Weight Loss

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Medical Weight Loss Clinical Criteria

Weight loss medications are generally prescribed for individuals with a Body Mass Index (BMI)
of 30 or higher
or
a BMI of 27 or higher in the presence of specific risk factors.
**We review each individual’s personal goals, current health, and risk factors to determine
eligibility. We recognize weight loss and medicine are not one size fits all.

Weight loss can result in:
● lowering blood pressure
● reducing joint pain
● improved energy levels
● Improvement of sleep apnea
● Improvement in your lab values
For medical weight loss medication options we offer
● Compounded Semaglutide or Tirzepatide
● Wegovy
● Zepbound
● Metformin
● Contrave
● Bupropion
**Other options available please note NO CONTROLLED MEDICATIONS ARE PRESCRIBED
These medications can assist with weight loss and long-term weight management.

Please note that compounded Semaglutide and Tirzepatide are not FDA approved.

It’s important to share your entire medical history with your provider. Prior to use of these weight loss medications:

INCLUDING IF YOU HAVE:

Type 1 or type 2 diabetes
Thyroid cancer (Please indicate type and if you have the diagnosis or a family member)
Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
Pancreatitis
Kidney disease
Diabetic retinopathy
Depression/Suicidal thoughts or behavior past or current
Gastrointestinal issues or concerns
Gallbladder issues or concerns
Bariatric surgery within the last year
Pregnant, breastfeeding or planning to conceive in the next 3 months

Semaglutide and Tirzepatide cause a delay in gastric emptying, so it has the potential to impact the absorption of medications that are taken by mouth at the same time. PLEASE note all current medications so your provider can review and concerns.

Serious side effects can occur with semaglutide and Tirzepatide

Thyroid C-Cell Tumors:

It is unknown whether semaglutide and or Tirzepatide causes thyroid C-cell tumors in humans. **Tell your provider right away if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath. These may be symptoms of thyroid cancer.
Inflammation of Pancreas (Acute Pancreatitis):

Monitor for signs of acute pancreatitis, including severe abdominal pain that does not go away, sometimes radiating to the back, with or without vomiting.
Acute Gallbladder Disease:

Potential side effects can include gallstones. **Tell your provider right away if you have pain in your upper stomach, yellowing of skin or eyes (jaundice), fever, or clay-colored stools.
Low Blood Sugar (hypoglycemia):

he injectable medications lower blood glucose. PLease be aware of the signs of too low blood sugar such as dizziness, blurred vision, mood changes, sweating, or fast heartbeat.
Acute Kidney Injury:

In people who have kidney problems, diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration) which may cause kidney problems to get worse. It is important for you to drink plenty of water to help reduce your chance of dehydration. If you are taking Metformin and have persistent nausea and or diarrhea please stop the medication and notify your provider If you experience symptoms of a serious allergic reaction, including swelling of your face, lips, tongue or throat, severe rash or itching, very rapid heartbeat, problems breathing or swallowing, or fainting or feeling dizzy.

Diabetic Retinopathy Complications in Patients with Type 2 Diabetes:

If you have type 2 diabetes, tell your provider right away if you experience changes in vision.
Increase in Heart Rate:

Tell your provider if you have a racing heartbeat while at rest or a history of prior to starting these medications
Suicidal Behavior and Ideation:

You should pay attention to any mental health changes, especially sudden changes in your mood, behaviors, thoughts, or feelings. Call your healthcare provider right away if you have any mental changes that are new, worse, or worry you.

PLEASE NOTE: Never take a combination of medication for weight loss such as Semaglutide with Tirzepatide as that is not safe. One cannot have two medical providers for weight loss as it is not safe or advised. We will require verification of your last prescription dose and date to
transfer to our weight loss program.

PLEASE NOTE: Lab results are not mandatory, but if we believe they are needed to make a clinical assessment if one should move forward we will require them before medication is prescribed. Here at Grounded we ENCOURAGE labs to be completed if you have not had labs
in the last 12 months.

PLEASE NOTE: Mounjaro, Zepbound have a warning on oral birth control and combined use with these medications. If you take oral birth control pills, alert your provider before you use Zepbound. Birth control pills may not work as well while using Mounjaro or Zepbound. You may be advised by your provider to utilize another type of birth control for 4 weeks after you start Mounjaro or Zepbound and for 4 weeks after each increase in your dose.

COMMON SIDE EFFECTS OF THESE MEDICATIONS (other side-effects may result)

● Nausea/Vomiting
● Diarrhea/Constipation/Abdominal cramping
● Upset stomach/Indigestion/Belching and gas/heartburn
● Injection-site reactions
● Fatigue
● Hair loss

Weight Loss

Service

Medical Weight Loss Clinical Criteria

It’s important to share your entire medical history with your provider. Prior to use of these weight loss medications:

INCLUDING IF YOU HAVE:

Serious side effects can occur with semaglutide and Tirzepatide

Thyroid C-Cell Tumors:

Inflammation of Pancreas (Acute Pancreatitis):

Acute Gallbladder Disease:

Low Blood Sugar (hypoglycemia):

Acute Kidney Injury:

Diabetic Retinopathy Complications in Patients with Type 2 Diabetes:

Increase in Heart Rate:

Suicidal Behavior and Ideation:

COMMON SIDE EFFECTS OF THESE MEDICATIONS (other side-effects may result)

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