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Did you realize that shedding just one pound of weight can alleviate approximately 4-5 pounds of pressure on your knees?

As one of our founders and CEO, I am a double board-certified Anesthesiologist and Pain Medicine specialist with over 15 years of experience. 

 

Consider this: In the realm of Pain Management, a prevailing issue is low back pain. The weight borne by our backs and joints significantly contributes to spine and joint discomfort.

Throughout my extensive practice, I've observed numerous patients achieve remarkable weight loss transformations, leading to enhanced appearance and overall well-being. Intrigued by their success, I delved into their strategies, only to find that their achievements were not shrouded in secrecy.

We are all familiar with pharmaceutical advertisements and celebrity weight loss anecdotes through the off-label use of medications. Enter "Semaglutides" (also known as GLP-1 agonists) and now "Tirzepatides" (GLP-1/GIP agonists), offering promising avenues for weight management.

Notably, Semaglutides mitigate adverse effects such as anxiety, depression, insomnia, palpitations, and tachycardia, commonly associated with previous weight loss medications and stimulants. These medications facilitate weight loss ranging from 25-30% of baseline, owing to their capacity for appetite suppression, satiety promotion, craving reduction, and metabolic enhancement.

Moreover, Semaglutide therapy yields ancillary benefits, including improvements in blood sugar levels, blood pressure reduction, and enhancement of various cardiovascular parameters. Additional advantages encompass reductions in cholesterol levels, improvements in lipid profiles, mitigation of fatty liver disease, and decreased risk for heart and kidney diseases.

Modern weight reduction programs extend beyond mere weight loss to address metabolic and mechanical comorbidities associated with obesity. These programs strive to normalize parameters such as blood pressure, blood sugar, cholesterol, and triglyceride levels, alongside improvements in conditions like fatty liver and polycystic ovary dysfunction.

Additionally, mechanical benefits emerge from fat mass reduction around crucial areas like the neck, abdomen, and legs, leading to enhancements in conditions such as sleep apnea, back pain, and arthritis of the hips and knees.

Research indicates that metabolic benefits often precede mechanical enhancements, with diabetic patients experiencing improved glycemic control and pre-diabetic individuals returning to normoglycemia. As weight decreases, blood pressure and HDL cholesterol levels tend to normalize, often resulting in reduced reliance on medications for hypertension and diabetes.

Anti-obesity medications, including Semaglutides, aim to promote a healthy body composition rather than mere weight reduction. Studies highlight a significant reduction in total body fat compared to lean body mass, highlighting the effectiveness of these medications in fostering favorable body composition changes.

Despite these strides, nutritional support remains essential. Consider integrating adjunctive measures such as the Herbalife® GLP-1 Nutrition Companion for comprehensive support in your weight management journey.

Edmond & Oklahoma City Weight Loss Clinics

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How do GLP-1 agonists work?

To comprehend the mechanism of action behind GLP-1 agonists, it is beneficial to grasp the function of the naturally occurring GLP-1 hormone.

GLP-1, produced by the small intestine, serves several vital roles, including:

1. Stimulating insulin release from the pancreas: Insulin is crucial for utilizing ingested food for energy, thereby regulating blood glucose levels. Inadequate insulin production can lead to elevated blood sugar levels, resulting in diabetes.

2. Inhibiting glucagon secretion: Glucagon, a hormone that elevates blood sugar levels when needed, is countered by GLP-1, thus preventing excessive glucose release into the bloodstream.

3. Slowing stomach emptying: By delaying digestion, GLP-1 reduces the amount of glucose entering the bloodstream from ingested food.

4. Enhancing satiety: GLP-1 influences brain regions responsible for hunger and fullness sensations, promoting a feeling of satiety after meals.

Now, let's delve into the mechanism of action of combined GLP-1/GIP Receptor Agonists, also known as tirzepatides.

These medications emulate the actions of two incretin hormones, GLP-1 and GIP, referred to as "twincretins." Acting synergistically, these hormones stimulate insulin secretion post-meal consumption. Insulin facilitates glucose utilization or storage within the body, thereby reducing hyperglycemia.

By targeting both GLP-1 and GIP receptors, tirzepatide exerts a more potent effect on reducing hyperglycemia compared to GLP-1 agonists alone. Additionally, it modulates appetite, leading to decreased food intake and subsequent significant weight loss.

Key Takeaways:

  • Tirzepatide mimics the actions of two distinct hormones, GLP-1s and GIPs, enabling enhanced efficacy in managing blood glucose levels and promoting weight loss.

  • While medications like Wegovy® and Ozempic® activate the GLP-1 receptor as semaglutide derivatives, tirzepatide medications like Mounjaro® and Zepbound™ engage both GLP-1 and GIP receptors.

  • The dual agonism approach of tirzepatide surpasses the efficacy of single-agonist medications like semaglutide, leading to superior weight loss outcomes.

In summary, tirzepatide's dual receptor activation presents a promising therapeutic approach for managing blood glucose levels and achieving substantial weight loss, underscoring its potential as a safe and effective long-term solution compared to other available weight loss options.

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How will I feel?

For instance, if the scheduled injection is missed on a Friday, there is flexibility to administer it on Saturday, Sunday, or Monday to maintain the prescribed regimen.

Moreover, there is no documented evidence suggesting enhanced effectiveness by administering injections in specific areas of the body. While the abdomen serves as the most common injection site, alternatives such as the upper arms or thighs are equally viable.

Now, let's address potential adverse effects. It's important to note that most gastrointestinal (GI) side effects typically arise when the dosage is increased. Over time, these side effects tend to diminish in severity.

The majority of our patients experience minimal to no side effects, largely attributed to commencing treatment at the lowest effective dose. However, among the most prevalent GI-related side effects—nausea, vomiting, diarrhea, constipation, and indigestion—nausea has been reported in less than 10% of patients. In such cases, medications like Zofran or similar options can be prescribed to alleviate symptoms.

Typically, GI side effects are transient, lasting around two weeks, after which the body acclimates to the treatment. To mitigate these effects, adopting practices such as consuming smaller portions at a slower pace, avoiding fatty and high-carb foods, and stopping consumption before feeling full can be beneficial.

In the event of diarrhea, maintaining hydration and utilizing over-the-counter antidiarrheal products are recommended. Similarly, for constipation, the proactive use of stool softeners or laxatives can help manage symptoms.

While indigestion was initially anticipated due to the delayed gastric emptying associated with treatment, its incidence has been relatively low. Over-the-counter products can be utilized to alleviate acid reflux or indigestion symptoms if they arise.

However, the most concerning adverse effect is pancreatitis, characterized by inflammation of the pancreas. Symptoms include upper abdominal pain, tenderness, rapid pulse, upset stomach, and vomiting, necessitating urgent medical attention.

It's crucial to contextualize the incidence of pancreatitis, particularly concerning recent updates indicating a comparable rate of occurrence between Tirzepatide-treated groups and placebo. This underscores the importance of understanding the nuances of clinical data, especially regarding adverse effects.

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