Frequently Asked Questions GLP1 Self-pay Options:

You can estimate by calculating your Body Mass Index (BMI) using your height and weight:

• Underweight: <18.5
• Normal: 18.5-24.9
• Overweight: 25-29.9
• Obese: 30+

Typical qualification criteria: 

• BMI: 30+
• BMI: >27 with related condition, such as: High Blood Pressure, Type 2 Diabetes, High Cholesterol, Sleep Apnea

Absolute contraindications:

• Personal or family history of medullary thyroid cancer (MTC) or MEN 2 
• Known serious allergy to the medication 
• Pregnancy or breastfeeding

Use With Caution If You Have: 

• History of pancreatitis 
• Gastroparesis or severe digestive issues 
• Inflammatory bowel disease (IBD) 
• Severe kidney disease 
• Diabetic retinopathy

Additional Considerations:

• History of eating disorders (use caution) 
• Gallbladder disease (increased risk of gallstones) 
• Mental health conditions, including prior suicidal thoughts (monitor closely)

There are two GLP-1 medications used for weight loss: 

1. Zepbound (tirzepatide)
2. Wegovy (semaglutide)

Both medications are effective options for weight loss. 

If you are paying out of pocket, you have two main pathways: 

1. Brand-name medications (through manufacturer programs):

• Discounted pricing may be available directly form the manufacturer. 

1. Compounded versions (from licensed compounding pharmacies):

• Often more affordable
• Typically administered as injections

If cost were equal, tirzepatide (Zepbound) is often a preferred starting option because:

• It is typically well tolerated
• It may be slightly more effective for some patients

Semaglutide (Wegovy) is also highly effective.  Some patients do very well on it, while others may switch to tirzepatide if results are limited. 

Available through Lilly Direct:

https://www.lilly.com/lillydirect/medicines/zepbound

Oral Pill: (Foundayo)

• Starting Dose: $149/month
• Mid doses: $199/month
• Higher Doses: $299/month 

Injection:

• Starting dose: ~$299/month
• Mid doses: ~$399/month
• Higher doses: ~$499/month

Note: some patients lose weight on lower doses, while others require higher doses. 

Available through NovoCare: 

https://www.novocare.com/pharmacy.html

Oral Pill: 

• Starting dose: ~$149/month
• Higher doses: up to ~$299/month

Injection: 

• Starting dose: ~$199/month
• Higher doses: up to ~$349/month

Note: many patients require higher doses for optimal results.

If affordability is your top priority:

Tirzepatide (compounded): 

• ~$449 for a 3-month starting supply 
• ~$299/month for higher doses 

Semaglutide (compounded): 

• ~$224 for a 3-month starting supply 
• ~$149/month for higher doses 

Many patients have had positive experiences with reputable compounding pharmacies such as orderlymeds.com

Most common side effect: nausea 

• Anti-nausea medication (like ondansetron/Zofran) can be prescribed if needed.

To reduce side effects: 

• Take a daily fiber supplement (e.g., fiber gummies or Citrucel) 
• Take a daily multivitamin

Doses are typically increased monthly if:

• Your are tolerating the medication well
• Your have not yet reached your goal weight

Once you reach your goal: 

• Gradually reduce the dose every 4 weeks 
• Avoid stopping suddenly to prevent weight regain

Important Note: If you stop the medication for several weeks, you will likely need to restart at a lower dose to avoid significant  nausea. 

Once you start treatment, check in regularly with your provider. Dose adjustments, side effect management, and long-term planning are key to success.