Frequently Asked Questions

Absolutely! On average we are seeing our patients lose between 15-30% of their starting body weight over a 6-12 month period. Someone needing to lose 50% or more of their body weight can still achieve their goals, it will likely take longer.

Also, our perspective is that obesity is a condition and this medication is a treatment, not a cure. This treatment can help people lose weight that have struggled for years, trying all sorts of fad diets, to finally have success. For people that may have never experienced what it feels like to feel full, this medication can be life-changing! It mimics a hormone that tells your brain you are full, and you will feel full whether you actually are or not. For some, this is the critical missing piece to help them lose weight and keep it off.

GLP-1 medications are beneficial for cardiovascular health. Studies have shown that GLP-1 receptor agonists can:

• Reduce the risk of stroke, heart attack, and death due to cardiovascular causes by around 12% in people with type 2 diabetes.
• Promote weight loss, improve lipid profiles, and have anti-inflammatory effects, all of which can reduce cardiovascular risk.
• Enhance myocardial glucose uptake and utilization, reduce oxidative stress, and inhibit cardiomyocyte apoptosis, leading to improved coronary blood flow and vascular relaxation.
• Modulate the renin-angiotensin-aldosterone system, further influencing vascular tone and blood pressure regulation.

However, the cardiovascular benefits of GLP-1 medications may be more pronounced in those with established cardiovascular disease compared to those in primary prevention. Additionally, some cardiologists have expressed concerns about potential side effects like gastroparesis and severe nausea/vomiting, which may limit their willingness to prescribe these medications.

Overall, GLP-1 medications are an effective option for managing glucose and insulin in type 2 diabetes, with additional cardiovascular protective effects that make them a valuable treatment approach.

Sources:

1. https://evidence.nihr.ac.uk/alert/glp-1-drug-for-diabetes-gives-modest-cardiovascular-benefits-compared-with-placebo/
2. https://professional.heart.org/en/education/assessing-the-benefits-of-glp-1-ras
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10739421/
4. https://www.medscape.com/viewarticle/glp-1-ras-cvd-are-cardiologists-ready-2023a1000ve0

GLP-1 receptor agonists are a class of medications that mimic the effects of the naturally occurring hormone GLP-1 (glucagon-like peptide-1). GLP-1 is produced in the small intestine and has several beneficial effects in people with type 2 diabetes:

• Increases insulin secretion from the pancreas in response to elevated blood glucose levels, helping to lower blood sugar.
• Decreases glucagon secretion, which prevents the liver from releasing more glucose into the bloodstream.
• Slows gastric emptying, which delays the absorption of glucose from food and reduces post-meal blood sugar spikes.
• Increases feelings of fullness and satiety, leading to reduced food intake and weight loss

By activating GLP-1 receptors, GLP-1 medications stimulate insulin release and suppress glucagon secretion, which helps to lower and stabilize blood glucose levels. The delayed gastric emptying and increased satiety also contribute to weight loss effects.

GLP-1 medications are often used in combination with other diabetes drugs like metformin to provide better glucose control. They also have a low risk of causing hypoglycemia (low blood sugar) on their own.

Sources:

1. https://diatribe.org/glp-1-agonists
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556578/
3. https://my.clevelandclinic.org/health/treatments/13901-glp-1-agonists

The naturally occurring GLP-1 and GIP hormones remain in the body for only a few minutes. Scientists call this the "half-life" of a substance. The medication versions of semaglutide and tirzepatide remain in the body for several days, extending the benefits of the hormones for days instead of only minutes. Instead of eating, and feeling full for a little while, the medicine tells your brain that you're full for days, even If you haven't eaten. Similarly, instead of the natural hormone triggering glucose and insulin management for a short time, the medication keeps these mechanisms working all week long, slowly diminishing until it's time for your next weekly shot. This is the essence of why they work so well.

For a more detailed explanation, check out this blog post.

Studies show that up to 30% of the weight you lose when on GLP-1 medications can be lean muscle mass, if you don't do anything to influence how your body normally converts both fat and muscle into energy while on a caloric deficit. Fortunately you can combat this by:

1) Consuming a protein-rich diet. A common rule of thumb is to to consume 50-100% of your body weight, in grams, daily, for each pound that you weigh. For example, if you weigh 200 pounds, try to consume 100-200 grams of protein per day.

2) Exercise, specifically lifting weights.

These two things can help you reduce or even eliminate the loss of lean muscle mass while taking a GLP-1 weight loss medication. Some of our patients have even reported gaining muscle mass while on the medication! It's possible to monitor this by getting a DEXA scan every 3-6 months, which will give you very specific data on your body composition (ie. how much of your weight is fat vs. muscle, vs. bone vs. water, etc).

We compound our tirzepatide and semaglutide with both glycine and vitamin B12.

The purpose of compounding with glycine and vitamin B12 is to enhance the beneficial effects of these GLP-1 drugs for weight loss and overall health. Specifically:

• Compounding with vitamin B12 helps address the common side effect of fatigue and low energy that can occur when starting GLP-1 treatment. Vitamin B12 is essential for energy metabolism and production of red blood cells, so adding it can boost energy levels and combat tiredness.
• Glycine is an amino acid that may help support insulin production and glucose regulation when combined with tirzepatide. This can further improve the blood sugar control benefits of tirzepatide and semaglutide.
• Glycine can also help with "muscle wasting" which is the loss of muscle during weight loss.
• The combination of tirzepatide/semaglutide, glycine, and vitamin B12 provides a synergistic effect. The GLP-1 medicine helps suppress appetite and promote weight loss, while the added nutrients support energy, metabolism, and blood sugar management.

By compounding with these complementary ingredients, the weight loss and overall health benefits of the medication can be optimized. This helps mitigate potential side effects and provides a more comprehensive treatment approach for patients.

• Vision changes
• Pancreatitis
• Kidney failure
• Gallbladder issues
• Allergic reactions

Neuroprotective Effects
GLP-1 receptor agonists have been shown to have neuroprotective effects, helping to control vascular risk factors and improve cardiovascular health.

Studies have found that GLP-1 medications can reduce the risk of stroke, heart attack, and death due to cardiovascular causes by around 12% in people with type 2 diabetes.

The neuroprotective benefits of GLP-1 drugs may be mediated through their ability to enhance myocardial glucose uptake and utilization, reduce oxidative stress, and inhibit cardiomyocyte apoptosis, leading to improved coronary blood flow and vascular relaxation.

Cognitive Benefits
GLP-1 receptor agonists may also have beneficial effects on cognitive function and help prevent or slow the progression of cognitive impairment in people with diabetes.

Experimental studies have shown the expression of GLP-1 receptors in brain regions like the hippocampus, which is crucial for learning and memory. GLP-1 medications may produce a reduction in oxidative stress and promote new brain connections and neuroplasticity, conferring neuroprotective effects.

Peripheral Neuropathy
GLP-1 receptor agonists may also help manage peripheral neuropathy, a common complication of diabetes that can cause numbness, tingling, and pain in the extremities.

Many risk factors for diabetic neuropathy are cardiovascular in nature, and the cardiovascular benefits of GLP-1 drugs may translate to reduced risk of peripheral nerve damage as well.

Overall, the neuroprotective, cognitive, and peripheral nerve benefits of GLP-1 medications make them a valuable treatment option for managing the neurological complications of diabetes.

Sources:

1. https://link.springer.com/article/10.1007/s11154-023-09807-3
2. https://evidence.nihr.ac.uk/alert/glp-1-drug-for-diabetes-gives-modest-cardiovascular-benefits-compared-with-placebo/
3. https://my.clevelandclinic.org/health/treatments/13901-glp-1-agonists

This is primarily because tirzepatide is doing two things while semaglutide only does one. Tirzepatide is a dual agonist of both the GIP and GLP-1 receptors, whereas semaglutide is a selective agonist of only the GLP-1 receptor. 

Studies have shown that GIP receptor agonism can help reduce the GLP-1-induced nausea and vomiting often seen with selective GLP-1 agonists like semaglutide. This suggests the dual mechanism of action of tirzepatide may lead to a more favorable gastrointestinal side effect profile compared to semaglutide, for a given level of efficacy.

Amazingly, yes! We have heard this from numerous patients, and even those of us that work at LeanRx ourselves have personally experienced this. These GLP-1 medications mimic a naturally occuring hormone your body produces when you eat, to signal to your brain that you are full. This happens automatically, even if you haven't eaten recently. You'll feel full and satisfied all the time.

The protocol is to take a shot weekly, and as time passes your dose may increase. If you took your shot on a Monday, for example, by Saturday or Sunday you will likely begin to feel your hunger returning, and you may be excited to take your next shot again. As the medicine wears off, the strength of its effects diminish. However, when that medication is working, you simply won't feel hunger. The "food noise" we all experience where we think about food, think about what we're going to eat later that day, or feel the urge or temptation for a treat simply goes away! It's miraculous and must be experienced to really understand how amazing it is. If you crave candy, or burgers, or ice cream or even something like wine - you will probably find that days and days have passed without even the thought to eat/drink your biggest tempation.

Unfortunately, no. We do not accept patients under the age of 18.

It depends:

People with Type I diabetes: Please work with your primary care physician. We are not prepared to manage your diabetes or your weight loss in.

People with Type II diabetes: We accept patients on a case-by-case basis. Please complete the qualification questionaire and schedule a virtual consultation.

People who are pre-diabetic: We can work with you.

Women who are pregnant, plan to become pregnant, or have had a baby less than 2 months ago are not eligible for this medication.

If you are breastfeeding you are also ineligible. As soon as you stop breastfeeding, you can begin the medical weight loss programs we offer.

Most people qualify, however there are a few situations where we cannot prescribe the medical weight loss medicine:

• Women who are pregnant, plan to become pregnant, or are breastfeeding.
• People with Type I diabetes. Work with your primary care physician.
• People with Type II diabetes are case-by-case.
• If you are pre-diabetic we can work with you.
• If you are going to a specialty doctor, or have in the past, you should get clearance. from them first. Examples: cardiology, nephrology, oncology. 
• People with a history of pancreatitis.
• People with medullary thyroid cancer.
• People with conflicting medication. Please ask your primary care physician if any ongoing prescriptions are conflicting with tirzepatide and/or semaglutide. 
• Anyone under the age of 18.

Although not required, we also recommend patients have a BMI of 25 or higher.

Unfortunately no, they are not. Like any medication, individual results vary. The way a medication is received by each person's body, their age and gender, the way it interacts with other medications, and maybe most importantly, the decisions each person makes regarding diet and exercise, all contribute to the results each person gets from the medication. 

The good news is, these appear to work for most everyone. In our experience our patients that put in the most effort to maximize the investment and opportunity, achieve the best results:

• Eat a healthy, protein-rich diet while on the medication
• Don't starve yourself. Get enough calories that your deficit is 400-800 calories per day. Slow weight loss is healthy weight loss. Target 1-2 pounds per week. It adds up!
• To avoid losing muscle, be sure to exercise. Not just cardio, lift weights too.

It's up to you!

Please don't. This is a prescription medication, prescribed only for you by a licensed medical professional. You shouldn't share this prescription drug, just like you shouldn't share any other prescription medication.

Yes! If you are worried about keeping it cold, you can put it in a cooler or even a thermos with ice in it. You can even take unmelted ice through security at the airport.

Please keep the medication refrigerated. Although the pharmacy is required to put a label on the vial saying to keep it frozen, please rest assured that this is overkill. Independent testing has been done by our compound pharmacy. After a full week at 105 degrees, the medication had not lost any effectiveness or potency. If you forget to put it back in the fridge for a day or two, don't panic. It will still work. 

You absolutely need your own doctor. LeanRx is not a replacement for your general health. You should still maintain access to a doctor and have regular check ups. 

While our service offers a quicker and more convenient method for obtaining prescriptions for specific medications, it's important to note that it does not serve as a substitute for your primary healthcare provider. When it comes to issues extending beyond the safe and easy procurement of prescription weightloss medications, we strongly advise consulting your primary health care physician in person. This applies to checkups, personal health concerns, or keeping them informed about the medications you are presently taking.

We would recommend most people to commit to 6-12 months of the medication. The amount of time needed depends on how much weight you are trying to lose, and what percentage of your current weight that represents. 

Some people may need to stay on a very low "maintenance dose" long-term, to keep the weight off.

However, in our experience most people will hit their weight goal and be able to stop taking the medication. There is no need to wean off of it; you can stop taking it abruptly with no adverse side-effects whatsoever. Within a week or so, your hunger will return to normal. This is why it's so critical that you use the time while on the medication, when you're receiving so much encouragement and positive reinforcement from your friends and family (and the mirror!) to change your diet and exercise habits. That way when you hit your goal, you can stop taking the medication, and keep the weight off for good.

Indefinitely. These medications are designed to be taken long-term. Some patients hit their weight loss goals and stop taking the medication. Others move to a small "maintenance dose". And others do something in-between where they may begin taking the meidcation again, from time to time, if they feel they've gained a little weight back or desire the appetite control the medication creates. Each persons' situation will vary. The good news is that the medication can be taken long-term. Talk to your provider about your unique goals and needs and we will help you navigate this.

On average we are seeing our patients lose between 15-30% of their starting body weight, over a 6-12 month period. Our experience as a weight loss clinic seems to support the independent studies of the effectiveness of these and other GLP-1 medications. 

Also, it's important to note that tirzepatide has been shown to be twice as effective as semaglutide. Both medications work, but tirzepatide works faster with fewer side effects. 

Finally, everyone's experience is different, and results cannot be guaranteed. However, we can say with confidence that these breakthrough medications really do work and are changing the lives of so many people!

Everyone's experience is different. Some people lose a lot of weight very quickly, while other people lose their weight more slowly. Some people lose their weight in a very steady, predictable way, losing a similar amount each week, while other people lose their weight in spurts, losing weight quickly and then experiencing a "stalling phase" for a time before beginning to lose weight again. In our experience most patients will lose weight over time. It's important to be patient and consistent in your dosing. Also, it is important to know that the healthiest and most sustainable way to lose weight is to lose it slowly, around 1-2 pounds per week. Although it's exciting to lose 10 pounds in a week, that isn't sustainable or healthy.

As a general rule of thumb, we are seeing our patients lose between 15-30% of their body weight over 6-12 months. Also, tirzepatide has been shown to be twice as effective as semaglutide.

Please discuss this on your telehealth call and depending on your situation we will help you start with an appropriate dosage for your situation. 

THE SHORT ANSWER
They are similar, but are from the same class of GLP-1 drugs, but tirzepatide was discovered more recently, does more to help your body lose weight. Although it costs more, tirzepatide has been proven to be both more effective and also to have less side-effects for most people. 

ADDITIONAL DETAIL 

Similarities
Both semaglutide and tirzepatide are glucagon-like peptide-1 (GLP-1) receptor agonists, which means they both mimic the GLP-1 hormone and make you feel less hungry. When you eat, your digestive tract releases the GLP-1 hormone, prompting the body to create more insulin. It can also send fullness signals to the brain.

Differences
Tirzepatide is both a GLP-1 receptor agonist (as described above) and a glucose-dependent insulinotropic polypeptide (GIP). Tirzepatide mimics the GLP-1 hormone and the GIP hormone. The GIP hormone also triggers insulin creation and sensations of fullness. Basically, tirzepatide does 2 things while semaglutide only does 1. This is why it is more effective.

Both medications will work, but semaglutide may take longer to achieve your weight loss goal. Also, tirzepatide has been shown to have less severe side effects.

Dosing schedules are designed as a guideline, but it is common for a medical provider to authorize slight adjustments to these schedules based on the specific needs and feedback from the patient. Our dosing schedules are different for tirzepatide versus semaglutide, so be careful not to mix them up!

See the tirazepatide dosing schedule here.

See the semaglutide dosing here.

Please chat with us inside the Healthie app (you can login here) or send us an email to shipping@LeanRx.com and provide your name, date of birth, phone number and your updated shipping address.

Compounded semaglutide and compounded tirzepatide, both are compounded (or mixed) with vitamin B12 and glycine. The medication your LeanRx practitioner prescribes for you will depend on your medical history and your goals.

We currently prescribe semaglutide injections and tirzepatide injections, only for qualified patients, as part of our weight loss program.

We are working on expanding as quickly as possible! Click here to view our current licensing map.

The New England Journal of Medicine has published the following articles:

Once-Weekly Semaglutide in Adults with Overweight or Obesity | NEJM
Tirzepatide Once Weekly for the Treatment of Obesity | NEJM

Tirzepatide and semaglutide can help nearly anyone lose weight, because of the way that it works. Whether you have only 5-10 pounds to lose or 100+, the medicine can help.

The medicine does a few things to help produce weight loss, but the main thing is that it makes it easy to acheive a calorie deficit, which is the fundamental key to losing weight.

• If you burn more calories than you consume, over time, weight loss is inevitable.
• It will signal to your brain that you are full, even if you haven't eaten.
• It slows your digestion, helping you feel fuller longer. 
• It helps manage how your body processes glucose (sugar) in a more efficient way.

It's important to lose the weight at a healthy rate, and not lose too much weight too quickly. For this reason we encourage a healthy diet and exercise while on the medication. For example, someone that needs 2,000 calories per day to maintain their weight should possibly target 1,200-1,500 calories per day. You may not feel like you need to eat, but you should still eat a protein-rich diet of some amount each day to have energy and not literally starve yourself. If you do this, you will lose weight.

It's backwards! Instead of needing to have the discipline to not overeat, the medication will force you to be disciplined to remember to eat enough - because you won't feel the urge to eat.

The answer to this is really up to you. We've worked with a ton of people and the result is really clear: If you use this amazing weight loss as a motivator to change your habits with your diet (healthier, smaller portions) and exercise, you can keep the weight off! However, if you don't change your habits, after going off the medication, gaining the weight back is inevitable. 

Use this opportunity to develop new healthy eating and exercise habits!

Yes, but don't worry, it's easy! You can also have a friend help you. Check out this short video that illustrates the process of self-administering a weekly weight loss shot.

Yes, your shipment will come with everything you need to take the medication. You will receive syringes and alcohol wipes. Check out this short video that illustrates the process of self-administering a weekly weight loss shot.

If you purchased a package for 12 or 48 weeks, or if you have a recurring subscription, your vial will ship to you automatically. If you have any questions or concerns about this, please let us know by emailing help@LeanRx.com 

If you previously purchased our program and would like to order again, please schedule a consultation. You can always reach out to us at help@LeanRx.com as well.

If at any time you need help and want to talk to us, you can schedule a call or you can reach out by chat (here, on our website in the bottom right hand corner) or by email at help@LeanRx.com

We're here to help!

It's simple and easy.

1. You can schedule a free consultation by clicking here and you can select a time that's convenient for you to have a call. Typically our calls last for around 15 minutes.
2. After scheduling your call, you will receive instructions by email. This will include a short questionnaire about your health history.
3. At the end of your call with one of our board-certified providers, if you choose to move forward we will help you select the best plan and medication for you. After making payment, you can expect to receive your medication within 7-10 days. 

One week (7 days). Throughout the week you will feel the medicine having less of an effect on your appetite control. After a week you will be ready for your next shot. Do not give yourself your next shot if it has been less than 4 days since your last shot.

No, it is not. In some situations, based upon your health history, our providers may request blood work in order to prescribe medication to you. Please discuss this during your video call.

The short answer is: no.

The longer answer is more complicated. No, there isn't a specific type of diet you need to follow or a theory (like no carb, or Atkins, etc) that is part of this program. The medicine does the work for you. You lose weight when your calorie intake is less than how many calories you burn throughout your day. This is called a calorie deficit.

The medicine suppresses your appetite and most people feel almost no desire to eat. Your cravings will probably stop. If you do eat, and you eat a lot or you eat something that is greasy, there's a chance you will feel sick to your stomach. All of this makes the 'not eating' easy. Almost too easy. Will-power is the hardest part of traditional diets, but it isn't part of the equation with this medication. While we love that the medicine makes achieving a calorie deficit easy, to lose weight in a healthy way you have to force yourself to eat a reasonable amount of calories each day. 

We recommend structuring a meal plan that allows you to eat enough calories in the day to still have energy, and to lose weight at a reasonable rate, such as 1-2 pounds per week. That may seem slow, but it's a responsible pace and it really adds up. Over a year that's 50-100 pounds!

How many daily calories do you need? How many should you consume daily?
The specific number varies for each person based on age, gender, and how active you are, but most people will burn 1800-2300 calories per day just through their normal activities.

A pound is equal to 3,500 calories. Your goal should be a daily calorie deficit of 500-1000 calories. That will add up to 1-2 pounds of weight loss each week! For example, if you determine your normal daily calorie burn is 2,000 and your goal is to lose 1 pound per week, your goal should be to consume only 1,500 calories each day. Over the course of a week, you will have a 3,500 caloric deficit and you'll weigh 1 pound less. Do that formula for a year and you'll lose 52 pounds.

There are many calculators online that can help you estimate your daily calorie burn. There are also many tools out there, including fitness and meal apps, that help you track your calorie intake. Spend some time on this to understand your needs. Don't worry, the medicine will make the "not eating" part very easy! 

We recommend a thoughtfully constructed meal plan that helps you eat in a healthy, disciplined way, with an emphasis on protein (so you lose mostly fat and not much muscle). Consider this article to help you get started.

Strictly speaking, no.

But we strongly recommend making some sort of exercise part of your habits and lifestyle.

This medicine is incredibly effective and losing weight is the easy part. The harder part is using the opportunity in front of you to really make long-term changes to your lifestyle. A critical part of a healthy lifestyle is exercise. As you lose weight you will probably feel better than you have in many years, maybe since you were young. We hear this from our patients every day! You will have people telling you how good you look. All of this positive reinforcement will hopefully give you the motivation to start doing some activities that aren't currently part of your routine. We encourage this and want you to use this time to reset your habits and patterns. Introduce long walks, yoga, jogging, lifting weights, cardio machines, or other forms of exercise and make these new, long-term habits that stick, well after the program ends and the medication stops!

Additionally, we always encourage lifting weights while on semaglutide or tirzepatide. This will help you retain more muscle so that the majority of your weight loss comes from fat and not lean muscle mass. Lifting weights, and sufficient protein intake, are key to this goal.

While not for everyone, if you are interested in really growing muscle during this process, please check out this article.

Probably both. Typically when people lose weight, especially when they lose it rapidly, as much as 30% of the weight can come from the loss of lean muscle mass. However there are ways to reduce this so that the majority of the weight loss can come from fat. The best way to minimize the loss of lean muscle mass is:

1. To get plenty of protein.
2. To be active and use your muscles, preferably by lifting weights.

Check out this article that explains how important protein is in this process.

Unfortunately we do not offer any type of payment plans. However we do offer preferred pricing to patients that commit to 12 and 48 week program plans.

Furthermore, we offer discounts to people who commit to a recurring subscription. You will be automatically charged every 4 weeks, and your medications will be automatically shipped to you. After an initial 24 week commitment (6 vials of medication), you can cancel at anytime.

We don't take insurance, but we do accept HSA and FSA cards. We also take all major credit cards. We do not accept cash.

It depends on whether you're looking for 1 month of our program or can commit to a longer period of time. Please visit our tirzepatide page and our semaglutide page for details.

$35 per shipment, which includes the medication in a cold-pack, with the necessary supplies to self-administer your weekly shots.

If you purchase a recurring subscription, or commit to a 12 or 48 week program where payment is taken upfront, we waive all shipping costs!

Prescriptions take approx 7 days to process from your initial consultation. Once shipped, shipping is sent overnight. Future shipments will not require a 7 day processing period. 

It's free!  It's complimentary and included as part of our process to help make sure you are qualified and that all of your questions and concerns have been addressed as you consider making our program part of your journey. 

At LeanRx, we exclusively provide prescription-grade supplements meticulously compounded and formulated at one of our partnered compounding pharmacies regulated by the FDA. Given their prescription status, these supplements are only intended for the individual specified on the prescription supplement vial and cannot be accepted for return or a refund.

You can read our full return policy here.