Semaglutide (GLP-1 agonist)

Semaglutide (GLP-1 agonist)

Weight loss is not always about willpower but rather our biology. Every day, the brain receives signals from different places in the body. Some of these signals, called appetite hormones, help regulate food intake.

Our providers can prescribe a class of metabolic medications that mimic the effect of glucagon-like peptides-1s. GLP-1s are powerful hormones made by your gut that send signals to your brain to regulate your metabolic function, help you feel full, and decrease your appetite. S people who hold onto more weight experience reductions in GLP-1 signalling.

Semaglutide mimics a hormone that focuses on areas in the brain that regulate appetite and food intake. This appetite suppression can help you eat less, leading to weight loss.

Different doses of semaglutide have been FDA-approved since 2017 (Ozempic®) and 2019 (Rybelsus®).

Semaglutide has been researched for over a decade and is known to be both effective and safe. But the new dose demonstrates even more metabolic health benefits and weight loss than previous doses.

Each of the four studies focused on weight as the primary endpoint and demonstrated weight loss from 15-20% over a year, focusing on the sustainability of that weight loss over the longer term.

While GLP-1s like semaglutide are powerful, our program and your weight loss are about much more than the medication alone.

Before being prescribed semaglutide for weight loss, an initial weight loss consultation will be required. A medical history, medical exam, and lab work will be completed to determine whether semaglutide is an appropriate option for the patient.

Dosing Schedule

You will start semaglutide at a dose of 0.25 mg (10 units) weekly, and up the dosage every 4 weeks until you start taking the full dose of 2.4 mg (96 units). Therefore, following the dosing schedule as recommended by your healthcare provider is very important.

How to administer a subcutaneous injection

Eating Protocol

Because Semaglutide slows down your gastric emptying and decreases hunger, it is important that when you eat, you are intaking high-nutrient foods with an abundance of vitamins, fiber, good fats, and protein. Decrease your intake of empty calories – i.e. NO white bread, simple sugars, sodas, pastas, cereals, crackers, pastries, etc.

Blueberry and Spinach Collagen Smoothie
1 tbs. Chia(2) ¼ c. water

1 tbs. Coconut Oil

1 tbs. Almond Butter

1 tbs. Coconut Flakes

1 tsp. Grated Ginger

1 c. Spinach (Raw or Frozen)

1 c. Blueberries (Raw or Frozen)

2 Scoops Flavorless Collagen

¼ tsp. Cinnamon

Dash of salt

4-6 ice cubes

  1. Soak 1 tbs. of chia seeds in ¼ c. water for 15 minutes.
  2. Prepare other ingredients while waiting.
  3. Add ¼ c. water, coconut oil, almond butter, grate the ginger, add spinach, blueberries, collagen, cinnamon, and salt.
  4. Then add soaked chia and ice. Blend ingredients together to taste.

 

19 g Net Carbs

19 g Protein

32 g Fat

 

Spinach and Tomato Scrambled Eggs

8 eggs, 2 cups fresh spinach leaves, ½ cup fresh tomatoes, chopped, 1 tablespoon butter, Salt and pepper to taste, 2 cups raspberries (optional)

Crack the eggs into a bowl, add a pinch of salt and pepper, and whisk until blended.  Melt butter in a large saucepan over low heat.  Pour egg mixture into saucepan and cook until a thin layer of cooked egg appears around the edge of the saucepan. Fold the eggs gently. Continue to cook, pushing and folding eggs around the pan occasionally. Halfway through cooking, add the spinach and tomatoes. Continue pushing and folding eggs until eggs are barely set. They should look a bit runny on top. Serve the scrambled eggs with a small bowl of fresh raspberries

Greek Yogurt Bowl or Smoothie 

¾ plain Greek Yogurt, 3 tablespoons chia seeds, ¼ cup almonds (almond butter for Smoothie), ½ cup strawberries or blueberries

    1. Wash berries and pat dry.
    2. For Smoothie: Mix all ingredients in blender until smooth. You may need to add water while blending if smoothie mixture is too thick.
    3. For Bowl: Cut strawberries in half or quarters, depending on size. Rough chop almonds. Put yogurt in bowl and top with strawberries and almonds. Sprinkle chia seeds on top and enjoy!

Shrimp Scampi with Zucchini Noodles

12 ounces raw shrimp

2 tablespoons olive oil

2 tablespoons butter

4 cloves of garlic, minced

Pinch of red pepper flakes (optional)

Salt and pepper to taste

2 cups zucchini, spiralized

Juice of one lemon

¼ cup fresh flat-leaf parsley, chopped

Heat a pan over medium. Add shrimp and 6 tablespoons of water. Sauté until pink. Add the olive oil, butter, garlic, and red pepper flakes and stir to combine. Season with salt and pepper and remove from heat.  Add the zucchini spirals to the pan and cook for a few minutes until desired texture is reached.  Add the shrimp back into the pan, along with the lemon juice and parsley, and stir to combine.  Plate the shrimp scampi and zucchini noodles. Enjoy!

 

Stuffed Portobello Mushrooms

¼ cup olive oil

8 ounces 90% lean ground beef

4 cloves of garlic, minced

1 cup cauliflower rice

Salt and pepper to taste

½ teaspoon dried oregano

½ teaspoon dried thyme

½ teaspoon dried basil

½ teaspoon dried rosemary

8 ounces parmesan, shredded

2 cups fresh spinach

4 large portabello mushrooms, stem removed

Preparation

Preheat oven to 400℉.

Bake the mushrooms on a sheet pan for 10 minutes. Remove from oven and use a paper towel to absorb any excess water from the mushrooms.

Set the mushrooms aside

Heat the olive oil in a pan over medium heat.

Add the ground beef to the pan, season with salt and pepper, and cook for 4-6 minutes. Break up the ground beef into smaller pieces while cooking.

Add the garlic and cauliflower rice to the pan and cook for 4-6 minutes.

Add the oregano, thyme, basil, and rosemary and stir to combine.

Add the spinach and cook until wilted.

Stuff the mushroom caps with the ground beef mixture, top with parmesan cheese, and bake in the oven for 10 minutes, until the stuffing is heated through and the cheese is golden brown.

Plate the mushrooms and enjoy!

 

Fresh Lemon And Thyme Chicken And String Beans.

Macros: 7g net carbs, 4g Fiber, 38g fat, 40g protein

Ingredients

½ cup slivered almonds

2 medium yellow onions, sliced

1 pound chicken breasts, cut in ½” pieces

½ cup ghee, divided

Salt and pepper to taste

2 cups fresh string beans, trimmed

¼ cup water

1 tablespoon fresh thyme

1 lemon, quartered

Preparation

Heat a saucepan over medium heat.

Add sliced almonds. Cook until the almonds start to brown, stirring constantly. Remove from pan and set aside.

Add ½ of the ghee to pan. Once melted, add the sliced onions and sauté until golden brown. Remove from pan and set aside.

Season chicken with salt and pepper, add to pan, and sauté for 4-5 minutes (until reaches 165 degrees). Remove chicken from pan and set aside.

Add the remaining ghee to the pan, Once melted, add the string beans and the water to the pan. Cover and steam fry the string beans for 3-4 minutes.

Plate onions and string beans.

Place chicken over onions, and garnish with fresh thyme.

Garnish the string beans with the toasted almonds.

Serve with a piece of lemon on the side.

Common Side Effects on Semaglutide

(These side effects should be expected to some degree)

Tips for managing nausea

 Eat bland, low-fat foods, like crackers, toast, and rice

 Eat foods that contain water, like soups and gelatin Avoid lying down after you eat

 Go outdoors for fresh air

 Eat more slowly

Semaglutide can cause serious side effects, including:

  • Thyroid tumors, including cancer. Let your healthcare provider know if you have trouble swallowing, swelling, a lump in your neck, hoarseness, or shortness of breath. These may be symptoms of thyroid cancer. 
  • Avoid Semaglutide if you or any one in your family have had a type of thyroid cancer called medullary thyroid carcinoma, or if you have a condition called or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
  • Avoid Semaglutide if you have an allergic reaction to Semaglutide’s ingredients.

 

Before using semaglutide, let your healthcare provider know of any other medical conditions. These include:

  • problems with your kidneys or pancreas 
  • have type 2 diabetes and a history of retinopathy.
  • have depression, mental health issues or suicidal thoughts
  • plan to become pregnant or are pregnant. Semaglutide can be harmful to an unborn baby. Stop using Semaglutide for at least 2 months before you become pregnant.
  • plan to or are breastfeeding. Semaglutide may pass into breast milk.

 

Let your healthcare provider know about the medications you take. These medications include over the counter, prescriptions, vitamins, and herbal supplements. Semaglutide can affect how some medicines work, and some medicines may cause problems with Semaglutide. Let your healthcare provider know about other medications you use to treat diabetes, including insulin or sulfonylureas. Semaglutide decreases stomach emptying and this can cause problems with medicines that need to pass through the stomach quickly. 

 

Semaglutide can cause side effects, including:

  • inflammation of pancreatitis (inflammation of the pancreas. Avoid using semaglutide. Call your healthcare provider immediately when you have severe pain in your abdomen or stomach area with or without vomiting. Pain is possible from your back to your abdomen.
  • gallbladder problems. Semaglutide can cause gallbladder issues and gallstones. Notify your healthcare provider of pain in your abdomen (upper stomach), fever, yellowing of the skin or eyes (jaundice), fevers or stools that are clay colored.
  • There is an increased risk of hypoglycemia or low blood sugar in those with type 2 diabetes. Be careful if you take type 2 diabetes medications such as insulin or sulfonylureas. Inform your healthcare provider how to recognize and treat low blood sugar. Check your blood sugar before use Semaglutide. Symptoms of low blood sugar often include blurred vision, hunger, sweating, dizziness, anxiety mood changes or irritability, confusion, and drowsiness, weakness, headache, fast heartbeat, feeling jittery.
  • kidney failure or kidney problems. If you have kidney problems, diarrhea, nausea, and vomiting you may be subject to dehydration which can make kidney problems worse. Drink fluids to reduce your chance in dehydration.
  • allergic reactions. Avoid semaglutide and get medical immediately if you have any symptoms of an allergic reaction. Reactions include swelling of your lips, tongue, throat or face, problems breathing rashes or itching, fainting, or fast heartbeat.
  • vision changes especially if you are type 2 diabetic. Notify your healthcare provider if you have vision changes while using Semaglutide.
  • racing heart rate. Semaglutide may increase your heart rate when resting. Notify your healthcare provider if you feel your heart pounding or racing in your chest and it continues for several minutes.
  • thoughts of suicide or depression. Pay attention to any thinking or mental changes, or drastic changes in your mood, thoughts, behaviors, or feelings. Call your healthcare provider immediately if you have any mental changes that worry you, are worse or new.

While you are taking semaglutide, it is very important that you follow up with your medical provider as instructed. You will be required to have a follow up visit with the medical provider monthly to continue being prescribed semaglutide. Your next follow up visit should be scheduled at check out after every weight loss visit. You can cancel and/or reschedule your follow up appointments, however the office requires 24-hour notice in order for you to not be charged a “no-show” fee.

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