Working with your gut hormones.
GLP-1 (glucagon-like peptide-1) is a hormone your gut produces after you eat. It signals your pancreas to release insulin, tells the liver to reduce glucagon secretion (which would otherwise raise blood sugar), slows the movement of food through the digestive tract, and sends satiety signals to the brain.
Semaglutide is a synthetic GLP-1 analog designed to be more stable and longer-acting than the natural hormone. It binds to GLP-1 receptors throughout the body and activates all the same pathways — but for much longer and more consistently than the hormone you produce after a meal.
The result is a sustained shift in the hormonal environment around hunger, satiety, and blood sugar regulation. Patients eat less not because they're white-knuckling it, but because the hormonal signal for hunger is genuinely quieter.
Metabolic weight management, done properly.
Semaglutide is appropriate for patients with a meaningful weight management goal, particularly those where metabolic factors — insulin resistance, appetite dysregulation, slow metabolism — are contributing to difficulty losing or maintaining weight through diet and exercise alone.
Patients with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 are not candidates. A thorough health history review is part of every initial evaluation.
- Significant weight reduction
- Appetite and hunger regulation
- Improved insulin sensitivity
- Blood sugar stabilization
- Cardiometabolic risk reduction
- Reduction in food noise and cravings
Once weekly. Titrated carefully.
Semaglutide is started at the lowest effective dose and titrated upward at 4-week intervals based on tolerance and response. This titration phase is essential — rushing the dose escalation is the most common reason patients experience significant GI side effects.
The injection is subcutaneous — abdomen, thigh, or upper arm. Most patients barely notice it after the first few times. We provide training on self-injection technique and support throughout.
| Phase | Dose | Duration |
|---|---|---|
| Titration start | 0.25mg weekly | 4 weeks |
| Step 2 | 0.5mg weekly | 4 weeks |
| Step 3 | 1.0mg weekly | 4+ weeks |
| Maintenance | 1–2.4mg weekly | Ongoing, per response |
What you should know
GI symptoms — nausea, constipation, and reduced appetite — are the most common side effects and are most pronounced during dose titration. Most patients adapt within 2–4 weeks at each dose step. Eating smaller, lower-fat meals and staying well-hydrated significantly reduces these symptoms.
Rare but important: pancreatitis has been reported. Symptoms of acute pancreatitis (persistent, severe abdominal pain) warrant immediate evaluation. For patients with a history of pancreatitis, this is generally not an appropriate treatment.
Common questions about Semaglutide
Ozempic and Wegovy contain semaglutide — the same active compound. What we prescribe is compounded semaglutide from a licensed 503B pharmacy. The molecule is identical; the delivery system and price point differ. We also provide direct physician oversight and protocol management, which is different from a prescription filled at a retail pharmacy.
GLP-1 agonists work while you're taking them. Stopping the medication typically results in appetite returning to previous levels, and many patients regain weight. This is why we discuss the long-term plan upfront — these medications are most effective when paired with genuine lifestyle changes that become sustainable.
Rapid weight loss can include lean mass loss — this is a legitimate concern. We address it through adequate protein intake guidance and, for patients interested in preserving or building muscle, pairing semaglutide with appropriate resistance training and sometimes additional protocols.
Response varies. Most patients see meaningful appetite reduction within the first few weeks. Weight loss follows at a pace that depends on your dose, your diet, your activity, and your individual metabolism. Average clinical trial results are encouraging, but individual results vary widely.
We review your labs, goals, and health history before recommending any protocol. Available in-person in St. Louis or via secure telehealth.
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