults taking it in clinical trials lost an average of about 10% their starting body weight. They lost an additional 8% of their body weight through week 68.

What are the common side effects of semaglutide?

Common side effects of semaglutide may include nausea, diarrhea, vomiting, abdominal pain, and constipation. These side effects will likely begin to taper off once your body has adjusted to the medication via the recommended titration schedule. *A beneficial side effect of semaglutide is weight loss*

Is it better to take semaglutide at night or in the morning?

There is no evidence to suggest whether morning or night is better for administration of semaglutide. It should be taken subcutaneously once weekly, on the same day each week, at any time of day, with or without meals.

How does semaglutide work for weight loss?

Semaglutide mimics a hormone called glucagon-like peptide-1(GLP-1) in the body that targets areas of the brain that regulate appetite. *When a person eats, GLP-1 signals to the brain that they are full*. Semaglutide also slows gastric emptying, decreasing appetite.

Who is a candidate for semaglutide for weight loss?

The treatment with semaglutide is not appropriate for everyone. The medication can be considered for adults who are obese (with a BMI ≥ 30) or overweight (with a BMI ≥27 who also have at least one weight-related comorbid condition (ie. hypertension, type 2 diabetes mellitus, or dyslipidemia).

Is the semaglutide injection painless?

Most patients report that the semaglutide injection is painless. Pain, redness, warmth to touch, swelling, or purulent (white, milky, creamy, pus-like) discharge at the injection site may indicate an infection and should be promptly reported to a healthcare provider.

How is semaglutide dosed for weight loss?

The subcutaneous dosage initiation and monthly titration will be based on the prescribing guidelines outlined by the pharmaceutical manufacturer to a maximum dose of 2.4 mg per week.

Weekly Dose Month 1: 0.25 mg subcutaneously/week

Weekly Dose Month 2: 0.5 mg subcutaneously/week

Weekly Dose Month 3: 1 mg subcutaneously/week

Weekly Dose Month 4: 1.7 mg subcutaneously/week

Weekly Dose Month 5 and Onward: 2.4 mg subcutaneously/week (Maintenance dose)

How long should I take semaglutide?

Several factors determine the length of time that someone takes semaglutide. Taking the medication for 12-16 weeks and not experiencing weight reduction (ie. ≥4% to 5% weight loss) is likely to result in discontinuance of treatment as it should have started showing effectiveness within that time frame. Discontinuance is also recommended if safety or tolerability issues arise. After you achieve a BMI of 18.5-24.9 (normal BMI), you may be able to stop taking this medication and/or begin titrating down the dose.

Do you accept insurance?

We DO NOT process any insurance. Unfortunately, most insurance companies do not cover medical weight management.

What forms of payment are accepted?

We accept cash, credit cards, debit cards, and most flexible spending account (FSA)/health spending account (HSA) cards. Payment is due at the time of service. *Personal checks are not accepted*. We can provide you with an invoice of your office visit to submit to your insurance if they do offer reimbursement in your policy.

Can I pay with FSA/HSA?

Yes! Most FSA/HSA accounts for medical weight management treatments and medications can be paid for with your pre-tax flexible spending account (FSA) or health savings account (HSA).

RESOURCES

OFFICE VISIT FORMS

New Patient (INITIAL Office Visit; for NEW Weight Management Patients being seen at Lapband Solutions)

Established Patient (FOLLOW-UP Office Visit; ESTABLISHED Weight Management patients being seen at Lapband Solutions)

* Complete TOP SECTION only of Established Patient office visit form*

ARTICLES

Article: Obesity is a Chronic Disease

Article: New England Journal of Medicine (Semaglutide)

GENERAL INFORMATION ON SEMAGLUTIDE/VITAMIN B12

Semaglutide/Vitamin B12 Description and Medical Weight Management Program Recommendations

Counseling (Warnings, Precautions, and Side Effects)

Taking Semaglutide (Titration Schedule, Missed Dose, Side Effects, Tips)