Tirzepatide is once-weekly injectable dual glucagon-like peptide 1 (GLP-1) receptor and glucose-dependent
insulinotropic polypeptide (GIP) receptor agonist. It works by increasing insulin production and lowers
glucagon secretion as well as targets areas in the brain that regulate appetite and food intake. A small change in
the molecule allows the drug to last weeks in our bodies rather than the natural version our bodies make, which
lasts minutes.

How Does Tirzepatide Work?
Tirzepatide acts in the following ways:
● Delays how quickly our stomachs digest food. Leading to a feeling of fullness and satisfaction with smaller meal sizes.
● Slows intestinal motility so you will feel fuller longer after meals.
● Dual action receptor allows for lower blood sugars, in part by reducing the production of sugar in the liver.
● Stimulates insulin secretion by the pancreas.
● GIP increases energy expenditure, resulting in weight loss reductions

 A phase 3 clinical trial found a high dose of tirzepatide helped patients lose 22.5% of their body weight on average, or about 52 pounds, better than any medication currently on the market. This is a once weekly injection that you do at home. The dosage increases over several weeks or months time if needed. Side affects can include headache, nausea, vomiting, constipation, diarrhea. Not everyone experiences these and if requested a prescription for zofran (anti nausea) can be ordered at the same time.The dosing for semaglutide increases over time if necessary. This also may cause an increase in pricing at very high doses. Contraindications for tirzepatide include thyroid cancer and pancreatitis.  

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Semaglutide is a modified molecule our bodies make, called a GLP-1 analog. It works by increasing insulin
production and lowers glucagon secretion as well as targets areas in the brain that regulate appetite and food
intake. A small change in the molecule allows the drug to last weeks in our bodies rather than the natural
version our bodies make, which lasts minutes.

How Does Semaglutide Work?
Semaglutide acts in the following ways:
● Delays how quickly our stomachs digest food. Leading to a feeling of fullness and satisfaction with smaller meal sizes.
● Slows intestinal motility so you will feel fuller longer after meals.
● Lowers blood sugars, in part by reducing the production of sugar in the liver.
● Stimulates insulin secretion by the pancreas.

 Semaglutide works in a similar fashion to tirzepatide. While studies show weight loss up to approximately 20%, many users lose more. Semaglutide is a once a week injection done at home. Side affects include headache, nausea, vomiting, stomach pain, constipation, diarrhea, and dyspepsia (indigestion). Not all users experience these side affects and zofran, an anti nausea medication may be ordered if requested. The dosing for semaglutide increases over time if necessary. This also may cause an increase in pricing at very high doses. Contraindications include thyroid cancer and pancreatitis.

Low Dose Naltrexone has been shown to be effective in promoting weight loss through several mechanisms. One way it may work is by reducing appetite and food cravings, leading to decreased caloric intake. Additionally, LDN has been found to increase levels of growth hormone, which aids in the development of lean muscle mass and fat burning. LDN may also help to reduce insulin resistance, which is a contributing factor in obesity and other health issues such as diabetes, heart attacks, and strokes. Overall, LDN appears to have the potential to not only support weight loss efforts, but also address other related health issues. This is a capsule taken at bedtime. Side affects may include vivid dreaming during while titrating to higher dose.

Phentermine is a prescription medicine used to lessen appetite. It can help weight loss by making you less hungry. Or it can help you feel full longer.

Phentermine also is offered combined with topiramate for weight loss (Qsymia). The combined drug is approved for long-term use. Phentermine is approved for use for up to 12 weeks. But weight management can take time. So some health care providers might order it for longer use.

Like other weight-loss medicines ordered by providers, phentermine is meant to be only part of a weight-loss plan. For example, it can be be used with healthy eating, physical activity and behavior change. Phentermine is for people with obesity or overweight who haven't been able to lose enough weight with diet and exercise alone to improve their health.

Phentermine is a Schedule 4 drug. This is a label given to drugs that can be misused. But the rate of misuse seems to be low.

Common side effects of phentermine include:

• Faster heart rate

• Sleeplessness

• Nervousness

• Constipation

Phentermine is one of the most prescribed weight-loss medicines. But it isn't a good choice for people with heart disease, high blood pressure, an overactive thyroid gland or glaucoma. It also isn't for people who are pregnant, may become pregnant or are breastfeeding.