GLP-1 medications work on appetite signaling in the brain and on how quickly the stomach empties. They are effective, they are real medicine, and they carry real considerations: dosing that has to be titrated, side effects that need managing, contraindications that need checking, and effects on the body that are worth watching. That is the whole reason this sits with a physician rather than a subscription form.
Who this is for
When a GLP-1 is not appropriate
These medications are not for everyone, and part of the consultation is establishing that.
- A personal or family history of medullary thyroid carcinoma, or multiple endocrine neoplasia type 2.
- A history of pancreatitis, which changes the risk calculation and needs discussion.
- Pregnancy, breastfeeding, or planning pregnancy. These medications are stopped in advance of conception.
- Active gallbladder disease, severe gastrointestinal disease, or gastroparesis.
- A history of an eating disorder, where appetite suppression can do harm rather than good.
Your history and your medication list are reviewed before anything is prescribed.
Branded medication, not compounded
What is prescribed here is branded, FDA-approved medication through normal pharmacy channels. Not compounded semaglutide, not vials from a research chemical supplier, not a peptide blend sold as a cheaper equivalent.
That is worth stating plainly, because the compounded GLP-1 market that grew during the 2023 and 2024 shortages no longer has the legal footing it had. Semaglutide and tirzepatide both came off the FDA shortage list in 2025, and with that the exception permitting routine copying of an approved drug expired. Bulk-stocked compounded GLP-1 is now among the most enforced-against practices in this field, and it was never subject to the manufacturing oversight the branded products go through.
There are now several approved options, injectable and oral, which means the conversation is about which one fits your history rather than what happens to be in stock.
What weight loss does to the face
Rapid weight loss takes fat from the face along with everywhere else, and the face is where people notice it. Temples and cheeks hollow, the midface loses the support the skin above it was resting on, and the result reads as aging rather than as thinness.
Most weight programs do not mention this until a patient raises it, and most aesthetic practices treat it after the fact without knowing the medication history. Here both sit in the same place. Facial change is assessed as part of your follow-up, and if it needs treating, collagen stimulation addresses the structural side rather than only filling what looks empty.
What the program is like
- First visit
- History, examination, and a decision about whether this is appropriate.
- Baseline labs
- Metabolic panel, A1c, lipids and thyroid before starting.
- Medication
- Branded FDA-approved product, filled at your pharmacy.
- Dosing
- Started low and titrated on a schedule, adjusted to how you tolerate it.
- Follow-up
- Scheduled visits with Dr. Mundluru, not asynchronous refills.
- Repeat labs
- On a set interval while you are on treatment.
- Facial assessment
- Part of follow-up, so volume change is caught early.
- Duration
- Ongoing. These medications work while they are taken.
Most side effects appear in the first weeks and during dose increases, and most are manageable with timing and titration rather than by stopping. That is what the follow-up visits are for.
Before, during and after
Open any of these to read it before booking, or again when you start.
Common questions
Do you prescribe compounded semaglutide?
No. Only branded, FDA-approved medication filled through a normal pharmacy. When semaglutide and tirzepatide came off the FDA shortage list in 2025, the legal exception that had permitted routine compounded copies expired. Beyond the legal position, compounded versions were never held to the manufacturing standards the approved products meet, and there have been documented dosing errors with them. If cost is the obstacle, that is worth discussing directly rather than solving with a cheaper vial.
Which medication will I be on?
That is decided at consultation. There are now several FDA-approved options, weekly injectables and daily tablets, and they differ in how they are taken, how they are tolerated and what they cost you. Your medical history, any diabetes, what you have tried before and what your insurance covers all feed into it.
Will my face change?
Often, yes, and it is one of the more common regrets people report. Fat is lost from the temples, cheeks and midface along with everywhere else, and the face can read as older rather than slimmer. It is assessed at your follow-up visits here rather than left for you to notice in a photograph. If it needs treating, collagen stimulation addresses the loss of structure rather than simply filling the hollow.
How bad are the side effects?
Nausea, reflux, constipation and fatigue are the common ones, and they cluster in the first weeks and after each dose increase. Most are manageable by adjusting how fast the dose goes up, when you take it, and how you eat. Going up too quickly is the usual reason someone has a miserable time, and it is avoidable. Less common but more serious problems, including pancreatitis and gallbladder disease, are what the follow-up and the lab work are watching for.
What happens if I stop?
Appetite returns, and for most people weight follows. These medications treat an ongoing condition while they are being taken, in the same way blood pressure medication does. That is not a failure of willpower and it is worth understanding before you start, because it shapes how you think about cost and about how long you plan to be on treatment. Stopping is a decision made with a plan, not by running out of medication.
Do I need labs?
Yes. A metabolic panel, A1c, lipids and thyroid before starting, and repeat testing on a schedule while you are on treatment. This is how you find out whether the metabolic picture is actually improving, rather than only watching the scale, and it is how problems get caught early. Anyone prescribing a GLP-1 without baseline labs is not managing your health, they are filling an order.
Can I get this if I am already on a GLP-1 from somewhere else?
Yes. Bring what you are taking, your dose, how long you have been on it and any labs you have. Plenty of people are prescribed these with no follow-up at all, and want the monitoring, the dose management and the facial change handled properly.
Is this covered by insurance?
Coverage for weight loss medication varies widely by plan and changes often, and coverage for the same drug prescribed for diabetes is usually different from coverage for weight. What we can do is document the clinical picture properly, which is what any prior authorization depends on. What it costs you is worth checking with your plan before your first visit.
This page is for general education and is not medical advice. It does not establish a physician-patient relationship, and it cannot account for your individual history, medications or skin. Suitability for treatment is decided at consultation following examination.