Wegovy

• Generic name - Semaglutide
• Adult titration (typical):
  0.25 mg weekly ×4 weeks → 0.5 mg ×4 → 1.0 mg ×4 → 1.7 mg ×4 → maintain at 1.7 or 2.4 mg weekly as tolerated.
• Weekly routine: Same day each week, any time of day, with or without food.
• Missed dose (Wegovy-specific):
  
  • If the next scheduled dose is >48 hours away, take the missed dose as soon as possible.
  • If <48 hours, skip the missed dose and take the next dose on your usual day.
  • If you’ve missed ≥2 weeks, contact your clinician for re-start guidance (you may need to re-titrate).

• Boxed Warning — Thyroid C-cell tumors: Do not use if you or a family member has MTC (medullary thyroid carcinoma) or MEN2. Seek care for neck lump, hoarseness, trouble swallowing, or shortness of breath.
• Pancreatitis / gallbladder: Urgent care for severe, persistent abdominal pain (± vomiting). Report right-upper-abdominal pain/fever/jaundice (possible gallbladder disease).
• Kidneys: Dehydration from nausea/vomiting/diarrhea can trigger acute kidney injury—maintain fluids; report reduced urination or swelling.
• Eyes (in T2D): Diabetic retinopathy may worsen with rapid glucose improvement—report vision changes; arrange eye monitoring if you have a history.
• Hypoglycemia with certain meds: Risk increases when combined with insulin or sulfonylureas—your clinician may lower those doses and increase monitoring.
• Pregnancy / planning: Avoid during pregnancy. Stop ≥2 months before a planned pregnancy (long washout). Discuss reliable contraception.
• Use-population notes: Not for type 1 diabetes; safety not established under 12 years. Hypersensitivity to semaglutide/components is a contraindication.
• Alcohol: Can worsen side effects and increase hypoglycemia risk if on certain diabetes meds—discuss intake with your clinician.‍
• Liver disease: No routine dose adjustment in hepatic impairment; clinicians individualize care.

• Generic name - Semaglutide
• Adult titration (typical):
  0.25 mg weekly ×4 weeks → 0.5 mg ×4 → 1.0 mg ×4 → 1.7 mg ×4 → maintain at 1.7 or 2.4 mg weekly as tolerated.
• Weekly routine: Same day each week, any time of day, with or without food.
• Missed dose (Wegovy-specific):
  
  • If the next scheduled dose is >48 hours away, take the missed dose as soon as possible.
  • If <48 hours, skip the missed dose and take the next dose on your usual day.
  • If you’ve missed ≥2 weeks, contact your clinician for re-start guidance (you may need to re-titrate).

• Clinically meaningful weight loss: In the STEP program, semaglutide 2.4 mg achieved ~15% mean weight loss at 68 weeks (with lifestyle support) vs ~2% with placebo.
• Cardio-metabolic improvements: Better A1C, BP, and lipids across studies.
• Prediabetes: Improved glucose regulation and lower progression risk versus placebo in STEP subgroups.‍
• Once-weekly convenience: Integrates with structured nutrition, movement, and behavior change for durability.

• Boxed Warning — Thyroid C-cell tumors: Do not use if you or a family member has MTC (medullary thyroid carcinoma) or MEN2. Seek care for neck lump, hoarseness, trouble swallowing, or shortness of breath.
• Pancreatitis / gallbladder: Urgent care for severe, persistent abdominal pain (± vomiting). Report right-upper-abdominal pain/fever/jaundice (possible gallbladder disease).
• Kidneys: Dehydration from nausea/vomiting/diarrhea can trigger acute kidney injury—maintain fluids; report reduced urination or swelling.
• Eyes (in T2D): Diabetic retinopathy may worsen with rapid glucose improvement—report vision changes; arrange eye monitoring if you have a history.
• Hypoglycemia with certain meds: Risk increases when combined with insulin or sulfonylureas—your clinician may lower those doses and increase monitoring.
• Pregnancy / planning: Avoid during pregnancy. Stop ≥2 months before a planned pregnancy (long washout). Discuss reliable contraception.
• Use-population notes: Not for type 1 diabetes; safety not established under 12 years. Hypersensitivity to semaglutide/components is a contraindication.
• Alcohol: Can worsen side effects and increase hypoglycemia risk if on certain diabetes meds—discuss intake with your clinician.‍
• Liver disease: No routine dose adjustment in hepatic impairment; clinicians individualize care.

Medication is the amplifier—care is the instrument. Our program is built to maximize benefit and minimize setbacks.

1. Clinical screening & eligibility
   
   • Contraindication check (MTC/MEN2, prior hypersensitivity)
   • Baseline labs (e.g., A1C, lipids, LFT/KFT, ± pregnancy planning)
2. Precision nutrition
   
   • Protein-first, fiber-rich, culturally adaptable plans; anti-nausea strategies during titration.
3. Movement science
   
   • Progressive resistance + low-impact cardio; protects lean mass, joints, and metabolic rate.
4. Coaching & side-effect playbooks
   
   • Weekly check-ins, dose-escalation support, hydration/electrolyte guidance, red-flag escalation.
5. Transition plan

Maintenance dosing/tapering options, relapse-prevention, habit consolidation to reduce weight-regain risk.