Frequently Asked Questions
Getting Started
How does the virtual weight loss program work?
Our virtual program is designed for adults interested in medical weight management with GLP-1 or GLP-1/GIP medications. Care is provided through online forms, email communication, prescription review, progress monitoring, and ongoing support. Routine in-person visits, Zoom visits, and phone appointments are not part of the program. Most care is handled conveniently through online forms and email communication.
How do I start?
Start by completing the new patient intake forms. After your forms are received, our office will email you a payment link for the $249 new patient fee. Dr. Garza will review your medical history, determine whether treatment is appropriate, answer your questions, and discuss medication options that may fit your goals, medical history, and budget.
Who is eligible for the program?
Our program is intended for adults 18 and older who meet appropriate medical criteria for weight management treatment. Eligibility is based on several factors, including BMI, medical history, current medications, prior treatment response, safety considerations, and treatment goals. You do not necessarily need to meet every listed criterion to qualify, but your information must be reviewed before treatment can be approved.
What if my BMI is under 27?
Eligibility depends on several factors, including your current BMI, starting BMI, weight history, medical conditions, treatment goals, and prior response to medication.
Some patients may still be appropriate for continued treatment as part of long term weight maintenance, especially if they previously met criteria and have had successful weight loss on medication. Our team will review your history and help determine whether GLP treatment or another option is appropriate for you.
What if I have sleep apnea?
Please let our office know if you have been diagnosed with obstructive sleep apnea or if you are being evaluated for sleep apnea. Weight loss may help improve sleep apnea symptoms for some patients, and Zepbound® is FDA approved to treat moderate-to-severe obstructive sleep apnea in adults with obesity when used along with a reduced-calorie diet and increased physical activity.
What are other FDA-approved indications for GLP medications?
FDA-approved uses vary by medication and brand. In addition to weight management, certain GLP or GLP/GIP medications may also be FDA-approved for conditions such as type 2 diabetes, cardiovascular risk reduction, obstructive sleep apnea in adults with obesity, chronic kidney disease risk reduction in certain patients with type 2 diabetes, and MASH, a form of fatty liver disease.
Do I have to live in Texas?
Our program primarily serves Texas patients. Some pharmacy options may be available for patients outside of Texas depending on the pharmacy, shipping rules, and state-specific requirements. In some cases, a Texas address may need to be on file with the pharmacy.
What if I want phentermine instead of injections?
Our virtual program focuses on GLP-1 and GLP-1/GIP medications. If you are mainly looking for a long-term weight loss program that uses phentermine, another clinic or program may be a better fit.
Do you offer in-person appointments?
No. This is a virtual program. Communication is primarily handled by email and online forms so that treatment plans, refill requests, and follow-up information are documented clearly.
Can I call the office with questions?
Email is the best way to contact us because it allows us to review your chart and respond more accurately. You may call during regular business hours, but many questions may still require email follow-up.
How quickly will I receive a response?
Please allow up to 3 business days for a response. We often respond sooner, but response times may vary depending on message volume, refill requests, pharmacy issues, prior authorizations, and clinical review needs.
Medication Options
What medications do you prescribe?
We prescribe selected weight-loss medications when clinically appropriate. Options may include injectable or oral brand-name medications such as Zepbound®, Wegovy®, Wegovy® pill, Mounjaro®, Ozempic®, or Foundayo™, as well as compounded options through selected pharmacies when appropriate, including semaglutide, tirzepatide, retatrutide, and retatrutide/tirzepatide combination therapy.
The best option depends on your medical history, treatment goals, insurance coverage, cost preference, medication availability, and how well you tolerate treatment.
How do GLP-1 medications help with weight loss?
These medications work by affecting appetite, fullness, cravings, and how the body responds to food. Many patients feel full sooner, have less food noise, and are able to eat smaller portions more comfortably.
How are semaglutide, tirzepatide, and retatrutide different?
Semaglutide, tirzepatide, and retatrutide are all GLP-1 medications used for weight management, but they work on different hormone pathways.
Semaglutide works mainly on the GLP-1 pathway, which helps reduce appetite, improve fullness, and support blood sugar regulation.
Tirzepatide works on both GLP-1 and GIP pathways, which may lead to stronger appetite control and weight loss for some patients.
Retatrutide is a newer investigational option that works on GLP-1, GIP, and glucagon pathways. Because it targets three pathways, it is sometimes referred to as a “triple agonist.” Retatrutide is not FDA-approved at this time and is still being studied in clinical trials.
The best choice depends on your medical history, weight-loss goals, response to treatment, side effects, medication tolerance, availability, and cost.
Which medication is best for me?
There is no one-size-fits-all answer. The best option depends on your medical history, BMI, prior medication use, insurance coverage, budget, side effect history, and weight loss goals. Dr. Garza will review your intake forms and provide guidance on appropriate options.
Can I switch medications later?
Yes. Medication changes may be considered if you are not responding well, having side effects, dealing with cost or coverage issues, or if another option becomes more appropriate for your situation.
Are brand-name medications stronger than compounded medications?
Brand-name medications are FDA-approved and manufactured under standardized commercial drug approval processes. Compounded medications are not FDA-approved and may vary by pharmacy, formulation, and concentration.
What other peptides do you prescribe?
At this time, we do not prescribe additional peptides outside of selected injectable weight loss medications when clinically appropriate.
What other supportive treatments do you prescribe?
Dr. Garza may discuss selected supportive treatments when clinically appropriate. Options may include Zofran®/ondansetron for nausea, MIC/lipo injections, vitamin B12, or other carefully selected adjunctive therapies.
These treatments are not required for weight loss and are not appropriate for every patient. Recommendations depend on your medical history, current medications, symptoms, goals, and overall treatment plan.
Insurance, Pricing, and Fees
Does your office accept insurance?
No. Our professional service fees are self-pay. Patients may still use insurance separately for brand-name medications if their plan covers the prescribed medication.
Does insurance cover weight loss medications?
Insurance may cover certain brand-name medications such as Zepbound®, Wegovy®, or Foundayo, depending on your plan’s requirements. Coverage varies widely by insurance plan. Even if a medication appears on your formulary, your plan may still require a prior authorization or may exclude weight loss medications.
Do you complete prior authorizations?
Yes, when appropriate. We complete prior authorizations for weight management
medications when patients are enrolled in the program and the medication is FDA-approved. Prior authorization approval is determined by your insurance plan and cannot be guaranteed.
medications when patients are enrolled in the program and the medication is FDA-approved. Prior authorization approval is determined by your insurance plan and cannot be guaranteed.
Can you check my insurance coverage before I enroll?
No. We cannot check medication coverage or complete prior authorizations for patients who are not enrolled. If you decide to move forward, you may upload your insurance information during the intake process so we can review coverage options when appropriate.
Are medication costs included in the program fee?
No. Program fees cover professional services related to your care. Medication costs are paid separately to the pharmacy or through your insurance plan, depending on the medication selected.
What is included in the new patient fee?
The new patient fee covers review of your intake forms, medical history review, medication eligibility review, treatment planning, prescription submission when appropriate, and the first 3 months of professional services through our virtual program. Medication costs are not included.
Why do you charge a monthly membership fee after the first 3 months?
The monthly membership covers ongoing professional services for established patients who continue treatment beyond the first 3 months. This includes refill review, dose adjustment review when appropriate, progress monitoring, email based support, and continued access to prescription renewals through our office. The easiest way to think of this fee is that it is similar to the cost of monthly office visits for medication refills, but handled virtually.
Does the monthly membership include medication?
No. The monthly membership covers professional services only. Medication costs are paid separately to the pharmacy.
Can I cancel the monthly membership?
Yes. You may cancel at any time by contacting our office. There are no long-term commitments.
Are there hidden fees?
No. We believe pricing should be clear from the beginning. Program fees and medication costs are separate, and we do not upcharge GLP-1 medications from
compounding pharmacies.
compounding pharmacies.
Prior authorizations are included when the medication is being prescribed for an FDA-approved weight management indication. If a medication is being used off label, a $25 prior authorization fee may apply, and we will explain this before charging the fee.
Can I use HSA or FSA funds?
Many patients choose to use HSA or FSA funds for eligible medical expenses. We can provide documentation when appropriate, but reimbursement rules depend on your plan.
What is the Medicare GLP-1 Bridge Program?
The Medicare GLP-1 Bridge is a temporary CMS program that may allow eligible Medicare Part D patients to access certain weight-loss medications for a flat $50 monthly copay.
The program runs from July 1, 2026 through December 31, 2027 and operates outside the usual Part D coverage process. Eligibility, medication options, and prior authorization requirements are determined by Medicare.
The $50 medication copay is separate from our program fees.
Refills and Ongoing Care
Are refills automatic?
No. Refills are not automatic. You are responsible for requesting refills when needed.
How early should I request a refill?
Please request refills at least 2 weeks before you run out of medication. Waiting until the last minute may lead to a lapse in treatment, especially if the pharmacy needs time to process, compound, ship, or obtain insurance approval.
What should I do if I have refills remaining?
If you have remaining refills on an active prescription, contact the pharmacy directly and provide the RX number printed on your medication box, vial, bag, or prescription label.
Why does my new prescription have a different RX number?
Each medication strength or dose may be processed as a separate prescription. If your dose changes, your pharmacy may assign a new RX number. This is normal and does not necessarily mean there is a problem.
How often do I need to complete a Progress Report?
Progress Reports are required approximately every 3 months. These reports help us review your weight changes, medication response, side effects, dose needs, and overall progress before continuing treatment.
What happens after the first 3 months?
After the first 3 months, patients who want to continue prescription renewals through our office must maintain an active monthly membership and submit a Progress Report every 3 months. Refill requests cannot be approved until both requirements have been met.
Can my dose be increased?
Dose increases are considered based on your progress, hunger control, cravings, side effects, and overall response to treatment. Higher doses are not always necessary. Our goal is to use the lowest effective dose that supports safe, steady progress.
Can I stay on a lower dose longer?
Yes. Many patients do very well staying on a lower dose for longer. If your appetite is controlled, weight is trending down, and side effects are minimal, staying at the same dose may be appropriate.
Can my dose be lowered?
Yes. Your dose may be lowered if you are having side effects, losing weight too quickly, nearing your goal weight, eating too little, or needing a more gradual approach.
Pharmacies, Shipping, and Medication Access
Which pharmacy will fill my prescription?
This depends on the medication selected, your location, insurance coverage, pharmacy availability, and cost preference. Brand-name prescriptions are usually
sent to retail or mail-order pharmacies. Compounded medications may be sent to selected compounding pharmacies that ship directly to patients.
sent to retail or mail-order pharmacies. Compounded medications may be sent to selected compounding pharmacies that ship directly to patients.
Do you prescribe to compounding pharmacies?
Yes, when clinically appropriate. We may prescribe to compounding pharmacies that accept Texas prescribers and meet our office’s review standards. Pharmacy pricing, processing times, shipping rules, and refill procedures are set by the pharmacy, not our office.
How long does it take to receive my medication?
Timing depends on the pharmacy. Some retail prescriptions may be filled quickly if the medication is in stock. Compounded prescriptions may require additional processing and shipping time. Please plan ahead.
What if the pharmacy texts me?
Many pharmacies communicate by text for payment, approval, shipping, and refill confirmation. Please respond promptly so your prescription is not delayed.
What if my medication is out of stock?
Medication availability changes often. If your pharmacy does not have your medication in stock, you may contact nearby pharmacies or let our office know if you want to discuss alternatives.
Can I have medication shipped to me if I live in another state?
Some pharmacies may be able to ship to patients outside of Texas depending on their policies and state rules. In some cases, the pharmacy may require a Texas address on file.
What about medication from Canada?
Some patients choose to use legitimate Canadian pharmacies for certain brand name medications. If appropriate, our office can provide a prescription for the patient to submit to the pharmacy. Our office does not control outside pharmacy pricing, processing times, medication availability, or dispensing policies.
Compounded Medications
Are compounded medications FDA-approved?
No. Compounded medications are not FDA-approved. This means they are not reviewed by the FDA for safety, effectiveness, or quality before they are dispensed in the same way commercially manufactured brand-name medications are reviewed.
Are compounded medications safe?
Compounded medications should only be obtained from appropriate pharmacies and used under medical supervision. As with any medication, there are potential risks. We review your medical history and monitor your response to help determine whether treatment remains appropriate.
Why would someone use a compounded medication?
Compounded medications may be considered when a commercially available medication is not accessible, affordable, covered by insurance, tolerated, or otherwise appropriate for a patient’s specific situation. This is reviewed on a case-by-case basis.
Does insurance cover compounded semaglutide or tirzepatide?
In general, insurance does not cover compounded semaglutide or tirzepatide. Patients typically pay the pharmacy directly.
How do I know which compounded dose I am taking?
Always follow the instructions on your prescription label and dosing instructions from our office. Compounded medication concentrations may vary by pharmacy, so do not compare units or dosing instructions from another patient, pharmacy, or online source.
Labs, Safety, and Side Effects
Are labs required?
Labs are not automatically required for every patient before starting semaglutide or tirzepatide. However, labs may be recommended depending on your medical history, current conditions, medications, symptoms, or treatment plan. We encourage patients to continue regular visits and blood work with their primary care provider.
Who should not use GLP-1 medications?
These medications may not be appropriate for everyone. Patients with certain medical histories, medication interactions, pregnancy, breastfeeding, specific endocrine conditions, or prior serious reactions may not be eligible. Your intake forms are reviewed carefully before treatment is approved.
What are common side effects?
Common side effects may include nausea, constipation, diarrhea, reflux, bloating, fatigue, headache, decreased appetite, or feeling full quickly. Side effects are often dose-related and may improve with slower dose changes, smaller meals, hydration, and dietary adjustments.
What if I have hair loss?
Hair shedding can happen during weight loss, especially with rapid weight loss, reduced calorie intake, low protein intake, stress, or vitamin and mineral deficiencies. This type of shedding is often temporary, but it can still feel frustrating.
What symptoms should I report right away?
Please contact our office promptly if you have severe or persistent vomiting, severe abdominal pain, signs of dehydration, inability to keep fluids down, allergic reaction symptoms, or symptoms that feel concerning or unusual.
What should I do if I have an urgent medical issue?
If you are experiencing a medical emergency, severe symptoms, chest pain, trouble breathing, signs of a severe allergic reaction, severe abdominal pain, or symptoms that feel urgent, do not wait for an email response. Seek urgent care or emergency care right away.
Can I drink alcohol while taking these medications?
Alcohol may worsen nausea, reflux, dehydration, or low appetite. Many patients tolerate small amounts, but we recommend caution, especially when starting treatment or increasing doses.
Can I travel with my medication?
Yes. Keep medication in its original packaging with the prescription label when possible. Avoid extreme temperatures, direct sunlight, and leaving medication in a hot car or checked luggage.
Does medication need to be refrigerated?
Storage instructions depend on the medication and pharmacy. Please follow the storage instructions printed on your medication label or pharmacy insert. If you are unsure, contact the pharmacy directly.
How do I dispose of needles or syringes?
Used needles and syringes should be placed in an appropriate sharps container. Do not throw loose needles directly into the trash.
Results, Lifestyle, and Long-Term Treatment
How much weight loss can I expect?
Results vary. Some patients lose a significant amount of weight, while others respond more gradually. Your response may depend on medication choice, dose, consistency, nutrition, physical activity, sleep, medical history, and how your body responds to treatment.
How long does it take to see weight loss?
Some patients notice appetite changes within the first few weeks. Weight loss may begin early for some patients, while others see more noticeable changes after dose adjustments over time.
What factors affect weight loss results?
Several factors can affect results, including starting weight, medication response, dose tolerance, protein intake, hydration, physical activity, sleep, stress, consistency, and other medical conditions.
Do I still need lifestyle changes?
Yes. Medication can be a powerful tool, but nutrition, hydration, protein intake, movement, sleep, and long-term habits remain important. Lifestyle changes help support better results and long-term weight maintenance.
What should I eat while taking GLP-1 medications?
Focus on protein, hydration, fiber, and smaller balanced meals. Avoid forcing large meals, but do not skip nutrition completely. Eating too little can worsen fatigue, nausea, constipation, hair shedding, and muscle loss.
Do I need to exercise?
Exercise is strongly encouraged, especially strength training or resistance exercise. Weight loss without muscle preservation can lead to muscle loss, so movement and adequate protein are important parts of long-term success.
What if I stop losing weight?
Plateaus are common. We may review your dose, nutrition, protein intake, activity level, medication consistency, sleep, stress, and other factors before deciding whether a dose adjustment is appropriate.
What if I am losing weight too quickly?
Please contact our office. Your dose may need to be adjusted, held longer, lowered, or spaced out depending on your symptoms and progress.
What happens if I stop the injections?
Some patients regain weight after stopping medication because the appetite and metabolic pathways affected by the medication are no longer being supported. We encourage patients to continue healthy nutrition, regular activity, and long term maintenance planning.
Will I have to use injections forever?
Many patients need long-term treatment to maintain results, just as many chronic medical conditions require long-term management. This does not always mean staying on the same dose forever. Some patients transition to a lower dose, a maintenance plan, or a longer interval between injections.
What is maintenance treatment?
Maintenance treatment means using the lowest effective plan to help maintain weight loss after you reach or approach your goal. This may involve staying on the same dose, lowering the dose, spacing out injections, or making other adjustments based on your progress.
Can semaglutide and tirzepatide help maintain weight loss long term?
These medications may help support long-term weight management for many patients when used consistently and combined with sustainable lifestyle habits. Long-term plans are individualized.
What makes this program different?
Our program is designed to be practical, medically guided, and flexible. We focus on individualized treatment planning, safe dose adjustments, realistic maintenance strategies, and helping patients choose options that fit their goals, budget, and medical needs.
Account, Cancellation, and Returning Patients
Can I cancel the program?
Yes. There are no long-term commitments. You may cancel by contacting our office or completing the cancellation process provided by our team.
If I cancel, can I come back later?
Yes. Established patients may be able to return without starting completely over, depending on how long it has been, current medical history, medication status, and program requirements at that time.
What if I have a balance on my account?
Any outstanding balance must be paid before prescription renewals, dose changes, or ongoing services can continue.
What if I have more questions?
Please email our office. For the fastest response, include your full name, date of birth, medication name, current dose, pharmacy, and a brief description of what you need.