Philadelphia, PA
Medical Weight Loss
What we prescribe, and why
We use tirzepatide, a dual GIP and GLP-1 receptor agonist sold under the brand names Mounjaro and Zepbound. It is dispensed here in the office, and we can also send a prescription to a mail-order pharmacy.
Tirzepatide acts on two gut hormone receptors rather than one, and in the first head-to-head trial against semaglutide it produced greater average weight loss over 72 weeks — about 20% versus 14%. That is the reason it is what we stock.
Your program is managed by Dr. Ghavami or Dr. Raneiro. At every visit we weigh you and measure your BMI and body fat percentage, and the next dose is decided from those numbers and from how you are tolerating the current one — increase, hold or taper. That is the difference between a medical weight loss program and a storefront that dispenses a pen.
What the evidence actually shows
This is one of the few areas in aesthetic and wellness medicine where the evidence is genuinely strong, and it is worth being specific rather than vague.
In the SURMOUNT-1 trial — 2,539 adults with obesity, randomized and placebo-controlled, published in the New England Journal of Medicine — average weight loss at 72 weeks was 16% at 5 mg, 21% at 10 mg and around 21% at 15 mg, against roughly 3% on placebo.
The three-year follow-up matters more, because the question everyone actually has is whether it lasts. At 176 weeks, average weight change was −18.7% at 10 mg and −19.7% at 15 mg, against −1.3% on placebo. In participants who also had prediabetes, progression to type 2 diabetes was substantially delayed.
Those are trial averages, not predictions about you. But they are real numbers from real trials, and we would rather quote them than talk about transformation.
How we actually run the program
The medication is the easy part. How it is used is what separates a good outcome from a poor one, and there are four things we do differently from a program that simply mails you a pen.
We aim for four to six pounds a month, not more. Faster is not better. Rapid weight loss is reliably followed by rapid regain, and it is harder on your muscle mass and on your skin. Steady loss also gives skin time to contract as you go, which is a large part of why some people finish this process looking well and others finish it looking deflated.
We do not raise your dose just because the schedule says so. If you are losing weight comfortably at a lower dose, there is no reason to climb. Many programs titrate on autopilot toward the maximum, which costs you more, increases side effects and gains nothing. We hold at the lowest dose that is working.
We plan the exit from the start. When you reach your goal, we taper deliberately rather than stopping abruptly. The habits built while the medication is doing the heavy lifting — how you eat, how you train, how you shop — are what carry the result afterward. That is the point of the time on treatment, not just the number on the scale at the end of it.
We will keep talking to you about exercise. Resistance training in particular. It is not a footnote and it is not optional if you want to keep what you gain from this.
Why the weight room matters more than you think
Weight lost on GLP-1 medication is not all fat. A body-composition substudy within SURMOUNT-1 scanned 160 of the 2,539 participants and found that roughly three quarters of the weight lost was fat and about one quarter was lean tissue.
Two honest notes about that figure. It is a favourable ratio, but it is not zero lean tissue. And the same rough three-to-one split appeared in the placebo group, which tells you it reflects how weight loss works generally rather than anything special the drug is doing to protect muscle. Losing muscle alongside fat is a real concern, particularly in older patients.
Muscle is also metabolically active tissue, and keeping it is a large part of why some people maintain their loss and others regain. The goal here is not simply a smaller version of you — it is a metabolism that works better, supported by habits that hold once the medication stops.
This is also why we track body fat percentage rather than weight alone. The scale cannot tell you whether the pound you lost this week was fat or muscle, and those are very different outcomes.
What achieves that is unglamorous: adequate protein, resistance training two or three times a week, fewer empty calories, and not titrating faster than you need to. We will talk about all of it, because a patient who ends up lighter and weaker has not had a good outcome.
When testosterone is part of the picture
For male patients, this is worth raising rather than leaving unsaid. Low testosterone and excess weight reinforce each other: adipose tissue converts testosterone to estradiol, and low testosterone makes lean mass harder to build and hold. Men doing the training and eating properly who still find their body composition immovable are sometimes fighting that loop rather than a lack of effort.
It runs the other way too. For a meaningful number of men, losing the weight raises testosterone on its own and no replacement is needed — which is exactly the sort of thing we would rather find out than assume.
Because we are a physician practice, checking is straightforward. If it turns out to be relevant, testosterone replacement therapy is managed here with proper diagnosis and monitoring rather than being someone else's prescription.
Two ways to get your medication
Dispensed in the office. You collect it here, and the monthly cost varies with your dose, since higher doses cost more to supply. That is the simplest route and the one most of our patients use.
Sent to a mail-order pharmacy. We can prescribe to LillyDirect or another mail-order pharmacy, and you pay the pharmacy directly for the medication. In that case you pay us only a consultation fee, roughly every two months, for refills or dose adjustments.
Either way we do not handle prior authorizations — we are a cash-pay practice. Most mail-order pharmacies accept HSA and FSA cards, which is usually the more practical route than pursuing insurance, and the office visit itself is generally an eligible HSA or FSA expense too.
What the monthly fee includes
For in-office dispensing, the monthly cost covers four weeks of medication and the visit — not the medication with the appointment billed separately.
That visit is where the program actually happens: weight, BMI and body fat percentage measured, a decision on whether to titrate or hold, side effects managed, and the rest of your health looked at rather than only the scale.
Side effects, and who should not take it
Nausea is the common one, along with constipation, diarrhea, reflux and reduced appetite to the point of forgetting to eat properly. Most of it is dose-related and manageable by titrating slowly — which is the main argument for having a physician involved rather than escalating on a fixed schedule.
It is not appropriate for everyone. A personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 is a contraindication. Pregnancy, a history of pancreatitis, significant gastroparesis and certain gallbladder disease all need discussing before starting.
What happens if I stop?
Weight tends to return when treatment stops abruptly and nothing has changed underneath it. That is not a failure of the drug — it is what happens when you stop treating a chronic condition without having built anything in its place.
It is also why we taper rather than stop, and why the habits matter. The three-year figures above are encouraging, but it is worth reading them carefully: they describe people who stayed on treatment for three years, not people who came off it.
Skin after significant weight loss
Losing 20% of your body weight changes how your skin sits. Losing it steadily helps — skin contracts far better over months than over weeks, which is one of the practical arguments for the pace we aim for.
Where it does not fully keep up, Morpheus8 Body is what we use to help you settle into the body you have worked for. It is a conversation for later in the process rather than something to plan at the outset, but it is worth knowing it exists — and that having both under one roof means nobody has to start over explaining their history.
Further reading
Why choose PhillyMedClub for medical weight loss in Philadelphia?
We prescribe tirzepatide, a dual GIP and GLP-1 receptor agonist, and we dispense it here in the office or send the prescription to a mail-order pharmacy — your choice. The monthly fee covers the medication and the visit rather than the medication alone. We do not raise your dose because a schedule says so: if you are losing weight comfortably where you are, we hold there, because titrating on autopilot toward the maximum costs you more, increases side effects and gains nothing. We quote the trial numbers rather than talking about transformation — around 21% average weight loss at 72 weeks in SURMOUNT-1 — and we are clear those are trial averages, not predictions about you. Physician-managed, in Fishtown, Philadelphia.
Tirzepatide (GLP-1) is the most effective tool currently available for sustained fat loss, including the visceral fat that resists diet and exercise. We manage dose titration, side effects and protein intake to protect muscle — and we will push you toward the weight room, because that is what decides whether you end up leaner or just lighter.
Frequently combined with Morpheus8 Body once significant weight has come off, when skin quality rather than weight becomes the concern. Because we are a physician practice, hormonal and metabolic contributors get looked at as part of the picture rather than ignored.
Frequently asked questions
What is the difference between semaglutide and tirzepatide?
Tirzepatide acts on two receptors — GIP and GLP-1 — while semaglutide acts on GLP-1 alone. In the first head-to-head trial, tirzepatide produced greater average weight loss over 72 weeks. That is why tirzepatide is what we dispense in the office, though the right choice still depends on your health history, your tolerance and what your insurance covers.
What are the side effects?
Nausea is the common one, along with constipation, diarrhea, reflux and appetite reduction to the point of under-eating. Most of it is dose-related and settles as your body adjusts. It is also the main reason we titrate slowly and hold at a dose that is working rather than climbing on a fixed schedule — side effects are often a sign of moving too fast rather than of the medication being wrong for you.
How much weight can I expect to lose?
In the SURMOUNT-1 trial, average weight loss at 72 weeks was around 21% of body weight at the 15 mg dose. At three years it was about 20%. Those are averages from a trial, not a promise — individual results vary with starting weight, dose tolerated, diet, activity and how long you stay on treatment.
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