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Southern New Hampshire's Premier MediSpa

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Lose It Right

End Yo-Yo Dieting Once and For All With Medically Managed Weight Loss

Watch this video to hear from Dr. Lisa exactly how this works

CLINICALLY PROVEN

Many clinical trials document the overwhelming success of these FDA approved medications

CONVENIENT

Once weekly dosing

makes it so easy!

CONNECTED

Your Private Health Coach meets with you online and supports your success

Don’t Accept a Body Size That Makes You

Uncomfortable or Leads to Health Problems

Two FDA Approved Medications Are Now Available

That Are Turning the Table in the Weight Loss Wars

The first FDA approved weight loss drug since 2014 has been labelled a

“game changer” by medical experts in the field of wellness and weight management.



Dr. Robert Kushner: "It's the very first time we have a medication that even begins to approach the weight loss people achieve with bariatric surgery."


You are not alone. Nearly half of all adult Americans are carrying around excess weight (defined as a Body Mass Index of >30 (*) .


Most have tried many times to lose the extra pounds, only to be frustrated by lack of progress or only temporary weight loss.


We know that the heavier you get, the harder it is to lose the weight in part due to the metabolic phenomenon of “insulin resistance”.


It’s a nasty catch 22- the heavier you are, the more insulin resistant you are, but the more insulin resistant you are the harder it is to lose weight.


* Body Mass Index (BMI) is weight in kilograms divided by height in meters squared


If you’ve been sweating it out at the gym but still not

losing the weight, your metabolism may be the problem.

Impressive Results,

Backed by Science

In clinical trials of semaglutide, patients lost an average of 15% of their body weight, with some losing as much as 20%.


The studies ran for 68 weeks, at 129 sites in 16 countries.


Patients started with an average weight of 232 pounds and a body mass index (BMI) of 38.

  • Customized instruction dosing


You can do this! Don’t worry even if you have

never performed a self-injection. This is

entirely painless. Your dose will start low, to

minimize side effects, and will be gradually

increased over time to maximize your results.


When the time comes to taper down or

discontinue, we will assist with this as well.


  • Regular Check Ins


Twice monthly weight and body fat %

measurements at Renew to celebrate your

progress


  • Online Support


Your Healing is Change Health Coach will

connect with you online, to individually

support your success.


Similarly, in a tirzepatide study of 2539 obese adults followed for

72 weeks, 57% had a reduction in body weight of 20% or more.

PRICING

Introductory Pricing: 3 Month Program: $1995

Includes:


  • Medical clearance to participate


  • 1 vial of semaglutide - lasts up to 3 months (Depends on dose schedule. Additional vials if needed can be purchased separately)


  • Self-injection supplies and hands on instruction


  • Twice monthly weight and body fat % measurements


  • Private online health coaching through the Healing is Change Health Coach Group


  • 15% off skin tightening services at Renew MediSpa



It’s time to see the number on

the scale go down and stay down!

We are committed to your success and are

ready to guide you down the path to the new you

Disclaimer: This program requires a medical review of your health information by Dr. Vuich.


We reserve the right to deny participation to anyone we feel would not be appropriate for this program.


Refer to our video for more detailed information on the process. Individual results will vary by person and are based upon patient variables (including but not limited to lifestyle choices, compliance with dietary and exercise recommendations, and the presence of other medical diagnoses), the amount of excess weight, and compliance with any recommended maintenance program.


No one can guarantee an exact outcome for any patient.


Prescription medication cannot be returned under any circumstances.


No refunds issued under any circumstances.


The content of this website is intended to be general information- it should not be used to diagnose or treat a medical condition, and is in no way meant to be a substitute for seeking appropriate medical care.


This type of medication may be available to you through your insurance.


We do not bill insurance and cannot assist you with prior authorizations.


To determine if you are eligible for this medication through your health insurance provider, contact them directly and/or speak with your Primary Care Provider.

Semaglutide FAQ (Frequently Asked Questions)

Is Semaglutide new?

Semaglutide was developed by Novo Nordisk in 2012, with clinical studies published starting in 2015. It was FDA approved in 2017 for blood sugar control. In June 2021 the FDA approved the brand name Wegovy TM for adults with obesity (BMI 30+, or BMI over 27 with at least one weight related ailment).

The cost of Wegovy TM for a cash paying patient is approximately $1400 per month.

How is Semaglutide taken for weight loss?

The dose is gradually increased over the first 4 months (16 weeks). Most studies evaluated patients over the course of 68 weeks. Semaglutide is best dosed by self-injection, once a week, into the arm, thigh or abdomen using a very fine needle similar to what is used for insulin injections.

Does the semaglutide injection “hurt”?

The needle used is very fine and should be painless. If desired, you can place an ice cube or ice pack on the area planned for injection for 30 seconds which should be sufficient to numb the region. Proper injection technique will be shown to you to minimize discomfort.

I have never given myself an injection. How will I know I am doing it correctly?

We will show you exactly how to perform the injection on site at Renew MediSpa (using saline). It is a very simple process! We are also happy to monitor you performing the injection for yourself, until you are completely comfortable.

How much weight is lost on average?

Studies specific to overweight or obese individuals without diabetes showed a body weight reduction ranging between 12.4% to 17.4%

What is my Body Mass Index (BMI)?

See Table at the end of document

Would my insurance cover Semaglutide?

We do not bill insurance and cannot answer questions specific to insurance formularies or pricing. We also cannot fill out prior authorization forms, as we are not providers for the various commercial insurance companies. Refer to your Insurer and Primary Care Provider any questions regarding whether you might qualify for prescription coverage.

How does Semaglutide work?

Semaglutide is a peptide which is 94% similar to a peptide in the body called glucagon-like- peptide 1 (GLP-1). It affects zones in the brain responsible for appetite, leading to a feeling of fullness as well as reduced appetite. Semaglutide also increases insulin secretion by the pancreas.

(A peptide is composed of a short chain of amino acids, whereas proteins are composed of long chains of amino acids)

When do I dose Semaglutide?

Semaglutide in this program is dosed via self injection once a week. It can be taken any time of day without regard to meals.

Can I take Semaglutide if I am on medication for diabetes?

Semaglutide cannot be taken along with other medications that are in the same class (GLP-1 agonists) Ex: exenatide (Byetta), dulaglutide (Trulicity), lixisenatide (Adlyxin), liraglutide (Saxenda) and brand name semaglutide (Wegovy, Rybelsus)

It is not approved for use in diabetics on insulin. Other medications such as sulfonylureas [ex: glipizide (Glucotrol), glyburide (DiaBeta and Micronase)], TZD’s [pioglitazone (Actos) and rosiglitazone (Avandia)] and metformin (Glucophage and others) are okay in combination, though their dose may need to be reduced.

If you are on medication for diabetes we will require a medical release to directly communicate with your Primary Care Provider regarding your prescription.

Who cannot take semaglutide?

(Renew MediSpa exclusionary criteria are listed)

Age < 18

Pregnant or planning to become pregnant

Type 1 (Insulin Dependent) diabetic

Active liver disease (such as Hepatitis) or Liver Failure

Advanced Kidney Disease or Kidney Failure Already taking another medication in this drug class such as:

Active Malignancy or Cancer Chemotherapy Personal or Family History of Multiple Endocrine Neoplasia

Personal of Family History of Medullary Thyroid Carcinoma

Body Dysmorphic Disorder or Unrealistic Expectations

Eating Disorder such as Anorexia or Bulemia Past history of allergic reaction to medications in this drug class


Will semaglutide affect other medications I take by prescription or over the counter?

Semaglutide does not seem to significantly affect the absorption of oral medications- RX or OTC

Do I need labwork before starting semaglutide?

We will request the results of your most recent labwork (preferably within 6 months) for our files. If you have not had labwork done, we can provide the labwork order, but we do not draw diagnostic labwork on site.

You are responsible for any costs incurred for labwork- please check with your insurance provider if this is a concern.

What are the common side effects of semaglutide?

The most common side effects of Semaglutide include:

• Nausea

• Diarrhea

• Vomiting

• Constipation

• Abdominal pain

• Headache

• Fatigue

• Indigestion

• Dizziness

• Belching

• Flatulence

To reduce the incidence of side effects, a dose titration schedule is used. This means that you will start at a low dose and gradually increase your weekly dose over the course of 3 to 4 months. If you are experiencing significant nausea, your dose may be reduced or simply not advanced until such time as the symptom has diminished on its own. Also, if you are experiencing significant nausea at any dose level, reflect on your portion size and the fat content of your meals as these will also impact the side effects experienced.

How long will I remain on semaglutide?

This will vary significantly from person to person. The key semaglutide studies followed patients for 68 weeks (16 months). It is anticipated that the longer you are on it, the less likely you will be to rebound (gain weight back). Remember, semaglutide should be seen as part of an overall healthy diet and exercise program and more of a long term solution rather than a quick fix magic bullet.

As you approach your ideal weight, your metabolism is expected to improve! You will become less insulin resistant. This will help you maintain your results with or without ongoing prescription management.

Most people with 25 or more pounds to lose should expect to be on semaglutide for a year or more.

How will my progress be followed?

We will schedule a follow up visit for you with one of our program staff every 2 weeks. Blood pressure, Pulse, weight and body fat% will be recorded and recommendations will be made regarding your dosing. It is important for you to keep these appointments, as this is also when refills will be processed.

Your Health Coach will also schedule time with you (via phone or Zoom meeting) on a regular basis.

How do I refill my prescription? Where does the prescription originate?

Refills are processed primarily at the time of follow up appointments as that is when we are adjusting dose/directions.

Your prescription will originate from our preferred compounding pharmacy, Wells Pharmacy Network (www.wellsrx.com)

How is semaglutide stored?

Semaglutide should be kept refrigerated, but NOT frozen. Do not use semaglutide which has been frozen (it would be expected to be ineffective).

Semaglutide is shipped “Cold” direct from the pharmacy. Do not place an order if you expect not to be home to receive it in a timely fashion.

How long will it take to get my Semaglutide Rx? How do I obtain refills?

Currently it is taking approximately 5 to 7 days from the time the order is placed. Refills will generally be processed at the time of a Check-In appointment at Renew to help ensure that you do not get “caught short”.

If you experience a delay, don’t worry. You are not expected to experience any type of adverse symptoms due to a delay in dosing.

How is my dose determined?

We will guide you through the dosing schedule. A gradual dose increase is important to reduce/minimize gastrointestinal side effects. Lower doses are still effective for weight loss, though higher doses do produce more significant weight reductions.

**Do not alter your dosing without the approval of Renew staff. Doing so may result in discharge from the program.**

The starting dose is 0.25 mg weekly. The usual maintenance dose is 1.75 to 2.25 mg weekly. Most clients will achieve their maintenance dose sometime during month #4.

*You will still be losing weight even at lower doses, provided you are following a healthy diet and exercise program!*

What diet should I follow while on semaglutide?

We encourage you to discuss your diet program/food choices with your Healing is ChangeTM Health Coach. The best dietary choices for one person may be very different than for another person, based on individual variables which we cannot control.

General recommendations:

In general, once you begin semaglutide you should expect to cut your portion size in half and then monitor your appetite and GI (gastrointestinal) side effects. Eating high fat (ex: fried) foods will make the GI side effects of semaglutide worse, so it is best to avoid these items.

Most people can benefit from lowering carbs, sugars, fried foods and alcohol. Focus on proteins and vegetables and water intake.

For more specific recommendations, speak to your Healing is ChangeTM Health Coach and/or your Primary Care Provider.

Do I need to count my calories?

Counting calories is optional. However, if you haven’t previously monitored your caloric intake it can be very useful and eye opening to do so even for a brief period of time (a few weeks). “Calories In” versus “Calories Burned” is a very important balance to have even after you have achieved your weight goal, in order to guard against future weight gain. Consider getting a “smart watch” such as a FitBit which will record your energy expenditure. The Fitbit program also allows you to log your food and will sum the calories for you.

A general rule of thumb is to have at least a 500 calorie “deficit” per day. This means that you eat at least 500 calories less than what you would need to eat to maintain your present weight. To know what that is, use an online calculator such as this one: https://www.mayoclinic.org/healthy- lifestyle/weight-loss/in-depth/calorie- calculator/itt-20402304

And subtract 500 from the number this calculator provides.

Will you communicate with my Primary Care Provider (PCP) regarding my results?

Under no circumstances are Renew MediSpa or Healing is ChangeTM Health Coach Group functioning as or taking the place of your PCP. We are happy to provide you with progress reports upon request, which you can submit to your PCP if you wish.

We certainly expect that YOU will inform your PCP that you are receiving this prescription from Renew. This is your responsibility!

It is also a good idea to let your pharmacist know about your semaglutide Rx as they will also screen for drug-drug interactions with any other medications you may be prescribed.

Can I take semaglutide if I plan to become pregnant?

No. Semaglutide is not approved for use in pregnancy and may cause harm to a developing fetus. Semaglutide should be stopped 2 months prior to attempting pregnancy, due to its long half life.

Can I take semaglutide orally?

Weight loss with oral semaglutide studied as a secondary outcome in cardiovascular disease and glucose-lowering trials found that weight loss was 4.6% (4.2 kg) versus 0.9% (0.8 kg) with placebo at 15.9 months.

4.6% weight reduction is substantially lower than what is seen with semaglutide delivered via self injection.

Husain M, Birkenfeld AL, Donsmark M, Dungan K, Eliaschewitz FG, Franco DR, et al.. Oral semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 2019;381(9):841-51.

Most studies of oral semaglutide (brand name

Rybelsus) have focused on its effects on lowering HgbA1C in diabetics.

Can I return the prescription if I cannot tolerate it or change my mind about the program?

Prescription medications cannot be returned nor can refunds be issued under any circumstances. You will receive your medication directly from the compounding pharmacy, which will have received payment from us on your behalf.

What happens if I suddenly stop taking semaglutide?

The beneficial effects will gradually wear off. semaglutide? There are no withdrawal symptoms to be expected and it is not “dangerous” to suddenly stop this prescription.

What if I am travelling?

Semaglutide needs to be kept cold. Contact us for advice regarding your particular travel plans/situation. Remember, you can “take a break” from Semaglutide without expecting to experience any adverse/withdrawal symptoms. Alternatively, you may be able to travel with your prescription in an insulated cold container. We understand that some of our clients spend certain months of the year outside of New Hampshire. With prior notice we can also arrange for a particular prescription refill to be delivered to a secondary address.

What is the program cost, and what is included?

The cost of the Semaglutide program at Renew is $1995 for the first 3 months.

This includes:

• Your first 2ml vial of Semaglutide (will last 2 to 3 months depending on dose titration), including syringes and shipping

• 3 months of wellness coaching with a private coach through Healing is Change Health Coach Group - 1 call every two weeks via phone or Zoom meeting

• Twice a month Check-Ins at Renew MediSpa- vital signs, weight and BF%, symptom review, Rx refill processing.

• For a limited time: One Free Session of Venus Bliss noninvasive body contouring (localized fat destruction)- Value $600

Month 4 and beyond

Semaglutide Rx refills are currently

priced at $695 for a 4.5 ml vial (includes syringes and shipping). Pricing is subject to change due to the potential for pharmacy price increases. A 4.5 ml vial will last 5 to 7 weeks (depends on maintenance dose achieved). Your Rx refill continues to include twice a month Check-Ins at Renew MediSpa, and entitles you to a 15% discount on skin tightening services for the body.

• Coaching from month 4 onward is arranged directly with Healing is ChangeTM Health Coach Group, based on your individual needs and preferences. We recommend a total of 6 months or more of coaching to help ensure your long-term success!


Can I obtain the Prescription without the Private Health Coaching?

Coaching is included in the program startup cost and must be a component of your participation for at least the first 3 months. Thereafter, as long as you are continuing to make progress, the coaching component is optional but highly recommended for at least the first 6 months. Coaching provides many benefits and can even cover topics that have nothing to do with weight management!

Is Healing is ChangeTM Health Coach Group part of Renew MediSpa?

Healing is ChangeTM Health Coach Group is Renew MediSpa’s preferred provider for health coaching. Healing is Change is a separate organization which will receive your information once you have completed a HIPAA release form allowing for the necessary information exchange to connect you with a private health coach.

How do I schedule my coaching calls?

After you have been approved for the Semaglutide program, we will connect you with an intake coordinator at Healing is ChangeTM

Health Coach Group, who will connect you with who will connect you with your coach and guide you through the program.

What if I don’t like my coach?

Healing is ChangeTM Health Coach Group has a variety of coaches. They will ensure that you are connected with an appropriate coach to help

you reach your goals. If you feel that you are not connecting well with your current coach, they will work to align you with a different one.

Do I have to follow my coach’s advice?

Unlike doctors, health coaches don’t prescribe what to do, but instead help you become clear on what you want to change and how you would

like to go about changing. It is up to you to determine what to do and then to do it. Your coach provides accountability to your self-

determined plan, and can offer ideas and suggestions but you are in the driver’s seat when it comes to your success.

Does Healing is ChangeTM Health Coach Group accept insurance?

Not at this time.

(*) for more info on our regular services, call, text or visit our website: https://www.renewmedispa.com/

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