Frequently Asked Questions

At Cedar Weight Loss, we do not require a long-term membership for care. Visits are purchased on a month-to-month basis, offering you complete flexibility. Your initial payment includes a 60-minute intake, labs, 30-60 minute follow-up (planning session), initial medication management/prescriptions and access to a video-based nutrition and lifestyle course created by a licensed Registered Dietician for your success, including a monthly online support group. 

For the best outcomes, we recommend consistent monthly check-ins. Regular follow-up is a cornerstone of successful weight management, providing ongoing support, tracking progress, and allowing us to make any necessary adjustments to your treatment plan. This consistent monitoring helps you stay motivated, navigate challenges, and build lasting, healthy habits for sustainable results.

We do NOT prescribe compounded GLP-1 medications at Cedar Weight Loss. Although compounded GLP-1s may be effective for many, and are often less expensive, I prioritize patient safety and efficacy above all else and only prescribe FDA-approved GLP-1 medications. Here are the primary concerns with compounded GLP-1:

• Lack of FDA Oversight: Compounded GLP-1s, such as those containing semaglutide or tirzepatide, are not FDA-approved. The FDA does not verify their safety, effectiveness, or manufacturing quality. Although there are many medications that can be compounded with an FDA-approved molecule (like hormones, naltrexone, antibiotics and others), this is not the case for these GLP-1 medications yet. 
• Unknown Efficacy and Purity: I cannot guarantee the purity, potency, or stability of a compounded drug. This means the medication may not contain the advertised dose, may be less effective, or could even contain harmful impurities.
• Legal and Regulatory Risks: The use of compounded versions of GLP-1 drugs has been the subject of regulatory scrutiny and legal challenges. I choose to avoid this uncertainty to protect myself and my patients.

At Cedar Weight Loss, you receive a structured and personalized path to help you achieve your goals. Our approach is comprehensive and designed for both immediate results and long-term success. Here's how we help you lose weight:

• Personalized Treatment Plan: After a thorough review of your health history, we will have an in-depth discussion about your health goals and what is right for you. We will work together to decide on appropriate weight loss medication options. 
• Customized Nutrition Support: Receive expert nutrition and lifestyle guidance, including through a specialized course and monthly online support groups that are designed and led by a Registered Dietitian with decades of experience in weight management and metabolic health. 
• Exercise and Activity Planning: We'll help you integrate a realistic and effective physical activity plan into your routine, focusing on activities you enjoy to ensure long-term success. Physical activity is a crucial component of long-term, sustained weight management. 
• Ongoing Clinician Support: You nurse practitioner is committed to building a lasting relationship with you—working together to reach your short-term goals and supporting you every step of the way toward long-term health and well-being. 

At Cedar Weight Loss, we believe in a highly personalized and medically comprehensive approach to your health journey. Here we are focused on your overall health and quality of life, not a number on a scale. Here's what sets us apart:

• Experienced, One-on-One Care: You will work directly with a very experienced Family Nurse Practitioner (FNP). This means you receive individualized attention and a treatment plan tailored specifically to you, your health conditions and preferences, not a one-size-fits-all approach. 
• Holistic Health Assessment: Your clinician's extensive experience allows her to see the bigger picture of your health. Before developing any weight loss plan, she will take the time to understand all of your existing health conditions, current medications and goals.
• Safety-First Approach: Our comprehensive review is crucial for your safety. Our practitioner can identify potential medication interactions, anticipate and help manage possible side effects, and ensure your weight management plan complements your overall health, rather than complicating it. Baseline and occasional monitoring lab work will be required.
• Access to Supportive Resources: From nutrition and meal planning to physical activity and behavior change tools, we’ll help you find the right mix of resources to support your goals. 
• Limited patient panel: Our commitment is to your well-being, providing expert guidance that is both effective and safe. We accept a very limited number of new patients every month to ensure you receive high quality care and support.

This is a common and important question. We approach overweight and obesity as chronic medical conditions, much like high blood pressure, high cholesterol, or diabetes. For these conditions, long-term management is often necessary to maintain health and prevent complications. Treatment does not stop or end once the condition is in control, but rather it continues to prevent relapse or complications.

Thus, long-term treatment is generally recommended to help you sustain your weight goal. This treatment may or may not include the long-term use of medications.

Our goal is to work with you to find a sustainable solution. We will continuously monitor your progress and health status. Decisions about your long-term plan—including the use of medication—will be made together, based on your preferences, individual needs and goals.

A DXA (Dual-Energy X-ray Absorptiometry) scan is the "gold standard" for measuring body composition. Using a low-dose X-ray, this differentiates between fat mass, lean muscle, and bone density. This is a powerful tool for tracking progress. It confirms that the weight you're losing is mostly fat rather than muscle, which is crucial for maintaining a healthy metabolism. It can also reveal continued fat loss and success even when the number on the scale or a measuring tape doesn't seem to be changing, helping you stay motivated and on track.

DXA can be a helpful tool for those interested. It can be obtained on your own at some gyms, radiology groups, or private companies without a referral. Other less precise but still very helpful options for measuring body composition include:

• Bioelectrical Impedance Analysis (BIA)
• Air Displacement Plethysmography (Bod Pod)
• Hydrostatic Weighing (Underwater Weighing)
• Skinfold Calipers
• Body composition home scales (such as Renpho)

NOTE- Prices for DXA vary (e.g. $50-$150) so compare before purchasing. Despite some companies marketing monthly or long term repeat scanning packages, this may not be beneficial or useful. I would advise a baseline, with repeat in 3-6 months, possibly again if appropriate further down the road. Talk with your healthcare professional about frequency and usefulness before scheduling or purchasing a "package".

To provide the effective and personalized medical care, we require baseline FASTING labs (fasting means you only drink water for 8-12 hours prior to your blood draw, no food or other drinks). This helps us assess your current health status and guides recommendations for your weight loss journey.  These are included in your 4-Week Essentials Plan cost (no hidden fees).

If you've had labs in the last three months, we may be able to use those if there hasn't been a significant change to your health. If we find abnormal results, we'll discuss them with you and offer appropriate recommendations. If we identify a new condition that needs to be managed, we'll direct you to your primary care provider to ensure you get the care you need. Depending on your unique health, other labs may be included that are not listed below.

 The lab panel:

• CBC (Complete Blood Count): Measures your red and white blood cells and platelets to check for conditions like anemia or infection.
• CMP (Complete Metabolic Panel): Evaluates your kidney and liver function, blood sugar, and electrolytes.
• TSH w/reflex to free T4 (Thyroid Stimulating Hormone): Screens for thyroid disorders, which can affect metabolism.
• Lipid Panel: Measures your cholesterol levels (total, HDL, and LDL) and triglycerides to assess your cardiovascular health.
• A1C (Glycosylated Hemoglobin): Provides an average of your blood sugar levels over the past 2-3 months to screen for pre-diabetes and diabetes.
• Fasting Insulin: Measures the level of insulin in your blood after fasting, which helps us assess for insulin resistance. 
• CRP-hs (High-sensitivity C-reactive protein): A marker that helps us identify underlying inflammation in your body.
• Uric Acid: Measures the amount of uric acid in your blood.
• Vitamin D: Checks your body's vitamin D level, which is important for overall health.
• UA (Complete Urinalysis): A urine test that can help detect early signs of certain diseases. Please note: this is NOT a drug or pregnancy screen.

Meal replacements are pre-portioned, nutritionally-balanced products like shakes, bars, and prepared meals that serve as a substitute for a full meal. They're designed to help with weight management by simplifying calorie and portion control and providing a quick, convenient option for busy lifestyles. Many products are high in protein and fiber, which helps promote a feeling of fullness and curb cravings. These are considered a processed food.

ARE MEAL REPLACEMENTS HELPFUL WHEN TAKING A GLP-1?

Yes, meal replacements can be helpful when working on weight loss or weight maintenance, especially if you're taking a GLP-1 medication like semaglutide or tirzepatide. GLP-1 medications can reduce appetite, making it difficult to consume enough food to get the necessary nutrients. Meal replacements offer a simple way to ensure you're getting adequate protein, vitamins, and minerals, which helps prevent nutrient deficiencies and preserve muscle mass during weight loss.

WHAT ARE POSSIBLE RISKS OF MEAL REPLACEMENTS?

While helpful, meal replacements have potential drawbacks, some of which include:

• Nutrient Deficiencies Some products may lack essential vitamins and minerals, especially if they are not designed to be a complete meal replacement.
• Digestive Issues Ingredients like lactose or whey protein, sugar alcohols, artificial sweeteners, and certain types of fiber can cause bloating, gas, or other digestive discomfort.
• Reliance on Processed Foods Over-relying on highly processed meal replacements can hinder the development of long-term healthy eating habits and may lead to weight regain once you stop using them.
• Excessive Sugar Many products, especially bars and shakes, can be loaded with added sugars, which can undermine your weight loss goals.
• Potential for Disordered Eating: In some cases, rigid reliance on meal replacements can contribute to a cycle of restrictive eating and a poor relationship with food. 

To mitigate these risks, it's best to choose high-quality products with a balanced nutrient profile and minimal added sugars. It's also important to use them as a tool within a broader healthy lifestyle, not as a complete replacement for whole foods.

WHAT ARE SOME MEAL REPLACEMENT OPTIONS? (not an exhaustive list)

MEDICALLY SUPERVISED PROGRAMS

These programs use structured meal replacements and should be overseen by a healthcare professional. Examples include HMR (Health Management Resources), Bariatrix, Ideal Protein, and Robard (New Direction). 

PREPARED MEAL DELIVERY SERVICES

These services offer a convenient, "whole-food" alternative to shakes and bars. They deliver pre-cooked, portion-controlled meals directly to your door. Some popular options include CookUnity, Factor, EatClean and Trifecta. Check macronutrient and sodium content to ensure they align with your needs.

NON-MEDICAL MEAL REPLACEMENT SHAKES AND BARS

These are widely available products that prioritize a good balance of protein and nutrients. There are many, but just a few examples include Huel, Soylent, and Ka'Chava. Check macronutrient and sodium content to ensure they align with your needs.

Having an underlying health condition is precisely why a medical weight loss program can be so beneficial. We view medical weight loss as an important and integrated component of preventing, improving, and treating a wide range of chronic medical conditions. We know that modest weight loss of 5-10% leads to substantial improvements in health and reduces the risk or severity of many chronic diseases.

A 5-10% weight reduction can significantly improve or prevent conditions such as:

• Cardiovascular disease, including high blood pressure and cholesterol
• Type 2 diabetes
• MAFLD (metabolic-associated fatty liver disease, previously known as NAFLD)
• Sleep apnea
• Asthma
• Knee osteoarthritis and other joint pain
• Autoimmune conditions
• GERD/reflux
• Reducing the risk of and improving outcomes for certain cancers

During your initial thorough health review, we take all of your medical conditions and current medications into account to create a comprehensive plan that supports your goals and overall health.

Due to safety concerns, we do not prescribe weight loss medications to individuals who are pregnant, breastfeeding, or actively trying for a pregnancy. If you become pregnant while on medication, please inform our team immediately, as the medication will need to be discontinued. For those planning a pregnancy, all weight loss medications should be stopped at least 2-3 months before attempting to conceive. 

It is important to note that achieving a healthier weight can often improve fertility and increase the chances of a healthy pregnancy.  

Cedar Weight Loss is a cash-based clinic and does not directly bill insurance companies. This allows us to focus entirely on your personalized care without the constraints of insurance-mandated visit times or treatment restrictions. This means you get more time with your clinician and a plan truly tailored to your unique needs.

We can provide you with a detailed invoice, often called a "Superbill," that you can submit to your insurance company for potential reimbursement. We recommend contacting your insurance provider to inquire about your "out-of-network" benefits for medical care. Be aware that many insurance plans do not cover obesity care, and it may be "exempt" from your plan. 

Please note that while our clinic fees are cash-based, the cost of any prescription medication or necessary lab work may be covered by your insurance plan. 

Working with your primary care provider (PCP) can be an excellent choice for managing your weight long-term. At Cedar Weight Loss, our program is designed to give you a strong start with a personalized plan. After our intake and 2-week follow up, if you choose to transition care to your PCP, we can fax visit and lab records to ensure a smooth handoff. Please note it may take up to three months to get an appointment with your PCP, please plan for this in advance. 

We advise seeing your PCP and/or a registered dietician monthly for weight management until you have maintained your goal weight for 6-9 months, at which point you may discuss quarterly follow-ups if preferred. Weight management is a chronic condition that benefits from routine, ongoing care. If you notice a weight gain of 5 pounds or more during maintenance, it’s important to schedule a follow-up visit with your provider. You will always be welcome to return for care at Cedar Weight Loss.