What to Expect During Your First Medical Weight Loss Consultation in Ann Arbor

Why Medical Weight Loss Is Different From Dieting

Before we walk through the consultation itself, it is important to understand why medical weight loss is fundamentally different from commercial diet programs.

When you restrict calories through dieting alone, your body responds by reducing metabolic rate, increasing hunger hormones (particularly ghrelin), and decreasing satiety signals. This is why the vast majority of diets fail long-term: your biology is actively working against sustained weight loss.

Medical weight loss uses FDA-approved medications, comprehensive lab work, and ongoing clinical monitoring to work with your biology rather than against it. A landmark 2023 review published in JAMA confirmed that comprehensive, evidence-based obesity treatment combines behavioral interventions, nutrition, physical activity, pharmacotherapy, and metabolic procedures as appropriate for individual patients, with GLP-1 agonists and GIP/GLP-1 receptor agonists achieving approximately 8% to 21% weight loss (Elmaleh-Sachs et al., 2023).

Step 1: Scheduling and Pre-Visit Preparation

When you schedule your initial weight loss consultation at Arbour Longevity, you will receive instructions for pre-visit preparation:

• Medical history forms: Completed online or in-office, covering your health history, previous weight loss attempts, current medications, and family history
• Fasting instructions: You may be asked to fast for 8 to 12 hours before your appointment if lab work will be drawn the same day
• Medication list: Bring a current list of all medications and supplements you take
• Insurance card and ID: For verification and potential lab coverage
• Your goals: Think about what you want to achieve and any specific concerns you want to discuss

Step 2: Comprehensive Health History Review

Your consultation begins with a thorough health history review. Gandhi Bhattarai, FNP-BC, PMHNP-BC, Anti-Aging/Functional Medicine BC will spend time understanding not just your weight, but the full picture of your health:

• Weight history: When did weight gain begin? What has been your highest and lowest adult weight? What methods have you tried?
• Medical conditions: Diabetes or prediabetes, thyroid disorders, PCOS, sleep apnea, cardiovascular disease, joint problems, and mental health conditions
• Medications: Many common medications contribute to weight gain, including certain antidepressants, antipsychotics, beta-blockers, corticosteroids, and insulin. Identifying these is critical.
• Family history: Obesity, diabetes, cardiovascular disease, and metabolic conditions in your family
• Lifestyle factors: Sleep patterns, stress levels, physical activity, eating patterns, and relationship with food
• Previous weight loss attempts: What worked, what did not, and what was unsustainable

This is not a rushed conversation. Understanding your full story is essential for creating a treatment plan that actually works for your unique situation.

Step 3: Physical Assessment and Body Composition

Beyond stepping on a scale, your physical assessment includes:

• Weight and BMI: Baseline measurements for tracking progress
• Waist circumference: A key indicator of visceral (abdominal) fat, which is more closely linked to metabolic risk than total body weight
• Blood pressure: Hypertension is common in individuals with excess weight
• Body composition analysis: Understanding your ratio of lean muscle mass to body fat helps guide treatment decisions and track meaningful progress beyond the scale number
• Physical examination: Assessing for signs of metabolic dysfunction, thyroid abnormalities, hormonal imbalances, and other conditions that may contribute to weight gain

Step 4: Laboratory Testing

Comprehensive lab work is a cornerstone of medical weight loss. Your labs may include:

Lab results are typically available within a few days. If drawn during your first visit, Gandhi Bhattarai will review them with you at a follow-up appointment or via telehealth to finalize your treatment plan. A result that falls inside a standard reference range is not always an optimal result, which is why it helps to understand how optimal lab ranges differ from standard normal ranges.

Step 5: Medication Selection and Discussion

Based on your health history, physical assessment, and lab work, your provider will discuss medication options that are appropriate for your clinical profile. Currently available medical weight loss medications include:

GLP-1 Receptor Agonists

GLP-1 receptor agonists like semaglutide (Wegovy, Ozempic) work by mimicking a natural gut hormone that reduces appetite, slows gastric emptying, and improves insulin sensitivity. This drug class is also being studied for effects beyond weight management, a subject covered in our article on GLP-1 therapy and the longevity connection.

Dual GIP/GLP-1 Receptor Agonists

Tirzepatide (Zepbound, Mounjaro) targets both GIP and GLP-1 receptors, producing even greater weight loss in clinical trials. A 2025 phase 3 trial published in the New England Journal of Medicine found that tirzepatide produced 20.2% body weight reduction at 72 weeks compared to 13.7% with semaglutide (Aronne et al., 2025).

Other FDA-Approved Options

Depending on your profile, other options may include phentermine-topiramate (Qsymia), naltrexone-bupropion (Contrave), or phentermine alone for short-term use. Each medication has different mechanisms, side effect profiles, and considerations.

As reviewed by Nauck and D'Alessio in Cardiovascular Diabetology, the dual-agonist approach represents an unprecedented advancement in obesity pharmacotherapy, with a sizable proportion of patients achieving more than 10% body weight reduction (Nauck & D'Alessio, 2022).

Your provider will explain the benefits, risks, expected outcomes, and costs of each option so you can make an informed choice together.

Step 6: Nutritional Guidance and Lifestyle Planning

Medication is a powerful tool, but it works best as part of a comprehensive approach. During your consultation, you will discuss:

• Protein optimization: Adequate protein intake (typically 0.7 to 1.0 grams per pound of goal body weight) is critical for preserving lean muscle mass during weight loss
• Meal structure: Simple, sustainable approaches to meal timing and composition
• Hydration: Many patients on GLP-1 medications need deliberate hydration strategies
• Movement: A realistic exercise plan that prioritizes resistance training for muscle preservation and cardiovascular health
• Sleep: Poor sleep is a significant, often overlooked driver of weight gain and metabolic dysfunction
• Stress management: Chronic stress elevates cortisol, which promotes visceral fat storage

This is not about rigid meal plans or extreme dieting. It is about building sustainable habits that support your medical treatment and long-term health.

Step 7: Follow-Up Schedule and Accountability

Before you leave your first visit, you will have a clear follow-up plan:

• Week 1-2: Medication initiation check-in (phone or telehealth) to assess tolerance and address any side effects
• Week 4-6: First in-person follow-up with weight check, symptom review, and potential dose adjustment
• Monthly: Ongoing visits for the first 3 to 6 months to monitor progress, adjust medications, and provide support
• Quarterly: Lab work to ensure metabolic health is improving and medications are safe

This structured follow-up is what separates medical weight loss from handing someone a prescription. Consistent monitoring and adjustment are key to achieving and maintaining results.

Your $35 Consultation: The Next Step

At Arbour Longevity, your initial medical weight loss consultation is $35, applied toward your treatment plan. This includes your comprehensive health history review, physical assessment, body composition analysis, treatment plan discussion, and medication selection. Lab work, if ordered, is billed separately and is often covered by insurance.

This consultation is your opportunity to understand your options, ask questions, and decide whether medical weight loss is right for you. There is no obligation to start treatment the same day.

Frequently Asked Questions

Do I need to be a certain weight to qualify for medical weight loss?

Medical weight loss medications are generally indicated for adults with a BMI of 30 or greater (obesity), or a BMI of 27 or greater with at least one weight-related health condition such as type 2 diabetes, high blood pressure, or high cholesterol. During your consultation, your provider will assess your candidacy based on your complete health picture.

Will my insurance cover weight loss medication?

Insurance coverage for weight loss medications varies significantly by plan. Some plans cover GLP-1 medications when prescribed for obesity, while others exclude weight loss medications entirely. At Arbour Longevity, we can help you navigate insurance coverage and, when appropriate, explore compounded medication options that may be more affordable.

What are the side effects of GLP-1 medications?

The most common side effects are gastrointestinal: nausea, occasional vomiting, diarrhea, and constipation. These effects are typically mild to moderate, occur primarily during dose escalation, and often resolve as your body adjusts. Starting at a low dose and titrating slowly significantly reduces side effect severity. Your provider will guide you through this process.

How much weight can I expect to lose?

Results vary based on the medication used, your adherence to treatment, and lifestyle modifications. Clinical trials have shown average weight loss of 15% to 20% of body weight with GLP-1 and GIP/GLP-1 medications over 12 to 18 months. For a 250-pound individual, this could mean a loss of 37 to 50 pounds. Your provider will set realistic, personalized expectations during your consultation.

Is medical weight loss safe?

FDA-approved weight loss medications have undergone rigorous clinical trials involving tens of thousands of participants. When prescribed and monitored by a qualified provider, they are considered safe for appropriate candidates. Ongoing monitoring through regular visits and lab work ensures your treatment remains safe and effective over time.

Take the First Step

Your first medical weight loss consultation is about information, not pressure. It is a chance to understand the medical science behind your weight, explore treatment options, and decide on a path forward with the guidance of an experienced provider.

Schedule your $35 consultation at Arbour Longevity and take the first step toward sustainable, medically supervised weight loss in Ann Arbor.

References

According to PubMed, the clinical evidence cited in this article includes:

• Aronne LJ, et al. (2025). Tirzepatide as Compared with Semaglutide for the Treatment of Obesity. New England Journal of Medicine, 393(1), 26-36. DOI: 10.1056/NEJMoa2416394
• Nauck MA, D'Alessio DA. (2022). Tirzepatide, a dual GIP/GLP-1 receptor co-agonist for the treatment of type 2 diabetes with unmatched effectiveness. Cardiovascular Diabetology, 21(1), 169. DOI: 10.1186/s12933-022-01604-7
• Elmaleh-Sachs A, et al. (2023). Obesity Management in Adults: A Review. JAMA, 330(20), 2000-2015. DOI: 10.1001/jama.2023.19897