A few questions is all it takes for our partner physicians to review your request and (if approved) prescribe your weight loss treatment with Zepbound, an FDA approved GLP1.

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It is not safe to take these medications while pregnant or breastfeeding. The FDA advises that these medications may pose a risk to a developing fetus. Oral contraceptives alone may not be effective, as the medication can reduce their effectiveness. The FDA specifically recommends continuing oral contraception alongside a barrier method (like condoms) for the first month after starting a weight loss medication and for the first month after any dose increase. Alternatively, you can switch to a non-oral contraceptive method (such as an IUD or implant) before beginning the medication. After stopping the medication, you should continue using a backup method, such as condoms, for two months to ensure the medication has fully cleared your system before trying to conceive. Additionally, its safety during breastfeeding is unknown, so if you are nursing, consult your doctor to explore safer weight loss options.

The traditional use of weight loss medications is for individuals with a BMI of 30 and above or to those who are overweight who have associated health conditions. Using it for someone with a BMI range (25-29) without an accompanying health condition is termed "off-label." 

Using a medication "off-label" refers to the practice of prescribing a drug for a purpose, age group, dosage, or form of administration that is not included in the approved labeling by regulatory agencies like the U.S. Food and Drug Administration (FDA).

While a medication undergoes rigorous testing for specific uses before receiving approval, healthcare providers may discover through clinical experience or research that it can be effective for treating other conditions. 

There may be benefits such as weight reduction for individuals within your range. If you agree to this off-label use, it's crucial to follow the prescribed regimen and report any concerns. Please discuss any questions with us.

Gallbladder disease information:

You noted that you have gallbladder disease or previous removal of our gallbladder. This medication may still be a good option.  However, this medication can affect how the body handles fats and bile. If you have had your gallbladder removed, the body's ability to store and release bile is altered. Bile is crucial for digestion and fat absorption. This medication may increase the likelihood of gastrointestinal side effects in these individuals because it can alter fat metabolism and bile flow. This can lead to symptoms such as diarrhea and stomach pain.

Additionally, medications that affect digestion and appetite, like this medication, might alter the absorption and metabolism of other nutrients (like fat soluble vitamins such as vitamin A, D, E, and K) and medications. This is particularly important for those without a gallbladder, as their digestive system already operates differently from those with a functioning gallbladder. If you wish to move forward, it is important to eat smaller and more frequent meals. In addition, to ensure that you're receiving enough vitamins, you should avoid processed foods while eating plenty of fruits and vegetables, as well as considering the use of a multi-vitamin unless told by your provider to avoid these for other reasons.

If you have asymptomatic gallstones, please note that these medications and weight loss itself may result in gallstone formation which could result in the obstruction of the normal flow of bile which can result in infection, pancreatitis, and/or emergent need for gallbladder removal.  It is important to receive prompt medical evaluation if symptoms appear as delayed action may result in serious harm or death if untreated. 

Keep in mind:

Please attest to the following confirming that all information you have provided to us is true and complete.

Consent: I verify that I am the patient and that I have answered the questions asked in this intake form.  I confirm that I have reviewed and understood all the questions asked of me.  I attest that the answers and information I have provided in this questionnaire is true and complete to the best of my knowledge. I understand that it is critical to my health to share complete health information with my doctor.  I will not hold the doctor or affiliated medical practice responsible for any oversights or omissions, whether intentional or not, in the information that I provided.

Indication for Use

You are requesting treatment with a GLP-1 agonist Zepbound as part of your treatment plan for the management of weight or obesity. This medication works by mimicking the action of incretin hormones, which help regulate blood sugar levels, promote feeling full, and reduce food intake.

Potential Benefits

Potential Side Effects

While these medications can be beneficial, they may also cause side effects.  Although not common, these medications can result in emergency room visits, hospitalizations, or even death. Common and serious side effects include, but are not limited to:

Common Side Effects:

Serious Side Effects:

Risks and Considerations

Monitoring and Follow-up

You will require regular follow-up visits to monitor your response to the medication and to assess for any side effects. We may intermittently ask for full-body selfie images to ensure that your reported weight is consistent.

I acknowledge the potential benefits, risks, and side effects of Zepbound. I understand the importance of regular monitoring and follow-up appointments. I consent to the use of Zepbound as part of my treatment plan for overweight or obesity.

If required by the prescribing doctor, you may be asked to provide a full-body selfie and a valid government-issued ID. This is to verify that your reported weight and identity match the information you’ve provided.

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Your healthcare provider is licensed in your state.