Anyone doing medical weight loss around here? Trying to figure out semaglutide vs tirzepatide

Posted by No-Bytes@reddit | plano | View on Reddit | 31 comments

So I finally decided to look into medical weight loss after going back and forth for like a year. My BMI is right around 30 and my PCP basically said diet and exercise alone isn't cutting it anymore so maybe try one of those GLP-1 shots.

I've been looking at a few clinics around DFW — Red Mountain in McKinney, VIO Med Spa, and there's one in Prosper area called Radi.8 that someone at work mentioned. Honestly I don't even know what the difference is between semaglutide and tirzepatide besides one being newer? Like does anyone here have actual experience with either?

My biggest concern is side effects tbh. I've read some people get super nauseous the first couple weeks and basically can't eat anything. Also pricing is kinda all over the place — some places are quoting me like $400/month, others way more.

If anyone's been through this around McKinney/Prosper area I'd love to hear how it went and where you ended up going. Did your provider actually monitor your bloodwork and stuff or was it more of a here's-your-shot-see-ya-next-month type thing?

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flilmawinstone@reddit

It sounds like you are cautious about this so I’ll ask a few questions for thought.

What exactly are you doing for diet and exercise? Are you diabetic? Or pre-diabetic? Why is your PCP not managing the use of these drugs or providing a referral to a qualified medical doctor to manage it instead of sending you out to fend for yourself at a med spa ?

these drugs have benefits and are useful for specific cases , but the fact that they are so easily available with limited medical oversight is a big red flag to me that pharmaceutical companies are just out for big $ with little care for actual well being — “ka-ching” (sound of cash register)

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raw2082@reddit

Came here to say this. I would go to an endocrinologist to have them prescribe and manage dosage. I’m so tired of half ass doctors. Reach back out to your pcp for a referral though usually helps with getting an appointment quicker. Good luck.

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flilmawinstone@reddit

Good luck finding a decent endocrinologist! I am still in search of one :-(

I was seeing one in Plano, then the group consolidated offices to Dallas (so I had to drive to Walnut Hill), then Dr. retired and the practice told me -- a long time patient -- that none of their doctors are taking any new patients. WTF? How am I a new patient?!?

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Impressive-Case431@reddit

Same thing happened to me when my gastro retired

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raw2082@reddit

Well that’s awful. I’m sorry that happened to you. Our health system seriously needs an overhaul.

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ShellmyBelle35@reddit

Also this. I’m on them but I’m also prescribed them by an NP that works with my surgeon and that actually sees me in person. Not just looking at a number. I used to work at an IV hydration place that was chomping at the bit to start selling them. That’s when I quit working there.

keepithonest38@reddit

My friend experienced blindness one morning from GLP-1 when doctor slightly increased her dose.

She went from being an active healthy person to now disabled and blind in both eyes. Apparently GLP can cause complications similar to a sudden stroke.

Ruined her life and has severely impacted her family. Caused permanent “ischemia” both eyes and now she is a 45 year old that has to learn how to live life as a blind woman. She can no longer drive her kids to school or do basic life things like cook…

Take caution

CelebrateByMe@reddit

tirzepatide hits both GIP and GLP-1 receptors so it tends to be more effective but also pricier, while semaglutide is the more affordable starting point. nausea is real for both but usually fades after week 2-3 if you titrate slow. the local med spas can be fine but pricing jumps when you move up doses, which gets annoying.

i went telehealth through NewSelf and the cost stayed flat even after titrating, which was the main draw for me.

Ineffable2024@reddit

I use Zepbound (aka Tirzepatide). My pcp prescribes it and I get it through [Eli] Lilly Direct and pick it up at Walmart. The higher doses are $450/mo. The two starter doses are cheaper but I forget how much, maybe $300 or something like that. My insurance doesn't cover it but I prefer the real medication from the manufacturer as long as I can pay for it.

Delicious-Sail-2085@reddit

This is what my wife just started. 2 month supply for $450. Got her shipment by UPS yesterday & ordered direct online.

TexasLiz1@reddit

You don’t need to go to one of these medspas. You just need a competent PCP and you will need to do some experimentation. There are compounding pharmacies and all kinds of savings plans.

Nausea is a common side effect as you grow accustomed to the medication and the amount of food you can eat will likely be significantly less. But you just got to try it.

squeadunk@reddit

I go to Vitality weight loss. They have dr, nutritionist, personal trainer, even a mindset coach

opspec-19820@reddit

Hi there, my wife is a double-board certified MD who practices family and lifestyle medicine, and definitely offers guided medical weight loss. She has her own practice and offers free 15-minute consults. She’d be happy to talk to you about semaglutide or tirzepatide to see if either is a good option for you. You can check out her website and book a consult at AlarysHealth.com

mllllllln@reddit

Diet and exercise aren't working? What does that mean? Weight loss is purely about caloric deficit, it's just mental discipline.

I would recommend having your doctor prescribe it. Then you’re not dealing with the upselling of those clinics. See if your insurance will cover the drug. If so, then you can get the name brand rather than paying $200+ per month for compounded.

My company stopped coverage on GLP-1s. I went from paying $25 a month after the wegovy coupon, to now paying $265 a month for compounded.

I would start with semaglutide. Especially if you’re concerned about side effects. I have done both. I have talked to plenty of people that were started on Zepbound (tirzepitide) right out the gate and had such severe side effects. Also… you are not required to titrate up every month. Semaglutide is a good starting point. Be patient and give yourself the time to titrate up before deciding to move to tirzepitide.

Also, if you struggle with any kind of depression or anxiety I would encourage keeping a journal of how you’re feeling. I noticed a significant uptick in my anxiety when I started. When I switched to tirzepitide I ended up having a panic attack… which had never happened to me before.

Listen to your body.

You are not required to titrate up each month on tirzepatide

I didn’t say they were? Sometimes people can be hasty if not seeing results fast enough.

On_Food@reddit

I was on semaglutide for a year, lost 70 pounds, which was 20% of my bodyweight. No real side effects, which you should take with a grain of salt since my diet was not great to begin with. The positive outweigh the negative if I ever noticed them.

I plateaued and stayed at the same weight for about 3 months, so I changed to tirzepatide and after a month, it's kicking in and I'm starting to tick down again. I'd like to lose 15% from my current.

I'm paying out of pocket through an online service. It's about $125 a month or whatever but compared to what I'd probably be spending on food and alcohol (which I'm not, since my cravings are completely eliminated), I'm probably come out ahead and that's on top of having to buy new clothes twice due to size jumps.

I'll take it.

medullaoblongtatas@reddit

I see Kathryn Davis at Addison Internal Medicine. I pay $150 for each vial through SandsRX. It’s compounded, but my insurance wouldn’t cover it (although I did qualify, insurance sucks). But I’m already down 20lb. She monitors my labs. It’s wonderful.

RecallGibberish@reddit

I lost 190 pounds on Tirzepatide and have been maintaining for 9 months.

Biggest suggestion for you is to join the r/Zepbound and r/Wegovy subreddits and read, read, read, starting with the pinned posts and sidebars to start learning the differences.

For compound, join r/tirzepatidecompound and again, start with the pinned posts and sidebars. You'll find significantly cheaper options than what you're quoting at medspas that lots of people in that subreddit use and recommend.

Personally, I'd go Tirz over Sema. It has shown to have milder side effects and be more effective. It's a little more expensive, but worth it. I did all the research over two years ago when I needed to start and it was clear that most people have better success with tirzepatide.

New-Introduction1076@reddit

Yeeeeessssss! I started at the end of 2024 on Zepbound and within three months I was doing compounding. I found all the answers I needed on the sub Reddits. I agree with your read read read research! What the doctors canned or won’t or don’t have time to tell you are the things you will find there!

Protein and water. It’s not just something people are doctors say with GLPs. They are the two biggest components.

bando469@reddit

I’ve been on Tirzepatide for 2 months, lost 30 lbs with proper diet. I order it from Vitastir, since they’re the cheapest I’ve found.

Saamari@reddit

My wife went through her primary for the script and buys it from a compounding pharmacy out of pocket, ends up being like $100 a month

ilovemydogs2323@reddit

This isn’t a direct answer but have you tried other medication first? I was too afraid to go on GLP-1 and my doctor prescribed contrave instead. I’ve had great success on it and it can be super cheap if you take as naltrexone and bupropion (vs the branded single pill). I pay a total of less than $2/month for this with my insurance and I’ve lost a little more than 20% of my starting body weight over about 6 months at a pretty steady rate of about a pound a week.

Also this. Zonisamide helped me lose 70lbs. Metformin is also a good starting off point.

Willing_Television25@reddit

Go to Bent Tree Family physicians and Dr Khan. He “specializes” in weight loss. I suggest going with a medical provider who can work with you on options. Good luck!

neatgeek83@reddit

Why isn’t your pcp prescribing it?

I’ve been on semaglutide for 2 years and lost 45 lbs. few side effects as I scaled up to the therapeutic dose but it’s been smooth sailing since.

libtay@reddit

Tirzepatide has a GLP-1 and GLP so works a little differently than the Semaglutide. It also worked better for me. I had less side effects. Costco has a cash price that is doable vs an online company. Also, can your doctor submit a form to insurance to cover it? Multiple issues sometimes can convince the insurance company.

mar_floof@reddit

Was on semaglutide for a few months, and have regretted it every day since.

I dont want to be that guy but my side effects were horrific and permanent. If you have existing acid reflux the first few weeks make it 100x worse. I also now have breathing problems and an irregular heartbeat.

I’m sure it works great for some people, but… be cautious.

ParcelPosted@reddit

Check Groupon for local places.

cris2miles@reddit

I was on mounjaro for 2 years, side effects minor, I started with an online provider, since finding one in person was almost non existence . On ozempic now, almost no side effects at the lower doses, but also no weightloss for me. AC1 is great on it, cravings are nearly gone ( sugar, Coca-Cola),. With mounjaro, you don't really have to anything to lose weight, it's much stronger. I get monitored every 3 months by my doctor, but my online doctor also did the same. Good luck!