FAQ
Frequently asked questions
Quick answers about visits, anti-obesity medications, lifestyle care and safety.
Written by Dr. Richard Kowalsky, MD, board-certified in obesity medicine Last updated Sources cited Editorial policy
Getting started
Do I need a referral?
Many people book directly. Some insurance plans require a referral for specialist care, so it’s worth checking your plan before your first visit.
What happens at the first visit?
A conversation about your weight history, goals and health, a review of your medicines and any recent labs, and a first plan across nutrition, activity, behavior and, if appropriate, medication. There is plenty of time for questions.
Can my visit be in Spanish?
Yes. Dr. Kowalsky speaks English and Spanish. Sí, se habla español.
How do I request an appointment?
Use the contact form or email [email protected]. The office replies by email with next steps.
Medications
Am I a candidate for a GLP-1 medication?
Guidelines consider anti-obesity medication for adults with a BMI of 30 or higher, or 27 or higher with a weight-related condition, alongside lifestyle care.[1] Whether it’s right for you depends on your health history, other medicines and preferences, which is what the evaluation is for.
How much weight will I lose on medication?
No one can promise a number. In the STEP 1 trial, average weight change with semaglutide was −14.9% over 68 weeks, compared with −2.4% on placebo, but individual responses varied widely.[3]
What are the common side effects?
For GLP-1 medications, the most common are nausea, vomiting, diarrhea and constipation, usually when the dose increases. Pancreatitis and gallbladder problems are less common but serious.[2]
Will I need medication forever?
Not necessarily, but stopping usually leads to regain. In the STEP 1 extension, about two-thirds of lost weight returned within a year of stopping semaglutide.[4] Any change is planned together.
Do you offer compounded medications?
This site doesn’t promote or sell any medication. Medication choices are discussed individually, with safety and FDA-approved options as the priority.
Lifestyle and results
Do I have to follow a strict diet?
No. Nutrition plans are built around your food preferences, culture and schedule. The goal is a way of eating you can keep.
How much exercise do I need?
It depends on where you’re starting. Activity is built up gradually and matters most for keeping weight off. Intensive behavioral programs that combine diet and activity are recommended for adults with obesity.[5]
Is a small amount of weight loss worth it?
Yes. Losing about 5 to 10% of body weight can improve blood sugar, blood pressure and other weight-related conditions.[6]
Safety
When should I go to the emergency room?
Call 911 or go to the ER for chest pain, severe abdominal pain that won’t go away, signs of severe dehydration such as confusion, fainting or very little urine, or very low blood sugar with confusion or loss of consciousness.
Can I use these medicines during pregnancy?
Most anti-obesity medicines are not used during pregnancy. If you could become pregnant, contraception and pregnancy plans are part of choosing a medication.[2]
Sources and references
- Apovian CM, Aronne LJ, Bessesen DH, McDonnell ME, Murad MH, Pagotto U, Ryan DH, Still CD. Pharmacological management of obesity: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2015;100(2):342-362. View source
- Grunvald E, Shah R, Hernaez R, Chandar AK, Pickett-Blakely O, Teigen LM, et al.; AGA Clinical Guidelines Committee. AGA clinical practice guideline on pharmacological interventions for adults with obesity. Gastroenterology. 2022;163(5):1198-1225. View source
- Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, et al.; STEP 1 Study Group. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989-1002. View source
- Wilding JPH, Batterham RL, Davies M, Van Gaal LF, Kandler K, Konakli K, et al.; STEP 1 Study Group. Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension. Diabetes Obes Metab. 2022;24(8):1553-1564. View source
- US Preventive Services Task Force; Curry SJ, Krist AH, Owens DK, et al. Behavioral weight loss interventions to prevent obesity-related morbidity and mortality in adults: US Preventive Services Task Force recommendation statement. JAMA. 2018;320(11):1163-1171. View source
- Garvey WT, Mechanick JI, Brett EM, Garber AJ, Hurley DL, Jastreboff AM, et al. American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract. 2016;22 Suppl 3:1-203. View source
Your questions deserve real answers.
Ask about a first visit, a medication you’ve heard about, or a plan that finally fits your life. Se habla español.