





Physician visits are billed through insurance — standard co-pays, co-insurance, or deductibles apply.
The $79 annual fee is separate from visit costs.






Physician visits are billed through insurance — standard co-pays, co-insurance, or deductibles apply.
The $79 annual fee is separate from visit costs.

All GLP-1 medications are prescription-only and require physician oversight.
Dosing starts low and increases gradually to minimize side effects..
SYMPTOMS:
• Nausea (most common early on)
• Vomiting
• Constipation
• Diarrhea
• Bloating & gas
• Heartburn / indigestion
• Heavy feeling after eating
MANAGEMENT TIPS:
✔ Eat smaller, more frequent meals — 4–6 per day
✔ Chew slowly; stop when just satisfied
✔ Choose bland, low-fat foods: crackers, bananas, rice
✔ Sip ginger or peppermint tea for nausea
✔ Stay hydrated — aim for 64+ oz water daily
✔ Avoid fried, spicy, greasy, carbonated foods
✔ For constipation: add fiber gradually (chia, prunes)
Most GI symptoms peak during dose escalation and improve after 8–12 weeks.
Symptoms persisting beyond 12 weeks should be discussed with your provider.
SYMPTOMS:
• Fatigue & low energy
• Muscle loss with rapid weight loss
• Generalized weakness
• Low nutrient intake from reduced appetite
MANAGEMENT TIPS:
✔ Prioritize protein at every meal — aim 100+ g/day
✔ Resistance training at least 2–3x per week
✔ Focus on nutrient-dense foods even when appetite is low
✔ Consider protein shake when solid food is difficult
Protein intake and resistance exercise are the two most important countermeasures for muscle loss — not optional extras.
WHAT'S HAPPENING:
• Increased shedding, often starting weeks 6–8
• Caused by rapid weight loss stress, not the drug
• Affects roughly 1 in 10 patients
• Typically reverses within 3–6 months
MANAGEMENT TIPS:
✔ Ensure adequate protein, iron, zinc, and biotin
✔ Avoid severe caloric restriction
✔ Ask provider about hair/nail/skin supplement
✔ Minimize heat styling and tight hairstyles
SYMPTOMS:
• Headaches (often dehydration-related)
• Dizziness or light-headedness
• Mild increase in heart rate
• Sleep disturbances
• Mood changes
MANAGEMENT TIPS:
✔ Increase fluid and electrolyte intake
✔ Limit caffeine and alcohol
✔ Eat lighter in the evening
✔ Maintain a consistent sleep schedule
✔ Notify your provider of mood changes
RED FLAG SYMPTOMS:
• Severe abdominal pain radiating to the back
• Severe vomiting or abdominal pain with fever
• Right upper abdominal pain (gallbladder)
• Sudden painless vision changes
• Neck lump, difficulty swallowing, hoarseness
• Signs of allergic reaction
CONTRAINDICTIONS:
• Personal/family history of medullary thyroid cancer
• Multiple endocrine neoplasia type 2 (MEN2)
• History of pancreatitis
• Pregnancy or breastfeeding
• Severe GI conditions (gastroparesis, IBD)
Sympathomimetic stimulant that suppresses appetite via the CNS. FDA-approved for short-term use alongside diet and exercise. Schedule IV controlled substance.
SIDE EFFECTS:
• Dry mouth
• Insomnia
• Increased heart rate / palpitations
• Elevated blood pressure
• Headache
• Nervousness or anxiety
• Constipation
MANAGEMENT TIPS:
✓ Take in the morning only
✓ Stay well hydrated for dry mouth
✓ Avoid caffeine — amplifies stimulant effects
✓ Monitor blood pressure regularly
✓ Report palpitations or chest discomfort promptly
✓ Increase fiber and water for constipation
Warning:
Not for use with heart disease, uncontrolled hypertension, hyperthyroidism, glaucoma, or history of drug abuse. Not safe during pregnancy.
Combines naltrexone (reduces food cravings) and bupropion (appetite suppressant). Not a controlled substance. FDA-approved for chronic weight management. Dose ramps up over 4 weeks.
SIDE EFFECTS:
• Nausea (most common early)
• Headache · Constipation
• Insomnia · Dry mouth
• Dizziness
• Increased blood pressure or heart rate
• Mood changes / irritability
MANAGEMENT TIPS:
✓ Take with food — NOT with high-fat meals (seizure risk)
✓ Ramp dose gradually as prescribed
✓ Take evening dose early to minimize sleep disruption
✓ Monitor blood pressure during escalation
✓ Report mood changes or unusual thoughts promptly
✓ Do not stop abruptly — taper with provider guidance
Black box warning:
Increased risk of suicidal thoughts. Do not use with MAOIs, opioids, seizure disorder, bulimia, or anorexia.
Pairs phentermine (stimulant appetite suppression) with extended-release topiramate (promotes satiety). FDA-approved for adults and patients 12+. Available only through the Qsymia REMS program due to birth defect risk.
SIDE EFFECTS:
• Tingling / pins-and-needles
• Dry mouth · Constipation
• Insomnia · Dizziness
• Altered taste / brain fog
• Mood changes
• Eye pain or vision changes (rare)
MANAGEMENT TIPS:
✓ Take in the morning only
✓ Sip water frequently for dry mouth
✓ Alert provider if cognitive effects persist
✓ Increase fiber and hydration for constipation
✓ Avoid alcohol — amplifies CNS effects
✓ Report sudden vision changes immediately
✓ Women must use reliable contraception
Warning:
Qsymia is a teratogen — causes serious birth defects. Contraindicated in pregnancy. Monthly pregnancy tests required for women of childbearing potential.
FDA-approved for type 2 diabetes; widely used off-label for insulin resistance, prediabetes, PCOS, and weight support. Extended-release (ER) formulation significantly reduces GI side effects.
SIDE EFFECTS:
• Nausea (most common when starting)
• Diarrhea
• Stomach cramping / bloating / gas
• Metallic taste
• Vitamin B12 deficiency (long-term use)
• Fatigue (if B12 is low)
MANAGEMENT TIPS:
✓ Always take with food — reduces GI upset significantly
✓ Start at 500 mg; increase slowly every 1–2 weeks
✓ Ask about switching to extended-release (ER) formulation
✓ Monitor B12 levels annually; supplement if needed
✓ Stay hydrated; limit alcohol
✓ GI side effects typically resolve within 4–6 weeks
Warning:
Hold before procedures using contrast dye. Contraindicated in significant kidney impairment. Weight loss is modest — expectations should reflect gradual, incremental results.

All GLP-1 medications are prescription-only and require physician oversight.
Dosing starts low and increases gradually to minimize side effects..
SYMPTOMS:
• Nausea (most common early on)
• Vomiting
• Constipation
• Diarrhea
• Bloating & gas
• Heartburn / indigestion
• Heavy feeling after eating
MANAGEMENT TIPS:
✔ Eat smaller, more frequent meals — 4–6 per day
✔ Chew slowly; stop when just satisfied
✔ Choose bland, low-fat foods: crackers, bananas, rice
✔ Sip ginger or peppermint tea for nausea
✔ Stay hydrated — aim for 64+ oz water daily
✔ Avoid fried, spicy, greasy, carbonated foods
✔ For constipation: add fiber gradually (chia, prunes)
Most GI symptoms peak during dose escalation and improve after 8–12 weeks.
Symptoms persisting beyond 12 weeks should be discussed with your provider.
SYMPTOMS:
• Fatigue & low energy
• Muscle loss with rapid weight loss
• Generalized weakness
• Low nutrient intake from reduced appetite
MANAGEMENT TIPS:
✔ Prioritize protein at every meal — aim 100+ g/day
✔ Resistance training at least 2–3x per week
✔ Focus on nutrient-dense foods even when appetite is low
✔ Consider protein shake when solid food is difficult
Protein intake and resistance exercise are the two most important countermeasures for muscle loss — not optional extras.
WHAT'S HAPPENING:
• Increased shedding, often starting weeks 6–8
• Caused by rapid weight loss stress, not the drug
• Affects roughly 1 in 10 patients
• Typically reverses within 3–6 months
MANAGEMENT TIPS:
✔ Ensure adequate protein, iron, zinc, and biotin
✔ Avoid severe caloric restriction
✔ Ask provider about hair/nail/skin supplement
✔ Minimize heat styling and tight hairstyles
SYMPTOMS:
• Headaches (often dehydration-related)
• Dizziness or light-headedness
• Mild increase in heart rate
• Sleep disturbances
• Mood changes
MANAGEMENT TIPS:
✔ Increase fluid and electrolyte intake
✔ Limit caffeine and alcohol
✔ Eat lighter in the evening
✔ Maintain a consistent sleep schedule
✔ Notify your provider of mood changes
RED FLAG SYMPTOMS:
• Severe abdominal pain radiating to the back
• Severe vomiting or abdominal pain with fever
• Right upper abdominal pain (gallbladder)
• Sudden painless vision changes
• Neck lump, difficulty swallowing, hoarseness
• Signs of allergic reaction
CONTRAINDICTIONS:
• Personal/family history of medullary thyroid cancer
• Multiple endocrine neoplasia type 2 (MEN2)
• History of pancreatitis
• Pregnancy or breastfeeding
• Severe GI conditions (gastroparesis, IBD)
Sympathomimetic stimulant that suppresses appetite via the CNS. FDA-approved for short-term use alongside diet and exercise. Schedule IV controlled substance.
SIDE EFFECTS:
• Dry mouth
• Insomnia
• Increased heart rate / palpitations
• Elevated blood pressure
• Headache
• Nervousness or anxiety
• Constipation
MANAGEMENT TIPS:
✓ Take in the morning only
✓ Stay well hydrated for dry mouth
✓ Avoid caffeine — amplifies stimulant effects
✓ Monitor blood pressure regularly
✓ Report palpitations or chest discomfort promptly
✓ Increase fiber and water for constipation
Warning:
Not for use with heart disease, uncontrolled hypertension, hyperthyroidism, glaucoma, or history of drug abuse. Not safe during pregnancy.
Combines naltrexone (reduces food cravings) and bupropion (appetite suppressant). Not a controlled substance. FDA-approved for chronic weight management. Dose ramps up over 4 weeks.
SIDE EFFECTS:
• Nausea (most common early)
• Headache · Constipation
• Insomnia · Dry mouth
• Dizziness
• Increased blood pressure or heart rate
• Mood changes / irritability
MANAGEMENT TIPS:
✓ Take with food — NOT with high-fat meals (seizure risk)
✓ Ramp dose gradually as prescribed
✓ Take evening dose early to minimize sleep disruption
✓ Monitor blood pressure during escalation
✓ Report mood changes or unusual thoughts promptly
✓ Do not stop abruptly — taper with provider guidance
Black box warning:
Increased risk of suicidal thoughts. Do not use with MAOIs, opioids, seizure disorder, bulimia, or anorexia.
Pairs phentermine (stimulant appetite suppression) with extended-release topiramate (promotes satiety). FDA-approved for adults and patients 12+. Available only through the Qsymia REMS program due to birth defect risk.
SIDE EFFECTS:
• Tingling / pins-and-needles
• Dry mouth · Constipation
• Insomnia · Dizziness
• Altered taste / brain fog
• Mood changes
• Eye pain or vision changes (rare)
MANAGEMENT TIPS:
✓ Take in the morning only
✓ Sip water frequently for dry mouth
✓ Alert provider if cognitive effects persist
✓ Increase fiber and hydration for constipation
✓ Avoid alcohol — amplifies CNS effects
✓ Report sudden vision changes immediately
✓ Women must use reliable contraception
Warning:
Qsymia is a teratogen — causes serious birth defects. Contraindicated in pregnancy. Monthly pregnancy tests required for women of childbearing potential.
FDA-approved for type 2 diabetes; widely used off-label for insulin resistance, prediabetes, PCOS, and weight support. Extended-release (ER) formulation significantly reduces GI side effects.
SIDE EFFECTS:
• Nausea (most common when starting)
• Diarrhea
• Stomach cramping / bloating / gas
• Metallic taste
• Vitamin B12 deficiency (long-term use)
• Fatigue (if B12 is low)
MANAGEMENT TIPS:
✓ Always take with food — reduces GI upset significantly
✓ Start at 500 mg; increase slowly every 1–2 weeks
✓ Ask about switching to extended-release (ER) formulation
✓ Monitor B12 levels annually; supplement if needed
✓ Stay hydrated; limit alcohol
✓ GI side effects typically resolve within 4–6 weeks
Warning:
Hold before procedures using contrast dye. Contraindicated in significant kidney impairment. Weight loss is modest — expectations should reflect gradual, incremental results.



© Copyright 2026. FitWellMD™. All Rights Reserved.


© Copyright 2026. FitWellMD™. All Rights Reserved.