Historically, the treatment of obesity focused almost exclusively on lifestyle-based approaches. However, evidence that diet and exercise prompt physiological counterregulatory mechanisms that limit weight reduction and impede weight maintenance has led to the realization that obesity is a complex, multicomponent metabolic disease of energy homeostasis involving central and peripheral mechanisms. Once obesity is present, those mechanisms render a return to lower weight difficult.
Accordingly, several clinical guidelines now recommend treatment with antiobesity medications for people with obesity or for those with overweight and weight-related complications. Recent studies with long-acting glucagon-like peptide-1 (GLP-1) receptor agonists demonstrated that greater efficacy with acceptable safety could be achieved by targeting the pathways of endogenous nutrient-stimulated hormones. Glucose-dependent insulinotropic polypeptide (GIP), another nutrient-stimulated hormone, regulates energy balance through cell-surface receptor signaling in the brain and adipose tissue. A molecule that combines both GIP and GLP receptor agonism theoretically may lead to greater efficacy in weight reduction.
Semaglutide​
In June 2021, the U.S. Food and Drug Administration approved semaglutide (Wegovy) injection (once weekly) for chronic weight management in adults with obesity or overweight with at least one weight-related condition (such as high blood pressure, type 2 diabetes, or high cholesterol), for use in addition to a reduced calorie diet and increased physical activity. This once weekly, under-the-skin injection (subcutaneous) is the first approved drug for chronic weight management in adults with general obesity or overweight since 2014. The drug is indicated for chronic weight management in patients with a body mass index (BMI) of 27 or greater who have at least one weight-related ailment or in patients with a BMI of 30 or greater.
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Originally used for diabetes and sold under the name Ozempic, a higher dose of the same drug was evaluated for weight loss. The results were dramatic, with the average individual losing 15(+) % of their body weight during the clinic trial. Due to such overwhelming results, it has become cost-prohibitive via insurance (average co-pay of $947/mo) or GoodRx( lowest price is $1333).
We prescribe Semaglutide through a compounding pharmacy for a fraction of the cost with the same results!
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How it works: Semaglutide works by mimicking a hormone called glucagon-like peptide-1 (GLP-1) that targets areas of the brain that regulate appetite and food intake; it is a powerful appetite suppressant. It also works by increasing the production of insulin and appears to enhance growth of β cells in the pancreas, which are the sites of insulin production. Additionally, it inhibits glucagon, which is a hormone that increases blood sugar. It has been known to aid not only in weight loss, but helps to lower glucose levels in those who are pre-diabetic or who have type 2 diabetes.
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Delays stomach emptying, leading to a feeling of fullness and smaller meal size
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Slows intestinal motility
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Lowers blood sugars, in part by reducing the production of sugar in the liver
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Stimulates insulin secretion by the pancreas
Semaglutide is started at a low dose which can be increased gradually to tolerate any GI symptoms. It is common for patients to have great success with minimal side effects around 0.25 - 2.5mg weekly.
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What to Expect: For your initial visit, you schedule a consultation appointment. Upon arriving for your appointment, you will have paperwork to complete and then you will have your consultation. Based on the FDA recommendations for treating obesity, we determine if semaglutide is a safe and good option for you. We carefully screen you by evaluating your past medical history, any current medications you take and your body mass index (BMI).
:Contraindicated: you have any of the following: diabetic retinopathy, low blood sugar, decreased kidney function, pancreatitis, medullary thyroid cancer (or a family history of medullary thyroid carcinoma), or multiple endocrine neoplasia type 2.
Since the semaglutide injection does not help increase energy or boost metabolism, we recommend pairing it with a vitamin b-12 injection and the AOD/ NAD sublingual that aids in melting visceral fat. We pair the injection with the AOD/NAD/ B12 daily sublingual for best results.
What is AOD?
AOD has become a real heavyweight among people looking to become both leaner and lighter. While many consider it a weight loss wonder, this peptide is actually a fragment of human growth hormone (HGH). Its natural ability to stimulate the pituitary gland helps to speed up your metabolism, which helps you burn fat and boosts your calorie burn—all without increasing your hunger or blood sugar.
Weigh the many benefits of AOD:
Fat doesn’t stand a chance against this naturally powerful peptide, whose impressive fat-fighting abilities can provide the following benefits, such as:
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Reduces body fat
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Increases calorie burn
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Triggers fat release
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Boosts your metabolism
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Prevents non-fatty foods from turning into body fat
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Doesn’t increase your appetite
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No negative effects on blood sugar levels or tissue growth
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May help with bone and cartilage repair
How AOD 9604 helps to tip the scales in your favor:
According to clinical studies, the remarkable power of AOD is found in its ability to regulate your body’s metabolism. By stimulating the metabolism’s natural fat-burning process, it triggers the release of fat from obese fat cells, while also working to decrease the growth of new fat in the surrounding fat cells. This results in greater weight loss and less overall body fat, without any uncomfortable effects on your appetite or your blood sugar. Along with its recognized fat-burning qualities, additional studies have found that AOD may have a regenerative influence on bone and cartilage repair.
NAD:
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NAD+ is important for species’ mitochondrial maintenance and gene regulation regarding aging. However, the level of NAD+ in our body declines drastically with age. “As we get older, we lose NAD+. By the time you’re 50, you have about half the level you once had when you were 20,” says David Sinclair of Harvard University in an interview.
Studies have shown the decrease of the molecule associates with age-related diseases including accelerated aging, metabolic disorders, heart disease, and neurodegeneration. Low levels of NAD+ is associated with age-related disease due to less functional metabolism. But replenishing NAD+ levels has presented anti-aging effects in animal models, showing promising results in reversing age-related diseases, increasing lifespan and healthspan.
Aging
Known as the “guardians of genomes,” sirtuins are genes that protect organisms, from plants to mammals, against deterioration and diseases. When the genes sense the body is under physical stress, such as exercising or hunger, it sends out troops to defend the body. Sirtuins sustain genome integrity, promote DNA repair and have shown anti-aging related properties in model animals like increasing lifespan.
NAD+ is the fuel that drives the genes to work. But like a car cannot drive without its fuel, sirtuins require NAD+. Results from studies show that raising NAD+ level in the body activates sirtuins and increases lifespan in yeast, worms, and mice. Although NAD+ replenishing shows promising results in animal models, scientists are still studying how these results can translate to humans.
Muscle function
As the powerhouse of the body, mitochondrial function is crucial for our exercise performance. NAD+ is one of the keys to maintaining healthy mitochondria and steady energy output.
Increasing NAD+ levels in muscle can improve its mitochondria and fitness in mice. Other studies also show that mice that take NAD+ boosters are leaner and can run farther on the treadmill, showing a higher exercise capacity. Aged animals that have a higher level of NAD+ outperforms its peers.
Metabolic disorders
Declared as an epidemic by the World Health Organization (WHO), obesity is one of the most common diseases in modern society. Obesity can lead to other metabolic disorders such as diabetes, which killed 1.6 million people around the globe in 2016.
Aging and high-fat diet reduce the level of NAD+ in the body. Studies have shown that taking NAD+ boosters can alleviate diet-associated and age-associated weight gain in mice and improve their exercise capacity, even in aged mice. Other studies even reversed the diabetes effect in female mice, showing new strategies to fight metabolic disorders.
Heart function
The elasticity of the arteries acts as a buffer between pressure waves sent out by heartbeats. But arteries stiffen as we age, contributing to high blood pressure, the most important risk factors for cardiovascular disease. One person dies from cardiovascular disease every 37 seconds in the United States alone, CDC reports.
High blood pressure can cause an enlarged heart and blocked arteries that lead to strokes. Boosting NAD+ levels gives protection to the heart, improving cardiac functions. In mice, NAD+ boosters have replenished NAD+ levels in the heart to baseline levels and prevented injuries to the heart caused by a lack of blood flow. Other studies have shown that NAD+ boosters can protect mice from abnormal heart enlargement.
Neurodegeneration
By 2050, the world’s population aged 60 and older is projected to total 2 billion, nearly double the number of 2015, according to WHO. People worldwide are living longer. However, aging is the main risk factor for many neurodegenerative diseases including Parkinson’s disease and Alzheimer’s, causing cognitive impairment.
In mice with Alzheimer’s, raising the NAD+ level can decrease protein build up that disrupts cell communication and increases cognitive function. Boosting NAD+ levels also protects brain cells from dying when there’s insufficient blood flow to the brain. Many studies in animal models present new prospects of helping the brain age healthy and defend against neurodegeneration.
Does NAD+ increase lifespan?
Yes, it does. If you were a mouse. Increasing NAD+ with boosters, such as NMN and NR, can extend lifespan and healthspan in mice.
Increased NAD+ levels give a modest effect with extending lifespan in mice. Using the NAD+ precursor, NR, scientists find in a study published in Science, 2016, NR supplementation increases mice’s lifespan by roughly five percent.
Boosted NAD+ levels also confer protection against various age-related diseases. Protection against age-related diseases means living a healthier life for a longer period, increasing healthspan.
Tirzepatide
Tirzepatide is a once-weekly subcutaneous injectable peptide (approved by the Food and Drug Administration [FDA] for type 2 diabetes) engineered from the native GIP sequence, with agonist activity at both the GIP and GLP-1 receptors. Preclinical data demonstrated that the affinity of tirzepatide for GIP receptors was equal to the affinity of native GIP for GIP receptors, whereas tirzepatide bound GLP-1 receptors with affinity approximately five times weaker than native GLP-1 bound GLP-1 receptors. GIP activation appeared to act synergistically with GLP-1 receptor activation to allow greater weight reduction in mice than that achieved with GLP-1 receptor monoagonism. In phase 2 studies in people with type 2 diabetes, tirzepatide induced clinically relevant weight reduction, warranting further investigation for the treatment of obesity. The present trial, SURMOUNT-1, evaluated the efficacy and safety of tirzepatide in adults with obesity or overweight who did not have diabetes.
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In addition to treating Type 2 diabetes, tirzepatide has been shown to help with weight loss in people without diabetes. A clinical trial of over 2,500 people with obesity or overweight experienced significant weight loss with weekly tirzepatide. Those treated with tirzepatide had an average weight loss of 15% to 20% of their starting body weight over 72 weeks (about 16 and a half months). Those taking the placebo (an injection with no medication in it) only had an average of 3% weight loss.