Don’t Accept a Body Size That Makes You
Uncomfortable or Leads to Health Problems
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."
Listen To a Conversation Between Dr. Lisa & Kelly
About Their Own Experience With Semaglutide
You are not alone. Nearly half of all adult Americans are carrying around excess weight.
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.
In clinical trials of semaglutide, patients lost an average of 15% of their body weight, with some losing as much as 20%.
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.
P.S. Prices subject to change (determined by compounding pharmacy)
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.
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%
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:
• Abdominal pain
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.
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?
The best dietary choices for one person may be very different than for another person, based on individual variables which we cannot control.
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.
See also the video where Dr. Lisa has a conversation with her friend Kelly on their experience with Semaglutide: https://youtu.be/YEMFJAlT_BM
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 is Renew MediSpa 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.