MEDICAL WEIGHT LOSS
(Men & Women)
Men often experience weight loss when starting testosterone replacement therapy (TRT). After 3-6 months, most men drop a pants size or two. They become leaner and stronger. However, sometimes more weight loss is necessary to help increase testosterone levels, as adipose tissue increases estrogen levels in men contributing to weight gain.
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Women often gain weight with age and fluctuations of hormones along with lifestyle changes. As adipose tissue accumulates, insulin levels--along with other hormones involved in the same negative feedback loop--increase, causing the hypothalamus of the brain to increase the body's weight set point continually. This can cause yo-yo-ing of weight with dieting.
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Medically guided weight loss is now more effective than ever. Some medications work well to help people lose a significant amount of weight in a relatively short amount of time.
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Here at Vitali-T Men’s Health & Testosterone Clinic, we have access to the most effective weight loss medications
on the market.
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We provide medically assisted weight loss therapies to both men and women in Oregon and Washington.
Semaglutide
One of the more popular weight loss medications is semaglutide. It’s classified as a Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist. Often, GLP-1s are used to treat diabetes mellitus type II. These are known as semaglutide, Ozempic, Wegovy. Newly published findings from a phase III trial published in June 2023 in The Lancet illustrate oral semaglutide pill is as effective as Wegovy for weight loss.
These medications work by decreasing inappropriate glucagon secretion, slowing gastric emptying, and acting on the areas of the brain involved in regulating appetite and caloric intake. Essentially, you don’t want to eat as much, are fuller after smaller meals, and don’t crave food like you used to. You don’t want as many calories.
Most Americans will qualify for this GLP-1, as semaglutide is indicated for weight loss in those with a BMI >27 kg/m2 with at least one comorbidity (elevated blood pressure, diabetes, high cholesterol, etc.). If your BMI is >30 kg/m2, then you can also qualify.
We promote the use of weight loss medications in select individuals. We typically promote intermittent fasting, exercise and moving to a whole-food diet, avoiding high glycemic and packaged foods.
Semaglutide has a dose increase schedule of once a month. The lowest dose starts at 0.25 mg using subcutaneous injections for the first month, increasing to a maintenance maximum dosage of 2.4 mg for weeks 17 and after. It’s usually well-tolerated. There is also an oral version of semaglutide with a different dosing and tapering process.
Tirzepatide
Another medication gaining popularity for medically managed weight loss include tirzepatide/Mounjaro. This is a GLP-1 and is also called a GIP. This medication is often used to treat diabetes but promotes weight loss--as well as or better than semaglutide. Tirzepatide improves insulin sensitivity, stabilizes glucagon, and reduces hunger and hunger hormones. This medication can be costly and is injectable.
Phentermine
This is often a more affordable option. This is known as a Central Nervous Stimulant. Its mechanism of action is a sympathomimetic amine with properties similar to amphetamines. It reduces appetite secondary to CNS effects, including hypothalamus stimulation to release norepinephrine. This medication has been used successfully for years for weight loss. Dosing is determined on a case-by-case basis.
Contrave
This is also a more affordable option than other newer medications. This combo drug bupropion and naltrexone is known as an anorexiant for weight management. The effects of weight loss are thought to be the result of action on areas of the brain involved in the regulation of food intake, such as the hypothalamus, which is the part of the brain responsible for appetite regulation and the reward system of the brain in the mesolimbic dopamine circuit. With Contrave, you don't crave food in the same way as you once did.