Introduction

Program Purpose: To help our patients achieve their unique health goals with an emphasis on weight loss, utilizing approved medications, alongside health coaching to incorporate meaningful lifestyle modifications.

Program Enrollment

Eligibility Criteria: Patients with a BMI ≥30  or  ≥27 with weight-related comorbidities, (i.e high blood pressure, prediabetes, high cholesterol, degenerative joint disease) without any known contraindications to medication-assisted weight loss. 

Initial Assessment: Includes evaluation for specific indications and contraindications to medication, considering your medical history, lab testing, current medications, and nutritional status. (Initial Labs collected within the past 3 months: Complete metabolic panel, CBC, Lipids, A1c, TSH)

Treatment Plan

Pharmacologic Therapy: Tirzepatide or Semaglutide compounded with L- Carnitine, Naltrexone + Bupropion, or Phentermine + Topiramate will be prescribed, and titrated to a safe and effective dose focusing on:

• Indications: Patients needing additional metabolic support and who may benefit from the combined effects of  on weight loss and glucose regulation, along with the potential benefits of L-Carnitine on energy levels and metabolic function.

• Dosing: The initiation and titration of medication will follow manufacturing guidelines, dosing adjusted based on baseline levels and individual needs.

• Administration: Instructions on the method of administration, storage, and handling of the compounded medication will be provided during a medical appointment, with administration of the first dose performed under the supervision of your medical provider. 

Lifestyle Modifications: We will work together to develop customized dietary and exercise plans. 

Visits

Monitoring: We will monitor the efficacy and safety of medications, including weight, and glycemic control. We will also address any potential gastrointestinal side effects common with Tirzepatide or Semaglutide. (Labs: Lipids, complete metabolic panel, CBC, A1c)

Adjustments: We will make dose adjustment to the medication, as indicated by the manufacturer, considering your therapeutic response and side effects.

Goal Setting

Specific Targets: We will incorporate specific goals related to the pharmacologic action of the medications, such as improvements in function in daily activities, exercise, as well as your weight loss goals.

Lifestyle Changes

Synergistic Approach: We will discuss dietary choices that support the action of the medications, focusing on metabolic health and nutrient density. We will provide guidance on calorie reduction, healthy eating patterns, and portion control. We encourage a diet rich in fruits, vegetables, lean protein, and whole grains. We also recommend the use of a probiotic to support GI health. 

Physical Activity: We will set goals for physical activity depending on your fitness level and preferences. We recommend you aim for at least 150 minutes of moderate-intensity or 75 minutes of high-intensity exercise per week, as tolerated. Additionally, we recommend strength/resistance training to maintain and build muscle mass and bone density. 

Safety and Monitoring

Adverse Effects: We will monitor for side effects, such as gastrointestinal symptoms. 

Drug Interactions: It is critical you report all medications or supplements you are taking in addition to the Bespoke Health & Wellness prescribed medications.

Confidentiality and Privacy

Patient Information: We ensure confidentiality and privacy of your information in accordance with HIPAA regulations.

Specific Consent: Included you will sign a consent form that covers the specifics of using compounded medications.