ARE YOU HITTING A ROAD BLOCK WITH LOSING WEIGHT?

There are currently three options available for weight loss.  Two of these involve medications.  The other is a simple caloric deficiency.  Even if medications are used, weight loss occurs because they help you create that deficit. 

For those who exercise, you can add to the daily calorie need by determining how many calories that exercise burns.  For example, a 100-pound person who walks a mile a day burns 100 calories, whereas a 250 pound person will burn 250 calories walking a mile.    

 A 500 calorie/day deficit will result in a one pound/week loss and a 1000 calorie/day deficit will result in a 2 pound/week loss. 3500 calories = 1lb.  Also, as you lose weight, you burn less calories and have a slower rate of loss.

Food choices are important. Eating foods with a high “glycemic index” (Simple Carbs) like potatoes, breads, sweets, and even bananas results in prompt satisfaction. These foods are rapidly absorbed. A better choice would be complex carbohydrates (beans, whole grains, and vegetables) which keep you full longer. Even fast foods like hamburgers are a good choice if not consumed with fries a sugary drink. Some people may ask for a lettuce wrap as an alternative to a bun. 

Semaglutide and Tirzepetide

These weekly injectable medications were initially created to treat diabetes but were found to cause weight loss. They both create a feeling of fullness and decreased hunger between meals. 

Semaglutide was created by Novo Nordisk and is marketed as Ozempic for diabetes and Wygovy for weight loss.  Tirzepetide is made by Lilly and is marketed as Monjouro for diabetes and Zepbound for weight loss.  For a motivated patient, Semaglutide can result in approximately a 20 percent weight loss over 6 to 9 months, and Tirzepetide about 30 percent.  

These medications should not be used by patients who have two different types of thyroid cancer, MEN Type 2, or medullary thyroid cancer. Patients with hypothyroidism (low thyroid) may use these medications. Semaglutide and Tirzepetide when purchased through the original manufacturers are expensive (approximately $1300/month) and insurance coverage is rare unless the patient has diabetes which is not controlled with other less expensive medications.

 There are pharmacies called “compounding pharmacies” which also make Semaglutide and Tirzepetide at a reduced price.  We are currently partnering with Rite Value Pharmacy which will mail the medication to you in about a week. It is injected weekly just under the skin of your abdomen, similar to insulin. If you are uncomfortable with this, bring your medication to our office so we may assist you.

Semaglutide is less expensive than Tirzepetide.  Both of these medications are gradually increased and are less expensive the first couple of months, but Semaglutide will range in cost from $99 – $200 per month and Tirzepetide $150 – $350 per month shipped to your door. Some patients will start with Semaglutide and switch to Tirzepetide if their goal is not achieved. Others may begin their weight loss journey with Tirzepetide.

Ultimately, the patient’s weight will plateau and a decision will need to be made to stop the medication or stay on a lower dose for maintenance. Others may decide to create a calorie restricted diet to maintain their new weight.

We only prescribe compounded Semaglutide and Tirzepetide. For those patients who desire Ozempic, Mounjaro, Wegovy, or Zepbound… we encourage you to discuss this with your PCP.

Benefits of Tirzepetide and Semaglutide

Tirzepetide & Semaglutide offers several potential benefits for individuals seeking weight management. Some of these benefits include:
 
1. Significant Weight Loss: These medications have shown the potential to induce substantial weight loss in motivated patients. Individuals may experience up to 30% weight loss over 6 to 9 months using Tirzepetide and up to 15% weight loss over 6 to 9 months using semaglutide.
 
2. Appetite Suppression: These medications helps regulate appetite by creating a feeling of fullness and reducing hunger between meals. This appetite-suppressing effect contributes to the overall weight loss observed in patients using the medication.
 
3. Weekly Administration:  Tirzepetide and Semaglutide are administered through a weekly injection under the skin of the abdomen or thigh. 
 
4. Potential Health Improvements: Weight loss achieved with Tirzepetide and Semaglutide may lead to improvements in various health parameters, such as reduced risk of obesity-related complications like cardiovascular disease, type 2 diabetes, and certain cancers.
 
5. Individualized Treatment: The availability of Tirzepetide and Semaglutide at reduced prices through compounding pharmacies allows for a reduced cost compared to the trade name product. 
 
6. Alternative to Surgery: For individuals who may not be suitable candidates for weight loss surgery or prefer a non-surgical approach, Tirzepetide provides a pharmacological option for significant weight reduction.
 
 

Risk of Tirzepetide and Semaglutide

While Tirzepetide and Semaglutide can be effective in promoting weight loss, like any medication, it comes with potential risks and side effects. It’s crucial for individuals considering this medication to be aware of these risks and discuss them thoroughly with their healthcare provider. Some potential risks associated with Tirzepetide include:
 
1. Gastrointestinal Issues: Tirzepetide may cause gastrointestinal side effects, such as nausea, vomiting, constipation, diarrhea, and abdominal pain. These symptoms can be bothersome and may impact a patient’s quality of life.
 
2. Pancreatitis: There have been reports of pancreatitis (inflammation of the pancreas) associated with Tirzepetide use. Symptoms of pancreatitis include severe abdominal pain, nausea, and vomiting. Patients experiencing these symptoms should seek medical attention promptly.
 
3. Fetal Risk: Tirzepetide may pose risks to a developing fetus. Therefore, it is not recommended for use during pregnancy. Women of childbearing age should use effective contraception while taking this medication.
 
4. Gallbladder Disease: Tirzepetide may slightly increase the risk of gallbladder disease resulting in abdominal pain. Individuals on this medication who develop upper abdominal pain should report this to a healthcare provider. 
 

Counting Calories

Even with all the diet plans out there, weight management still comes down to the calories you take in versus those you burn off during activity.

Popular fad diets may promise you that not eating carbohydrates (carbs) or eating a pile of grapefruit is the secret to weight loss. But it really comes down to eating fewer calories than your body is using if you want to lose weight.

 

Calories: Fuel for your body

 

Calories are the energy in food. Your body has a constant demand for energy and uses the calories from food to keep working. Energy from calories fuels your every action, from fidgeting to marathon running.

Carbohydrates, fats and proteins are the types of nutrients that have calories and are the main energy sources for your body. No matter where they come from, the calories you eat are either converted to physical energy or stored within your body as fat.

 

These stored calories will stay in your body as fat unless you use them up. You can do this by cutting how many calories you take in so that your body must draw on reserves for energy. Or you can add more physical activity so that you burn more calories.

Tipping the scale

 

Your weight is a balancing act, but the equation is simple. If you eat more calories than you burn, you gain weight. And if you eat fewer calories and burn more calories through physical activity, you lose weight.

In the past, research found about 3,500 calories of energy equaled about 1 pound (0.45 kilogram) of fat. So researchers thought burning or cutting 500 calories a day led to losing 1 pound a week. But this isn’t true for everyone.

 

In general, if you cut about 500 calories a day from your usual diet, you may lose about ½ to 1 pound a week. But this can vary depending on your body, how much weight you want to lose, your gender and activity level.

It sounds simple. But it’s more difficult because when you lose weight, you usually lose a mix of fat, lean tissue and water. Also, because of changes that occur in the body as a cause of weight loss, you may need to decrease calories more to keep losing weight.

Cutting calories

 

Cutting calories needs to include change, but it doesn’t have to be hard. These changes can have a big impact on the number of calories you take in:

  • Skipping high-calorie, low-nutrition items
  • Swapping high-calorie foods for lower calorie choices
  • Cutting portion sizes
 

Saving calories by cutting high-calorie, low-nutrition items

 

Skipping one or two high-calorie items is a good place to start when cutting calories. For example, you could skip your morning latte, soda at lunch or that evening bowl of ice cream.

Think about what you eat and drink each day and find items you could cut out. If you think that skipping your treat will leave you with a craving, swap it with a low-calorie choice.

 

Weight Loss program & Pricing

MP Weight Loss Clinic

  • First Visit: $200 – Weight Loss Consult 

Follow up appointments:

  • $75 – based on your current dose. 
  • When goal is reached your followup appointments will be every 3 months. 

In person:

  • Mondays: 8: 30 AM – 4:30 PM
  • Fridays: 8:30 AM – 4:30 PM

Consult takes typically an hour. 

Telehealth: 

  • Tuesdays: 8:30 AM – 2:00 PM
  • Wednesdays: 8:30 AM – 2:00 PM

We would like to see all new patients in clinic at first. We can do a new patient telehealth. Scheduling would have to be confirmed by Dr. Moore first. 

Please note: Phentermine can be only in an office appointment. We can not offer telehealth for Phentermine. 

Pharmacies:

Semaglutide & Tirzepatide: For the injections we have partnered with Axtell Rite Value Pharmacy in Whitesborro, Tx and Strive Pharmacy in Boerne, Tx. Your medication will last anywhere between 4 – 6 weeks depending on your dose. 

Financials: Please contact our office for current rates. Call 903.708.2533 Ask for Clay.

Payment is self pay. We do not accept insurance. We accept all credit cards, HSA/FSA, cash, and check.

Helpful steps to a sucessful weight loss journey

  1. Hydration: Drink plenty of water throughout the day to stay hydrated. Aim for at least 8-10 cups of water daily, and avoid sugary beverages and excessive caffeine intake.

  2. Balanced Macronutrients: Aim for a well-balanced diet that includes a mix of carbohydrates, protein, and healthy fats at each meal. This can help stabilize blood sugar levels and promote satiety.

  3. Complex Carbohydrates: Choose carbohydrates with a low glycemic index (GI) to prevent spikes in blood sugar levels. Opt for whole grains such as oats, quinoa, brown rice, and barley, as well as non-starchy vegetables like leafy greens, broccoli, cauliflower, and peppers.

  4. Lean Protein Sources: Incorporate lean protein sources into your meals to support muscle health and promote satiety. Examples include skinless poultry, fish, tofu, tempeh, legumes (beans, lentils), low-fat dairy products, and eggs.

  5. Healthy Fats: Include sources of healthy fats in your diet, such as avocados, nuts, seeds, olive oil, and fatty fish like salmon and mackerel. These fats can help improve insulin sensitivity and support heart health.

  6. Portion Control: Pay attention to portion sizes to avoid overeating. Use measuring cups, spoons, or food scales to ensure proper portion sizes, especially if you’re trying to manage your weight.

  7. Frequent Meals and Snacks: Instead of three large meals, consider eating smaller, more frequent meals and protein snacks throughout the day. This can help regulate blood sugar levels and prevent overeating.

  8. Limit Processed Foods and Added Sugars: Minimize your intake of processed foods, sugary snacks, desserts, and beverages, as these can contribute to weight gain and negatively impact blood sugar control.

  9. Regular Exercise: Incorporate regular physical activity into your routine, as exercise can complement the effects of semaglutide by improving insulin sensitivity and aiding in weight loss.

  10. Healthy Eating Plan: Focus on a balanced, nutritious diet rich in whole foods. This typically includes:

    • Vegetables: Aim to fill half your plate with non-starchy vegetables like leafy greens, broccoli, peppers, carrots, etc.
    • Protein: Incorporate lean protein sources such as chicken breast, fish, tofu, legumes, and eggs.
    • Whole Grains: Opt for whole grains like brown rice, quinoa, oats, and whole-grain bread instead of refined grains.
    • Healthy Fats: Include sources of healthy fats such as avocados, nuts, seeds, and olive oil in moderation.
    • Fruits: Enjoy fruits in moderation, focusing on lower-sugar options like berries, apples, and citrus fruits.

It’s essential to customize your diet plan based on your individual health status, dietary preferences, and lifestyle factors. Consult with your healthcare provider or a registered dietitian to create a personalized diet plan that meets your specific needs and health goals while using semaglutide.

Simple Diet Plan

Here’s a sample diet plan for weight management. Remember, it’s important to consult with your healthcare provider or a registered dietitian before starting any new diet plan, especially when using medication like semaglutide or tirzepatide.

Breakfast:

Option 1: Spinach and mushroom omelet made with 2 eggs (or egg whites), sautéed spinach, mushrooms, and a sprinkle of cheese. Serve with a side of sliced tomatoes.
Option 2: Greek yogurt parfait with low-fat Greek yogurt, mixed berries, and a sprinkle of granola or chopped nuts.
Option 3: Whole grain toast topped with mashed avocado and sliced boiled eggs, seasoned with salt, pepper, and a squeeze of lemon juice.

Mid-Morning Snack:
Option 1: Apple slices with almond butter.
Option 2: Carrot and cucumber sticks with hummus.
Option 3: A small handful of mixed nuts (such as almonds, walnuts, and pistachios).

Lunch:

Option 1: Grilled chicken salad with mixed greens, cherry tomatoes, cucumbers, bell peppers, and a balsamic vinaigrette dressing.
Option 2: Quinoa and black bean salad with diced avocado, corn, bell peppers, and a squeeze of lime juice.
Option 3: Whole grain wrap filled with tuna salad (made with canned tuna, Greek yogurt, diced celery, and spices) and mixed greens.

Afternoon Snack:
Option 1: Sliced bell peppers and cherry tomatoes with guacamole.
Option 2: Cottage cheese with pineapple chunks.
Option 3: Air-popped popcorn sprinkled with nutritional yeast.

Dinner:

Option 1: Baked salmon with roasted asparagus and quinoa.
Option 2: Stir-fried tofu with mixed vegetables (such as broccoli, bell peppers, snap peas, and carrots) served over brown rice.
Option 3: Turkey chili made with lean ground turkey, kidney beans, diced tomatoes, onions, and spices, served with a side salad.

Evening Snack (optional):

Option 1: A small bowl of mixed berries.
Option 2: Sliced cucumber with hummus.
Option 3: A piece of dark chocolate (70% cocoa or higher).

Fluid Intake:

Aim to drink at least 8 cups (64 ounces) of water throughout the day.
You can also include herbal teas, sparkling water, and other non-caloric beverages.
Notes:

Pay attention to portion sizes and avoid overeating, even of healthy foods.
Try to eat mindfully, paying attention to hunger and fullness cues.
Regular physical activity is important for overall health and weight management. Aim for at least 30 minutes of moderate-intensity exercise most days of the week, as tolerated.

Adjust portion sizes and food choices based on your individual calorie needs, dietary preferences, and any specific dietary restrictions or recommendations provided by your healthcare provider.