Sarah Nguyen, MD, FACE

Sequence (acquired by WeightWatchers) connects members with clinicians prescribing GLP-1 and other weight loss medications.

Calibrate is a 12-month program combining GLP-1 medication, coaching, and lifestyle interventions.

Ro's Body program connects users with prescribers for Wegovy, Zepbound, and compounded options.

Wegovy (semaglutide 2.4mg) is an FDA-approved once-weekly injection for adults with obesity or overweight with comorbidities.

Yes. Switching from Ozempic (semaglutide) to Mounjaro (tirzepatide) is common and clinically supported for type 2 diabetes patients seeking better A1C reduction.

Yes. Switching from Wegovy (semaglutide) to Zepbound (tirzepatide) is supported when Wegovy intolerance, plateau, or coverage loss occurs. Restart titration at Zepbound 2.5mg.

On raw weight loss, yes — Zepbound delivers ~22% body weight loss vs Wegovy ~15% in clinical trials. On cardiovascular outcomes evidence, Wegovy is ahead.

Most GI side effects (nausea, constipation, sulfur burps) resolve within 4-8 weeks as your body adjusts. Side effects flare again with each dose escalation.

Side effect profiles are similar. Zepbound users report slightly more fatigue at higher doses (10mg+). Wegovy users report more sulfur burps. Discontinuation rates ~comparable.

Yes, in moderation. Alcohol on Wegovy is not contraindicated, but most patients report dramatically reduced tolerance — 1-2 drinks may feel like 3-4.

Yes — and you should. Exercise on Wegovy preserves lean muscle mass, prevents the ~30% lean mass loss seen in patients who lose weight without strength training.

Adults with BMI ≥30, or BMI ≥27 with weight-related comorbidity (T2D, hypertension, dyslipidemia, sleep apnea, cardiovascular disease).

Yes. NovoCare direct cash-pay is $499/month for uninsured patients — same FDA-approved Wegovy as retail pharmacy, no insurance required.

Wegovy mimics GLP-1, a natural gut hormone. It slows gastric emptying, reduces appetite, and signals fullness — leading to reduced caloric intake.

Semaglutide has a half-life of ~1 week. After your last dose, it takes ~5 weeks (5 half-lives) for the drug to fully clear your system.

Yes, based on 5-year SELECT cardiovascular outcomes trial data. Long-term risks include pancreatitis, gallstones, and thyroid C-cell tumors (rare, FDA boxed warning).

Only for cardiovascular risk reduction indication (FDA-approved March 2024). Weight-loss indication remains excluded from Medicare Part D by statute.

Average ~15% of body weight at 68 weeks based on the STEP-1 trial. Real-world adherent users lose 12-18% in the first year.

No. Wegovy is contraindicated in pregnancy. Discontinue at least 2 months before attempting conception due to semaglutide's 1-week half-life.

Wegovy (semaglutide, weekly) outperforms Saxenda (liraglutide, daily) on both weight loss and convenience. Saxenda is the only GLP-1 FDA-approved for ages 12-17.

Refrigerated 36-46°F before first use. After first use, can stay at room temperature (up to 86°F) для up to 28 days. Never freeze. Protect from light.

Slowed gastric emptying from semaglutide causes food to ferment longer, producing hydrogen sulfide gas. Most common in first 4-8 weeks. Resolves as your body adapts.

Yes, potentially. Wegovy slows gastric emptying, which can reduce oral contraceptive absorption. Use backup contraception during titration and add 4 weeks after each dose increase.

Average: 2-3 lbs/week first 4 weeks, 1-2 lbs/week months 2-6, 0.5-1 lb/week months 6-12, plateau by month 18. Real-world varies sharply.

Indirect, not direct. Rapid weight loss triggers telogen effluvium (temporary shedding) in some users at months 2-4. Hair regrows by month 6-8.

Yes. Wegovy slows gastric emptying, reducing levothyroxine absorption. Space them 4+ hours apart and monitor TSH 6-8 weeks after starting Wegovy.

Three approved sites: abdomen (2 inches from navel), front of thigh, upper outer arm (с help). Rotate weekly to prevent lipohypertrophy (fat thickening).

Rare. ~1-2 cases per 1000 patient-years. Risk factors: prior pancreatitis, heavy alcohol use, gallstones. Severe abdominal pain warrants immediate discontinuation.

Wegovy substantially outperforms. STEP-1 trial: 15% weight loss vs phentermine ~5% historical. Wegovy is also long-term safe; phentermine restricted к short-term use.

No. FDA removed tirzepatide from the shortage list in October 2024. Some doses (5mg, 7.5mg) still have intermittent regional supply gaps. Check your pharmacy.

Yes, in moderation. Coffee doesn't interact with Wegovy. Beware: caffeine on empty stomach can amplify nausea during titration.

No. Wegovy is a prescription-only medication in the US. Anything sold online without prescription is counterfeit or illegal. Counterfeit semaglutide has caused hospitalizations.

Mixed evidence. Rapid weight loss generally reduces bone density. GLP-1 medications may have bone-protective effects partially offsetting this. Strength training is the proven mitigation.

Yes, ~10-15% of users report fatigue, especially first 4-8 weeks. Causes: reduced caloric intake, GI side effects, sleep disruption from nausea. Usually resolves by month 3.

Yes, emerging research. Wegovy reduces hsCRP ~30% independent of weight loss. May explain cardiovascular benefit and emerging applications in MASH, kidney disease, and Alzheimer's research.

FDA approved Zepbound for OSA с obesity in December 2024. Sleep study с AHI ≥15 + BMI ≥30 unlocks easier insurance PA than weight-loss-only indication.

Yes, increasingly common. ~20-30% of bariatric patients regain weight long-term; Wegovy helps maintain loss. Coordinate с bariatric team — usually start 6-12 months post-surgery.

Same active ingredient (semaglutide), different regulatory pathway. Brand: FDA-approved, $499/mo NovoCare direct. Compounded: not FDA-approved, $199/mo Hims, regulatory wind-down ongoing.